Inspection on 15/08/06 for Filsham Lodge Residential Care Home

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Filsham Lodge Residential Care... 31/07/07

Filsham Lodge Residential Care... 13/12/05

Filsham Lodge Residential Care... 28/06/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Filsham Lodge 135 - 139 South Road Hailsham East Sussex BN27 3NN Lead Inspector Nigel Thompson Unannounced Inspection 15th August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Filsham Lodge Address 135 - 139 South Road Hailsham East Sussex BN27 3NN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01323 844008 Mr and Mrs T Ravichandran Mrs Radha Ravichandran, Mr Nallanathan Suganthakumaran, Mrs Suganthini Suganthakumaran Mrs Olive Dunford Care Home 39 Category(ies) of Dementia - over 65 years of age (39) registration, with number of places Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only service users with a dementia type illness are admitted to the home The number of service users will not exceed thirty nine (39) Service users must be aged sixty five years (65) and over on admission. 13th December 2005 Date of last inspection Brief Description of the Service: Filsham Lodge is registered to provide personal care for a maximum of thirtynine service users with a dementia type illness. The building is on two floors with a passenger lift and one stair lift providing safe and easy access to all parts of the home. Service user accommodation comprises 31 single rooms and 4 shared double rooms. Adequate communal space includes 4 lounges (3 with integrated dining areas), a conservatory and sufficient bathrooms and toilet facilities. For personal care and support purposes the home is divided into three areas, with service users allocated rooms in these areas depending on their individual needs and current assessed level of dependency. There is level access to the front of the building with safe and attractive gardens to the rear. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of 15 August 2006, is £395.50 - £480. Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and toiletries. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours in August 2006. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were thirty nine service users living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with the manager and consultation with three members of staff and five service users. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: What has improved since the last inspection? Some much needed stimulation within the home has been implemented and continues to be provided through regular entertainment sessions and individual and small group activities. Since the previous inspection, four service users’ rooms have been redecorated and completely refurbished. The manager has recently commenced studying for the Registered Manager’s Award (RMA). Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: A detailed pre-admission assessment form has been developed and includes information relating to the individual’s personal, medical, social and psychological care needs. From discussion, it is evident that the manager and the proprietors are fully aware of the importance of a thorough needs assessment, as part of the admission procedure. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 9 Since the previous inspection there have been seven service users admitted to the home. In each case, through examination of their respective files, there was documentary evidence of a full and comprehensive needs assessment having been carried out, including all personal care and support needs, any mental health and mobility issues, social and cultural needs and family involvement. The manger confirmed that prospective service users and their relatives are encouraged to visit the home and have the opportunity to look around and meet members of staff and existing residents. Service users and relatives, spoken with during the inspection, were able to confirm that the home meets their individual needs and aspirations: ‘The staff here are all very kind. They can’t do enough for you. I’ve no complaints’. ‘I can’t fault the place. Everyone is so kind and helpful’. ‘They make my mother feel loved and special and allow her to be an individual and this gives me peace of mind’. Each service user is provided with a written contract containing a statement of terms and conditions of residence. In files that were examined it was noted that the contract had been signed by the service user, or a relative or representative, on their behalf. The manager confirmed that intermediate care is not provided at Filsham Lodge and emergency or unplanned admissions are avoided. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ health care needs are met and individual care plans enable staff to meet their assessed needs in a structured and consistent manner. The systems for service user consultation and participation are good and service users are treated with respect and, where appropriate, are encouraged to make decisions about their day-to-day living. EVIDENCE: Service users care plans that were viewed were found to be generally well maintained and up to date. They showed clear links with the individual’s assessed needs and contained details of action and intervention to be taken by staff to ensure consistency of care. There was also evidence of plans being regularly reviewed and updated. The manager confirmed that service users and their relatives are given the opportunity to take part in developing and reviewing individual care plans. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 11 However, in plans that were examined, there was little documentary evidence of service users or their relatives being involved in this process. It is required that this issue be addressed. All service users are registered with local GPs and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Nutritional screening is carried out as part of the initial assessment procedure. As part of their induction programme, the Manager confirmed that all staff receive instruction on the principles of dignity and respect. This was evident, through discussions during the inspection, comments form relatives and from direct observation of staff interacting sensitively and professionally with service users: ‘Mum receives care at all levels, physical and emotional and is made to feel well liked and ‘special’ by the staff’. Satisfactory and up to date policies and procedures are in place for the control, storage, safe administering and recording of medication. The manager confirmed that all staff involved in administering medicines receive appropriate training. This was supported by documentary evidence and through discussions with care staff. She was also able to confirm that, following risk assessments, there are currently no service users in the home who maintain responsibility for self administering their medication. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish. Opportunities for appropriate recreational and leisure activities are limited however service users benefit from menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: From discussions with service users and their relatives and through direct observation, it is evident that some much needed stimulation within the home continues to be provided through regular entertainment sessions and individual and small group activities, including music, arts and crafts, gentle exercise and various games and quizzes. All service users’ birthdays are celebrated in the home. The manager confirmed that where appropriate, residents are also supported to access the wider community, either individually or in small groups. There are regular minibus outings into Eastbourne and the surrounding area for teas, coffees and lunches and local theatre trips are also organised. ‘…to name but a few!’ Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 13 Comments received from service users and their relatives indicate a general but realistic level of satisfaction with the activities arranged in the home: ‘My mother and her fellow residents are not the easiest to provide activities for but the staff and management provide a range of things to do and a variety of entertainment. As a relative, I always feel welcome at these events’. Service users’ recreational and leisure interests are recorded in their individual care plan. The manager confirmed that, in accordance with the wishes of the service users, visitors to the home are welcome, at any reasonable time. However, they are asked to respect mealtimes. Service users may see friends or relatives in one of the lounges or in the privacy of their own room. Service users are provided with a varied, wholesome and nutritious diet. At lunchtime a choice of main meal is available and special diets are catered for. As part of a four week rolling menu, a daily menu is displayed, reflecting service users’ preferences and including seasonal variations. Positive comments received from service users demonstrate overall satisfaction with the choice and standard of the meal provided: ‘They are very good’. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Service users are safeguarded from abuse through relevant staff training and robust policies and procedures. EVIDENCE: An up to date copy of the complaints procedure is in place in the entrance hall, for the benefit of service users and visitors to the home. Service users, relatives and members of staff spoken to described how the manager operates an ‘open door policy’ and is generally considered to be approachable and understanding. They confirmed that they would have no hesitation in speaking to her or making a complaint if necessary and each person was confident that they would be listened to: ‘Everything at the home is to my satisfaction’. ‘Although my mother would not know how to complain, I feel confident that if I complained on her behalf it would be appropriately dealt with’. Since the previous inspection, the manager confirmed that three complaints have been received by the home, of which two were unsubstantiated and the third is still being investigated and the outcome is pending. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 15 The home ensures as far as is practicable that service users are safeguarded from all forms of abuse. Recently updated policies and procedures relating to Adult Protection, including a policy on ‘Whistle Blowing’ are in place. The manager confirmed that staff are also made aware of these key policies and procedures as part of their induction, foundation and National Vocational Qualification (NVQ) training and they are reinforced during staff meetings, including the regular and evidently well attended ‘Standards of Care’ meetings. This was supported by minutes from previous meetings and confirmed by staff, spoken with during the inspection. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from accommodation that is safe, comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: There has been little change in the physical environment since the previous inspection and with the well maintained décor and good quality furniture and furnishings it continues to provide a comfortable, safe and homely environment for service users. Filsham Lodge continues to provide a choice of communal sitting, recreational and dining areas, which are adequately furnished and well suited to their social purpose. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 17 Service users and relatives, spoken with during the inspection, expressed satisfaction with physical standards within the home: ‘My room is cleaned every day’. ‘The home always looks clean and tidy and has a nice ‘homely’ atmosphere’. ‘I like my room’ ‘Everything at the home is to my satisfaction’. The manager confirmed that independence and individuality continue to be promoted within the home, as far as is practicable, and this remains evident from the personalising of service users’ rooms, which clearly reflects individual tastes, preferences and interests. Since the previous inspection, it was noted that four service users’ rooms have been redecorated and completely refurbished. Following discussion with the manager, it is recommended that the currently unused bathroom on the first floor be reinstated, either as an assisted bathroom or possibly a walk-in shower room. A programme of routine maintenance, refurbishment and renewal is in place. Infection control procedures are in place and levels of cleanliness remain generally high throughout. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of the service users. Robust recruitment procedures and appropriate staff training help to ensure the safety and protection of service users. EVIDENCE: Care staff employed at Filsham Lodge have the relevant skills and are deployed in sufficient numbers to meet the assessed needs of the service users. The manager confirmed that staffing levels within the home are sufficient to meet the current care needs of service users and there is always some flexibility for additional staff hours should the need arise. All daytime shifts are covered by a minimum of five staff with additional twilight workers from 6am – 10am and 8pm to midnight. There are three waking night staff on duty each night. This was further evidenced by the current rota, viewed during the inspection, which details which staff are on duty at any given time and includes their designation. Service users, relatives and members of staff, spoken with during the inspection, confirmed that staffing levels within the home are adequate: Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 19 ‘There’s always someone around and they are all so kind and helpful’. ‘Within the restrictions of other residents’ needs, if staff are not immediately available they will normally come back to me or my mother’. ‘It does get busy at times but we manage. If we are struggling or need more help, we only have to ask the manager’. The manager continues to operate a thorough and robust recruitment procedure and all prospective staff are seen and interviewed by her before commencing work in the home. Personal files relating to three recently appointed members of staff, examined during the inspection, were found to be generally well maintained, containing necessary information, including employment history, two references and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. The manager stated that appropriate induction, foundation and core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. All staff have also undertaken specific training relating to dementia awareness. This was confirmed by staff and supported by training records examined. There are currently five care staff who hold the National Vocational Qualification (NVQ) level 2. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users benefit from sound management and improved quality assurance systems within the home, however current arrangements for the provision of formal staff supervision remain inadequate. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of service users and staff. EVIDENCE: The atmosphere in the home remains relaxed, friendly and welcoming. Staff, spoken to during the inspection felt valued and supported by the manager and confirmed her open and approachable style of leadership and clear and positive sense of direction. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 21 The Registered Manager is competent and experienced and has been in her current post for over five years. She is a registered nurse (SRN) and is currently studying for the Registered Manager’s Award (RMA), which she is confident of completing within the next twelve months. Despite previous requirements, it is evident that formal supervision is still not being provided for care staff. This issue was discussed with the manager, who confirmed that, since the previous inspection, she has actively researched and undertaken specific and updated training, related to the provision of formal staff supervision. However she also added that the home is yet to implement structured formal supervision for all care staff, as required. Through discussions with members of staff, it is evident that the manager continues to operate an ‘open door’ policy, with staff encouraged and able to discuss any issues or concerns that they may have at anytime. The home’s quality monitoring system includes satisfaction questionnaires for both service users and their relatives. The manager confirmed that, since the last inspection, recent surveys have been sent out although as yet no responses have been received. As the registered providers are now aware, it is a legal requirement that, in circumstances such as this, where the proprietors are not in ‘day to day charge’ of the home that, at least once a month, they will visit the home, unannounced. During this formal monitoring visit they are to inspect the premises, with regard to environmental standards (including the furniture and fittings and any necessary maintenance), speak with service users and staff and prepare a written report on the conduct of the home. A copy of this report is then to be supplied to the CSCI. Therefore monthly, unannounced visits by the owners are to be formalised, to ensure that they are aware of any significant issues or changes within the home, including the welfare and ongoing care needs of service users. The manager confirmed that the home currently maintains responsibility for approximately half of the service users’ money through a ‘Residents’ Deposit Account’. Individual balances are checked on a weekly basis and all financial transactions are recorded. The health, safety and welfare of service users and staff remains of paramount importance within the home and staff training is provided in many aspects of Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 22 safe working practices, including moving and handling; food hygiene; fire safety and first aid. COSHH assessments and guidelines are in place. Temperature regulators are fitted to all hot water outlets, accessible to service users and all accidents, incidents and injuries are recorded and reported, as required. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 2 X 3 Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1 & 2) Requirement Timescale for action 31/10/06 2. OP31 9 (2) (b) (i) 3. OP33 26 (1, 2, 3, 4 & 5) 4. OP36 18 (2) It is required that that the service users’ care plans, including risk assessments, be developed and regularly reviewed with the involvement of the service user, or a relative where appropriate, and updated to reflect changing needs. It is required that the registered 31/10/06 manager has the necessary qualifications to manage the care home. (Previous timescale of 31.03.2006 was not met). It is required that the registered 31/10/06 providers visit the home at least once a month to inspect the premises, monitor the conduct of the home and prepare a written report. A copy of this report is to be forwarded to the CSCI. It is required that formal 31/10/06 supervision be developed and introduced for all staff. (Previous timescales of 26.03.2005 31.08.2005 and 31.03.2006 were not met). Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations It is recommended that a minimum ratio of 50 of care staff obtain NVQ level 2 in Care. Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Filsham Lodge DS0000062001.V296275.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!