Inspection on 11/12/06 for Fitzwilliam Lodge

This inspection was carried out on 11th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fitzwilliam Lodge 25/02/09

Fitzwilliam Lodge 22/11/05

Fitzwilliam Lodge 14/12/04

Fitzwilliam Lodge 15/06/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Fitzwilliam Lodge Westfield Road Rawmarsh Rotherham South Yorkshire S62 6EY Lead Inspector Claire McAuley Key Unannounced Inspection 11th December 2006 09:00 Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 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 Fitzwilliam Lodge DS0000003094.V311214.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 Adults 18-65. 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. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fitzwilliam Lodge Address Westfield Road Rawmarsh Rotherham South Yorkshire S62 6EY 01709 523400 NONE NONE 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) Yorkshire Parkcare Company Limited Karen Blakeman Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specific service user over the age of 65, named on variation dated 7th January 2005, may reside at the home. The home can accommodate one named service user with an associated learning disability named on the application dated 1st June 2005 22nd November 2005 Date of last inspection Brief Description of the Service: Fitzwilliam Lodge provides care for up to fifteen residents with a physical disability. The home is located at Rawmarsh in Rotherham, close to public transport and other facilities. Fitzwilliam Lodge is owned by Craegmoor Healthcare. The home shares a location with two other homes also owned by Craegmoor Healthcare. It is a single storey modern building providing fifteen single bedrooms, appropriate bathroom and toilet facilities and lounge, kitchen and dining area. The home has suitable communal facilities, and garden and patio area for residents. There is a range of individualised disability equipment provided for residents. There is a car park which is shared with the other homes on the site. There are ten care staff and four registered nurses employed at the home. Weekly fees are from £400.00 to £1500.00. A service users guide is available for residents and their relatives/representatives. Fitzwilliam Lodge DS0000003094.V311214.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 from 9am to 3.30pm. The inspector spoke to four residents and four members of staff, who expressed their views on the service. A sample of records including menus, medication records, staff rotas, care plans, recruitment records, supervision, staff training, and procedures and policies were inspected and a proportion of the environment was checked. The inspector had discussions with the registered manager. Four questionnaires from staff were returned. What the service does well: What has improved since the last inspection? What they could do better: There had been a problem in recruiting the required number of staff, and shortages meant that existing staff were working long hours and extra shifts to cover. There had also been only one cook in post since March 2006 which was causing additional strain. Transport hours to take residents out in the minibus, and to their individual activities, had been reduced to ten hours a week from full time, and this was insufficient to maintain resident’s independence and choice. Staff said that there were insufficient activities in the afternoons. Some areas of the home were not clean; particularly bathrooms and toilets, and pads were not properly disposed of. Some areas of the home required redecoration. Food for special diets was not attractively presented. Staff members said that the food could be better and more fresh food should be provided. The manager was covering a number of shifts at the home; this meant that she could not fulfil her job as required. Quality assurance needed updating to in order to find Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 6 out the views of residents and their families on the service. Staff were not aware that they had received adult protection training and their communication with service users needed improvement. 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. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. Residents were not admitted to the home without their needs being fully assessed. This ensured that their health, social, and care needs were met. EVIDENCE: All residents admitted to the home had an assessment of needs completed before their admission. The manager had also completed assessments when residents were admitted. These assessments ensured that the service provided was appropriate to meet the needs of the resident. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. Care plans were in place that described resident’s needs and action taken to meet those needs. Resident’s rights to make decisions and choices in all areas of their lives were, promoted. Risk assessments that promoted the independence, safety and well being of residents were in place. EVIDENCE: Three care plans were checked in detail. They were of a good standard and included daily recording, reviews, risk assessments, nutrition, health care, disability equipment needed, and specialist interventions. Resident’s leisure, religious and educational needs and interests were recorded on the diversional therapy records. The manager said that the plans were to be rewritten in a Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 10 person centred planning format that would be more accessible to residents and their families. Residents said they went out to shop for their clothes and were asked what they liked to eat. They confirmed that they were able to decide on what time to get up, and when to go to bed. Resident’s bedrooms were personalised to their own taste. Individual risk assessments to ensure the safety of residents were in place. These included risks on swallowing, positioning, walking, travelling, and challenging behaviour. These were appropriately reviewed. Strategies were in place to minimise risks. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. A range of activities was provided which, in the main, met resident’s needs. Residents were able to maintain links with the community by participating in leisure and educational activities. Links with family and friends were maintained and encouraged. Staff maintained the privacy and dignity of residents. The diet provided could be improved by more fresh food and better presentation. EVIDENCE: There was a range of activities available for residents, and an activity coordinator employed. Activities were based on individual assessments of needs Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 12 and preferences. Activities included aromatherapy, computer skills, day centre, quizzes and visits to pubs and restaurants, cooking sessions, shopping trips, days out and holidays. None of the residents was able to take part in paid employment. Staff commented that there was a lack of activities in the afternoons for residents as they were usually put in front of the television after lunch. Residents were supported to participate in the local community by going out shopping, and participating in religious services if they wished. Residents activities had been curtailed however with the reduction of driver hours for the minibus from full time to ten hours a week. As none of the residents was independently mobile, this had reduced their ability to participate in outside activities. The manager stated that community transport had been accessed to help with this, but was unreliable. Residents were supported to maintain family and friendship links. One resident regularly went out with his/her family each week, and other residents visited relatives in places accessible to wheelchairs. Family and friends were welcomed to the home. Residents were able to receive visitors in private and choose whom they wished to see. Staff were aware of the need to respect residents privacy and gave examples of how they maintained this, such as ensuring a person was covered up when hoisting ready for bathing, knocking on bedroom doors and ensuring residents choice from a range of clothing presented to them. This was based on resident’s individual abilities and staff member’s knowledge of the resident. Residents letters were given to them unopened and staff would help to read letters only if they were asked. Residents had a choice of food and special diets were provided. There was a good range of food described on the menus, however, staff said that the food could be better with more fresh food and vegetables served. Liquidised diets were not attractively presented and items of food were not individually liquidised. Resident’s nutritional needs were monitored. Residents who had any problems with eating or special dietary needs were referred to a dietician or speech therapist. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. The staff maintained resident’s choice, privacy and dignity when providing personal care. Resident’s healthcare needs were met. The home’s medication policy and procedure ensured that medication was administered safely to protect residents. EVIDENCE: Personal care was provided in private, and guidance in personal hygiene given appropriately. The aids and adaptations within the home included specialised baths, wheelchairs, hoists, and chairs. Residents were individually assessed for these. The majority of the residents required personal support and guidance on a daily basis as their assessed needs reflected their primary assessment of physical disability. Staff assisted residents to access appropriate healthcare. They were registered with local GP’s and accessed physiotherapists, speech therapists, community Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 14 psychiatric nurse, specialist nurses and other healthcare professionals as required. Staff supported Resident’s outpatient hospital visits and their health was regularly monitored and reviewed and referral to specialists undertaken. Individual health problems associated with residents particular disabilities were recorded. Moving and handling and bathing risk assessments were in place. The home had a policy and procedure on medication, and a record was kept of all medicines received, administered and disposed of. Three resident’s medication was checked and was appropriately administered with the exception of the administration of Lactulose, which was being given to a resident from another resident’s prescription. The home had no controlled drugs. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. To protect residents, complaints were appropriately dealt with, and the complaints procedure was produced in a resident friendly format. Residents were, in the main, protected from abuse by the home’s policies procedures and staff training programme, although staff were not aware that they had received adult protection training. EVIDENCE: There was a complaints procedure on display in the entrance area that was produced in a format language/format for all residents in the home. There was also a complaints book. Residents spoken to said they could talk to staff if they had any concerns. There had been no complaints received since the previous inspection. The home had an Adult Protection Policy, and a Whistle Blowing Procedure in place. The staff spoken to were aware of the procedure, and of the action to be taken in the event of suspected abuse. However they were not aware that they had received adult protection training, and were confused about what adult protection was, although records confirmed that they had received this training. There had been no allegations of abuse at the home. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. To meet the residents needs, the standard of the environment was reasonable, and some areas were good. However other areas were in need of redecoration. Areas of the home were not clean and hygienic and staff did not maintain appropriate infection control measures. Therefore resident’s rights to live in a pleasant home were not maintained. EVIDENCE: The environment was generally of a reasonable standard. Resident’s rooms were individualised and the majority were well decorated and furnished. Areas of the home, including corridor walls, doors and doorframes were shabby, and battered, some damage being due to wheelchair use. One resident’s room required redecoration. The carpets in a resident’s room and the hall were stained. There was a maintenance and renewal programme in place. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 17 The home was not clean and hygienic, although there were no obvious unpleasant odours. Packets of continence pads and a urine bottle were seen in toilets, and this did not maintain resident’s privacy and dignity. Areas that needed thoroughly cleaning included bathrooms, showers and especially toilets. The lounge area was dusty in the corners and also required thorough cleaning. The home employed a cleaner for four hours each weekday, but cleaning time was reduced to one hour on Saturdays and Sundays. There were policies and procedures in place to prevent the spread of infection and records showed that staff had received training on infection control, and they were observed using protective aprons and gloves. However staff did not observe infection control measures appropriately, as used continence pads were in bins with no lids on, and some were on the floor. This was hazardous to the health of residents and staff. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. For the safety of residents, staff shifts were covered, but there was a shortage of staff. Care staff did not always have time to spend with residents, and their communication with residents was minimal at times. The home had not achieved the standards in supporting residents through an adequately trained staff team, as they did not have 50 of staff with NVQ2 or above. Residents were protected by the recruitment policy and procedure, and properly supervised staff. EVIDENCE: The inspector spoke to four members of staff. They were able to describe the needs of residents and how they would meet those needs. They said they worked well together as a team and felt supported by the manager and nursing staff. However, staff also said that morale was low in the team as they worked very hard, worked long shifts, and their pay was poor. The inspector observed that interaction between staff members and residents was quite minimal. In particular at lunchtime there was virtually no communication from staff to Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 19 residents while they were helping them. Residents were not asked their preferences for food, or how much they wanted to eat. This may have been due to cultural or language issues. Three staff personnel files were checked. There was a recruitment process in place that met the standards, including CRB check, references, medical check, and application form. The home had a high number of staff from Eastern Europe, and the manager confirmed that they were registered with the Home Office. She said that the home was having difficulties recruiting appropriate staff at the present time, including a cook. There was a good training programme in place, which delivered mandatory training on a rolling programme. New staff received a structured induction. Staff members confirmed that they had paid training days. Some specialist training was in place such as control and restraint. Returned staff questionnaires confirmed this. Supervision of staff took place at the required level, and included philosophy and aims of the organisation, and identification of training needs. Staff who were spoken to and those who returned a questionnaire confirmed they received regular supervision and that staff meetings took place. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence, and a visit to Fitzwilliam Lodge. The registered manager’s qualifications and experience ensured that the running of the home provided appropriate care and safety for the residents. However this was not maintained when she covered care workers or nursing shifts at the home. Quality control measures including monthly audits were in place but information from residents and families on quality had not been gained since 2004. The health, safety and welfare of the residents was protected by the procedures of the home, and staff training. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager was qualified competent and experienced to run the home. She had over two years of management/ supervisory experience. She had a RGN qualification and had gained the Registered Manager’s Award. The registered manager was covering two or three shifts a week at the home, and this meant that she could not appropriately fulfil her job as manager at these times. There was a quality assurance process in place. This included a monthly audit by the manager, of care plans, pressure sores, medication, and accidents to establish the quality of care being provided to residents. Regulation 26 visits were in place. However, residents and relatives/representatives views of the service had not been sought since 2004, and there had been only two residents and relatives meetings in 2006. Health and safety procedure and policies were in place and staff had health and safety training. Accident records were appropriately maintained. Other health and safety requirements were met including fire records and drills. Portable appliance testing, boilers and electrics were maintained. Equipment was serviced. COSHH assessments were in place. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 3 X Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA12 Regulation 16 Requirement Suitable activities for all residents must be provided each afternoon. This must be recorded. An assessment must be made of the hours required for driving residents to enable them to access the local community and engage in activities outside the home and suitable provision be made Liquidised diets must be attractively serviced and items of food separately liquidised. Lactulose and other medication must not be administered to any resident who is not named on the prescription. The manager must ensure that the training received by staff on adult protection is understood by them. Further training to establish this must be provided. The areas of the home requiring redecoration, including corridors, doors, skirtings doorframes, and residents bedrooms must have this completed. All stained carpets, including those in the hall and a resident’s DS0000003094.V311214.R01.S.doc Timescale for action 01/04/07 2. YA13 16 01/04/07 3. 4. YA17 YA20 16 12 13 01/02/07 11/12/06 5. YA23 13 01/02/07 6. YA24 23 01/04/07 7. YA24 23 01/02/07 Fitzwilliam Lodge Version 5.2 Page 24 8. 9. YA30 YA30 23 13 12 23 10. YA30 13 11. YA30 13 23 12 12. YA32 18 13. YA32 18 14. YA34 18 15. YA37 9 16. YA39 24 bedroom must be cleaned or replaced. All bathrooms, showers and toilets must be thoroughly cleaned. The cleaner must be supervised. To ensure her/his work is of a sufficiently high standard to ensure the cleanliness of all areas of the home. There must be sufficient cleaning hours allocated to ensure that all areas of the home are clean at all times, including the weekends. Training for staff on infection control must be reviewed and all staff made aware of the procedure for disposal of waste. Continence pads and urine bottles must be stored in resident’s rooms, not in communal areas. The registered person must ensure that a minimum ratio of 50 trained members of staff NVQ Level 2 or equivalent is achieved by 1st June 2007. Staff members must receive further training on maintaining appropriate and supportive communication with residents. There must be sufficient numbers of staff employed to ensure that the needs of the service users are fully met. The registered manager must not undertake shifts to cover nursing or care staff hours at the home. The quality assurance system must include updated views of residents and their relatives/representatives on the quality of the service. 01/01/07 01/01/07 01/01/07 11/12/06 01/06/07 01/02/07 01/04/07 01/02/07 01/02/07 Fitzwilliam Lodge DS0000003094.V311214.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 YA39 Good Practice Recommendations Residents and relatives meetings should be held more frequently. Fitzwilliam Lodge DS0000003094.V311214.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Fitzwilliam Lodge DS0000003094.V311214.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!