Inspection on 09/02/06 for Frodsham Christian General Care Home

This inspection was carried out on 9th February 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Frodsham Christian General Care... 16/04/08

Frodsham Christian General Care... 11/07/07

Frodsham Christian General Care... 27/09/06

Frodsham Christian General Care... 03/08/05

Frodsham Christian General Care... 21/03/05

Frodsham Christian General Care... 27/07/04

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

CARE HOMES FOR OLDER PEOPLE Frodsham Christian General Care Home Chapelfields The Main Street Frodsham Cheshire WA6 7BB Lead Inspector Denis Coffey Unannounced Inspection 9th February 2006 09:00 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 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Frodsham Christian General Care Home Address Chapelfields The Main Street Frodsham Cheshire WA6 7BB 01928 734743 01928 734745 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) Trinity Care Limited Mrs Linda Siddell Care Home 70 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (40), Terminally ill (3) Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 70 service users to include: * Up to 40 service users in the category of OP (old age not falling within any other category) * Up to 3 service users in the category of TI (terminally Ill) * Up to 30 service users in the category of DE(E) (dementia- over 65 years of age) * Up to 1 service users in the category of DE (dementia) The registered provider must, at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 3rd August 2005 2. 3. Date of last inspection Brief Description of the Service: Frodsham Christian Care home is a purpose built care home with separate units for the provision of nursing care for 40 elderly frail people, and 30 people who have dementia. The home has two storeys and all bedrooms are single rooms with ensuite facilities. There is a choice of lounges with a communal dining room on the ground floor of the unit for elderly people, and lounges and separate dining facilities on both floors of the dementia unit. In addition there are accessible ground floor gardens, and a large patio area, both of which are enclosed. A planned programme of care is formulated for each service user, reflecting individuality, privacy, dignity and choice. These are reviewed monthly or as required. Trained nursing staff are on duty twenty-four hours a day. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 ½ hours, during which time a tour of the premises took place, and staff and care records were inspected. The inspectors, Denis Coffey and Helena Dennett spoke with the residents’ visitors present at the time of inspection, and members of staff. Three requirements identified at the previous inspection remain outstanding. These relate to the care records of the residents, medicines, and risk assessments for the use of bed rails. A total of eleven requirements to be addressed were identified at this inspection, the details of which are included in the main body of this report. What the service does well: What has improved since the last inspection? Staff demonstrated a good awareness of their role and responsibilities in relation to protecting vulnerable adults in relation to abuse and poor practices. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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): 3 Assessments of needs are carried out prior to people taking up accommodation at the home to ascertain that their needs can be met. EVIDENCE: Records were seen of a pre-admission assessment being carried out by a trained nurse with prospective residents’ prior to them taking up accommodation at the home. A copy of the assessments completed by the local authority funding care was also in place in the care records of two residents. The home does not provide intermediate care; therefore Standard 6 does not apply. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 9 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, 9 & 10 Although there were plans of care for the residents, there were gaps in them that could lead to residents not receiving all the care they needed. Medicines are not well managed to ensure the safety of the residents. EVIDENCE: The care records of six residents were examined at this inspection, four on the elderly frail unit, and two on the dementia unit. Elderly Frail Unit The care records for the four residents contained a range of care plans that identified the care to be given in relation to a specific need/problem. When reading these care plans the inspector noted that one of the residents was being nursed in bed, but a plan of care identifying how their pressure areas were to be looked after was not in place. Another resident was receiving antibiotics, and an entry in their care records that was not dated described them as being ‘chesty’. A plan of care was not in place for this condition. A plan of care in another resident’s records was not dated as to when it had been Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 10 implemented, and there was no record available of the plan being evaluated as to whether the resident was responding to the care given. Assessments with regard to skin integrity, nutrition, moving and handling needs, continence, and falls were seen, some of which had not been dated or signed by the nurse completing them. Dementia Unit The care records of one resident contained a social assessment, and a nutritional assessment that was dated as being carried out in August 2005. This assessment had a high score indicating that further professional advice should be sought regarding the resident’s nutritional needs, but evidence that this had been followed was not available in their records. A moving and handling assessment dated August 2005 identified that the resident was able to mobilise independently, requiring the assistance of 1-2 staff at times. The night care plan makes reference to the resident wandering around the unit at night. This resident has been in hospital for treatment and returned to the home some 2-3 weeks ago and is now being nursed in bed. The moving and handling assessment should therefore be reviewed to take into account this change in the resident’s condition. A care plan for the care of the resident’s skin was devised in November 2004, and last reviewed on 14th August 2005. An assessment of the resident’s susceptibility to developing a pressure sore, last reviewed in August 2005 showed that they were at risk of developing such a sore. This assessment should be carried out again in light of the resident now being nursed in bed. Two plans of care were found in the resident’s records relating to pressure sores on one of their heels. This condition has been resolved, and the care plans should now be amended accordingly. The resident is prescribed strong pain relief medication, but a plan of care identifying why these had been prescribed was not in place, nor was there information as to how the resident’s pain relief was to be managed. Other needs/problems of the resident were identified in separate care plans containing information as to how these needs/problems were to be managed. The second set of records contained both an admission and social assessment along with a range of care plans in relation to the needs/problems of the resident. However, when reviewing the records it was noted that there was no plan of care for an eye condition the resident was currently suffering from. This resident had been transferred from the elderly frail unit, and some of the care plans had been in place for ten to twelve months. As the resident’s needs had noticeably changed, resulting in this transfer their care plans should have been reviewed and updated. There was no assessment in place with regard to incontinence. The medicines were inspected on both units of the home, and the following observations were made: Elderly Frail Unit Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 11 The Medicine Administration Record (MAR) sheets of four residents identified that they had been administered medicines more times than the dose prescribed, e.g. one resident was prescribed a medicine that should have been taken once a day but their MAR sheet had a record of it being administered twice a day. The records of another resident showed that one of their medicines had been out of stock for three days, and it was not possible to ascertain what was being done to obtain stocks of this medicine. One resident was prescribed an anti inflammatory cream that was recorded as being received into the home on 4th February 2006, but there was no record of this being administered to the resident on 6th, 7th and 8th February 2006. There were gaps in the MAR sheets of other residents, and one resident had two different preparations for the relief of constipation identified one on section of their MAR sheet. This means that it is not possible to ascertain which preparation the resident has received. Some of the MAR sheets contained handwritten administration instructions that had not been signed by the person making these, and did not identify the amount of medicines received as stock. Dementia Unit The medicine records were well maintained, apart for those for one resident who had a supply of a nasal decongestion spray stored in the medicines refrigerator, but there was no record on the resident’s MAR sheet of this being prescribed, or administered. Whilst visiting some of the bedrooms the inspector found a tube of a ointment that can only be obtained on a prescription in a resident’s bedroom. This tube did not have a label on it identifying for whose use it was intended. Staff were observed to maintain the dignity and privacy of the residents when assisting them with their personal care, and residents and visitors spoken with were positive in their comments about the standard of care provided. See Requirement 1 See Requirement 2 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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 Social and leisure activities are provided to cater for the interests of the residents, and the food provided was varied, providing residents with a nutritious diet. EVIDENCE: The home employs an activities co-ordinator for the provision of social and leisure activities for the residents. A weekly activity plan was on display that included; a musical afternoon, a sing-a-long session, board games and craft work. A relative of a resident visiting the home at the time of inspection told the inspector that she feels the range of activities are excellent, adding that she had been shown by an aroma therapist how to massage her husband’s hands and feet. Visitors said that they are made to feel welcome when visiting their relatives, and one visitor went on to say that the residents’ rights were promoted. Residents and relatives meetings are held on a regular basis. Menus were seen and these appeared varied and nutritious in content. Lunch on the day of inspection was a choice of cauliflower cheese or steak and mushroom pie, both of which were served with carrots, string beans and mashed potatoes. Rice pudding was served as a dessert. Residents spoken with said that they enjoyed the food provided. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 13 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 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 Information is provided for residents and visitors on how to make their concerns known, and training is provided for the staff in protecting residents’ from abuse. EVIDENCE: There have been three recorded complaints received at the home since the last inspection. Records were seen of these being dealt with and responded to satisfactorily. A copy of the home’s complaints procedure was on display, and information on how to make a complaint is included in the home’s statement of purpose. Records were seen of eighteen of the staff receiving training in the protection of vulnerable adults in January 2006. The home has its own policy on adult protection that meets the standard required and is available for staff to read. One member of staff spoken with displayed a good awareness of their role and responsibilities in safeguarding the residents’ from abuse. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 15 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, 21, 22 & 26 Areas of redecoration and refurbishment need to be attended to, to provide a more comfortable environment for the residents. The standard of cleanliness at the home was well maintained, but some aspects of personal care require addressing to reduce the risk of cross infection. EVIDENCE: At the last inspection it was noted that the carpets in both of the lounges on the dementia unit were noticeably stained, and the inspector was told that new carpets had been ordered to replace these. However, these carpets have not been replaced and the condition of the carpets in place has deteriorated. Staff said that when wet these carpets are a trip/fall hazard as they become extremely slippery. The walls in the downstairs dining room on the dementia unit were marked and the paintwork was chipped. The wall cupboards in this room were also marked and ill fitting. The front of one of the drawers in the base unit was missing in the dining room on the first floor, and the laminated covers in the wall units were chipped and marked. A number of the light Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 16 fittings on both floors of the dementia unit were not fully working, this staff said was due to the frequency of the light bulbs “blowing”. A bathroom on the elderly frail unit was being used as a storage area for wheelchairs and walking frames that were blocking access to the wash hand basin in this room. It was also observed that a number of towels were threadbare and in need of replacing. Five plastic washbowls were stacked in this bathroom, three of which were noticeably marked and stained. As these bowls are used in the personal care of residents they should be marked in such a way as to identify whose use they are intended, and should also be kept in a clean condition. Pressure relieving mattresses were available for those residents identified as being at risk of developing a pressure sore, and grab rails were sited within close proximity to the toilets for use by residents who experience difficulties in standing unaided. The home have a number of mobile hoists for use with residents who are unable to mobilise without assistance. All areas of the home were visited at this inspection and were found to be clean, tidy, and free from unpleasant smells. Creams used in the personal care of residents were found in two of the bedrooms on the dementia unit that did not have the name of the resident for whose use they were intended on them. Such creams should only be used on one person only to reduce the risk of cross infection occurring, and should therefore be labelled accordingly. See See See See See See See See Requirement 3 Requirement4 Requirement 5 Requirement 6 Requirement 7 Requirement 8 Requirement 9 Requirement 10 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 17 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): 28, 29 & 30 Training is provided for the staff to equip them with the skills required for the care of the residents. Recruitment procedures could be improved by ensuring that all relevant information is obtained on prospective staff to ensure that residents are protected from any possible harm. EVIDENCE: At the time of inspection there were forty-one care assistants employed, fourteen of which have an NVQ level 2 in care and a further five care assistants were in the process of undertaking this training. Five of the care staff are also trained nurses in their country of origin. Two members of the care staff hold a first aid certificate. The personnel files of two of the staff were examined at this inspection. Both contained a completed application form, job description and references. However, there was no reference from the previous employer for one of these staff. As the member of staff had only been in post for a short period of time prior to taking up employment at Frodsham Christian Nursing Home it would have been advisable to have requested a reference from their previous employer for this period. Satisfactory Criminal Records Bureau checks have been carried out on all of the staff employed at the home. Five of the trained nurses have recently undertaken training in the implementation of the new care records documentation, and records were seen Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 18 of the domestic staff receiving training in the Control of Substances Hazardous to Health. Food hygiene training was provided for the staff recently and is due to be repeated in May 2006. Recommendation 1 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 19 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 32 & 38 Residents and their relatives’ views are taken into account enabling them to have an influence on how the home is run. The arrangements for the safety and welfare of the residents is generally well managed, but this could be improved upon by ensuring that risk assessments are fully documented. EVIDENCE: At the time of inspection the home manager was absent from the home due to illness and a home manager from another care home owned by the company was providing management cover half a day each day from Monday to Friday. The operations manager for the home said that if the home manager was not returning to work in the next couple of weeks an alternative arrangement would be introduced, and the Commission informed of this. The post of deputy home manager has been advertised, and the operations manager was optimistic that this post would be filled in the near future. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 20 Residents and visitors spoken with said that their views are taken into account, and that meetings are held on a regular basis to enable them to do this. They described the home as having an ‘open door’ policy. Records were seen of the fire alarm system being tested weekly and the emergency lighting system being tested monthly. The portable electrical appliances at the home were tested in December 2005, and the landlord’s gas safety certificate is valid up to 2nd March 2006. The passenger lift was last serviced on 20th January 2006, and the cold water system was disinfected in September 2005. When reviewing the care records of the residents the inspectors noted that bed rails were fitted to the beds of three of these residents. Risk assessments for the use of this equipment was in place, but these did not meet the standard required. The risk assessment for one of the residents dated 16th November 2004, and 2nd July 2005 stated that the bed rails should be removed, as they had proved hazardous due to the resident climbing out the bottom of their bed. However, bed rails were seen to be still fitted to this resident’s bed. The risk assessments for the other two residents were incomplete, e.g. the problem of possible entrapment in the rails was not fully identified. Similar problems regarding bed rails have been identified at the previous two inspections and requirements made for adequate risk assessments be carried out for their use. See Requirement 11 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 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 2 X 2 3 X X X 2 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 22 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 Requirement Care plans must be in place that address all of the identified needs/problems of the residents accommodated at the home. Suitable arrangements must be made for the recording, handling, safekeeping, and safe administration of medicines received into the home. This requirement remains outstanding from the previous inspection. The carpets in both lounges on the dementia unit must be replaced with suitable carpeting. Arrangements must be made for the redecoration of the ground floor dining room on the dementia unit. The units in both dining rooms on the dementia unit must be repaired or replaced. Adequate lighting must be supplied to all area of the home accommodating residents. Suitable provision must be made for storage for the purposes of the home. Suitable towels must replace the torn and frayed towels at the DS0000018744.V283553.R01.S.doc Timescale for action 20/03/06 2 OP9 13 13/03/06 3 4 OP19 OP19 16 23 15/04/06 20/03/06 5 6. 7 8 OP19 OP19 OP21 OP21 23 23 23 16 27/03/06 13/03/06 27/03/06 20/03/06 Frodsham Christian General Care Home Version 5.1 Page 23 9 OP26 13 10 OP26 13 11 OP38 23 home. Washbowls used in the personal 13/03/06 hygiene of the residents must be identified for whose use they are intended to reduce the risk of cross infection occurring. Creams used in the personal 13/03/06 care of the residents must be identified to ensure that they are used only for those residents whose use they are intended for. A risk assessment must be in 13/03/06 place for all residents that have bed rails fitted to their beds, and that these assessments address all of the risks involved when using this equipment. This requirement remains outstanding from the previous two inspections. 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 OP29 Good Practice Recommendations A satisfactory written reference should be obtained for all staff to be employed at the home from their last previous employer. Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Frodsham Christian General Care Home DS0000018744.V283553.R01.S.doc Version 5.1 Page 25 - 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. 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