Inspection on 17/01/06 for Gorse Hill

This inspection was carried out on 17th January 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gorse Hill 23/01/07

Gorse Hill 02/08/05

Gorse Hill 05/01/05

Gorse Hill 16/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Gorse Hill 2 Stephenson Drive Burnley Lancashire BB12 8AJ Lead Inspector Mrs Julie Playfer Unannounced Inspection 17th January 2006 09:45 Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 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 Gorse Hill DS0000055145.V271611.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 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. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gorse Hill Address 2 Stephenson Drive Burnley Lancashire BB12 8AJ 01282 438916 01282 831457 gorsehill@voyage.freeserve.co.uk 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) Voyage Ltd inc. Thelma Turner Homes Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must, at all times, have a suitably qualified and experienced manager who is registered with the NCSC. The staffing of the home should be a minimum of 1 (one) staff member to 2 (two) service users during the day and 1(one) waking watch and 1 (one) sleep in member of staff at night. 2nd August 2005 Date of last inspection Brief Description of the Service: Gorse Hill is registered with the Commission for Social Care Inspection as a care home for adults (aged 18 -65) with learning disabilities. The home provides accommodation for up to 10 people of both sexes. The rooms are all single occupancy and there are small flats available which provide the opportunity for more independent living. These flats contain a sleeping area, sitting area, bath/shower room and kitchen. The communal areas of the home include a large sitting dining area, a smaller lounge, a quiet lounge, a kitchen, crafts room and a smoking room. The laundry and ironing rooms may be used with staff supervision. The home is surrounded by gardens and has a patio/ barbeque area with a large water feature. Gorse Hill is situated on the Burnley to Padiham Road with nearby bus stops to both towns. There are a variety of shops and other amenities nearby. A local park is within easy walking distance. There is a minibus available for trips to shops and supermarkets and other less easily accessible amenities. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over eight hours on 17th January 2006. The previous inspection was carried out on 2nd August 2005. No additional visits have been made to the home since the last inspection. On the day of inspection there were 9 residents accommodated at the home, with one person in hospital and one person visiting his family. Information was obtained from staff records, care records and policies and procedures. The inspector also spoke to the residents, the staff on duty and Mrs McQueston – the acting manager. A partial tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? Since the last inspection, residents had been involved in the care planning process and had signed their plans to indicate their participation and agreement. Varied desserts had been listed on the main menu and served at both lunchtime and teatime. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 6 Improvements had been made to the management of medication. The policies and procedures had been revised and record keeping had been improved. The procedure relating to the protection of residents had been updated so that it closely corresponded to the local protocol. This means in the event of an allegation or suspicion of abuse the manager and staff would know who to contact to discuss the situation in order to initiate an investigation. All records relating to the recruitment and selection of new staff were collated in line with legal requirements. Satisfaction questionnaires had been distributed to the residents’ families in order to gather their views about the quality of the service. 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. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 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 Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 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): 1, 2, 3, 4 and 5 The admission procedure was well managed. Each resident was fully involved in the transition plans and along with the flexible approach taken by the manager and staff to the number and type of introductory visits, this ensured the resident remained central to the process. EVIDENCE: Written information was available for residents in the form of a statement of purpose and service users guide. Both documents met with regulatory requirements. However, whilst the service users guide was available for residents in the office, none of the residents had been given a copy for their personal use. Prior to admission prospective residents’ individual needs were assessed by a social worker and the Voyage Senior Care Planner. Information was also sought from the previous carer and professional staff as appropriate, for instance a psychologist. The former registered manager had also visited residents in their previous placements. It was part of usual practice for prospective residents to visit the home prior to making the decision to move in. One resident new to the home said she enjoyed the introductory visits she made with her social worker. The resident had visited the home several times before she moved into the home and was given the opportunity to stay overnight. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 9 Following the initial assessment process a letter was sent by the organisation to the resident’s social worker; however, the residents had not received personal written confirmation to assure them that the home was suitable for meeting their needs. All residents had been issued with a contract, which fully covered the terms and conditions of residence. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 10 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, 8 and 9 There was effective use of individual care plans and behaviour management guidelines to ensure the delivery of care and support was consistent. The risk assessment and management arrangements supported residents to take responsible risks. EVIDENCE: The residents had an individual plan, which reflected their health and welfare needs. Detailed instructions were set out for staff to ensure all needs were met. Where necessary, the care plans were supplemented by behaviour management guidelines, which were designed to provide a consistent response to behaviours, which challenged others and the service. The guidelines focussed on positive behaviour and the use of distraction. A behaviour analysis form had also been completed for all residents. This presented an overview of all action plans relating to the management of behaviour. Since the last inspection, residents had signed their care plans to indicate their involvement and agreement. It was the practice of the home to support responsible risk taking and policies stated that the role of staff was to facilitate independence wherever possible. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 11 Detailed risk assessments and management strategies covered activities indoors and in the wider community and were included on residents’ plans. During conversations with the residents, it was evident they were consulted both informally and formally and they were able to participate in life in the home. Residents’ meetings were arranged on a regular basis. From the minutes seen it was evident a wide variety of topics were discussed and contributions had been made by the residents. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 12 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): 11, 12, 13, 14, 15 and 17. Residents were provided with good opportunities to engage in a wide range of appropriate activities and were supported to use community facilities. The residents maintained strong links with their families, which were supported by the manager and staff. Arrangements were in place to ensure the residents participated in the life of the home and their rights were respected. EVIDENCE: The individual plans and care records demonstrated that residents had opportunities to maintain and develop practical life skills. Where necessary tasks had been broken down and achievable goals had been set. Residents had good access to an extensive range of activities both inside and outside the home. Activities outside the home included; bowling, trips to the park, walks in the local area, shopping in Burnley town centre and the use of leisure centres. All residents had an activity schedule, which was freely available in the home. During the inspection two residents showed the inspector their activity schedules, both were very varied and designed around their individual interests. One resident had devised her own activity schedule, which combined social outings, visiting family members and learning new Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 13 skills. All residents spoken to said they enjoyed their activities. Staff were allocated to work with each resident and staffing levels were reviewed at regular intervals, to enable residents to pursue their individual interests. All residents had been offered the opportunity to go away on holiday and two residents had been away to Bridlington in a caravan. One resident who went on the holiday said, “we had a great time”. The residents were supported to maintain relationships with their families and where necessary staff assisted with transport and accompanied residents on journeys. One resident was away with his family at the time of the visit. The residents had unrestricted access to the home and grounds. The residents were also able to use their room at any time should they wish to spend some time in private. The registered manager maintained an individual record of meals served to residents, which included variations served to the main menu. The residents said they liked the meals and there was always plenty to eat. Meals were provided three times a day and a range drinks and snacks were available at all times. An emphasis was placed on healthy eating and as such fresh fruit was available in a plentiful supply at all times. Since the last inspection a variety of desserts had been listed on the main menu and served at both lunchtime and teatime. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 14 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 The residents’ healthcare needs were identified and met. Personal support was provided in a manner, which respected the residents’ rights to privacy and dignity. Further attention must be given to maintaining medication records in order to minimise the potential for error. EVIDENCE: The residents’ individual care plans set out the personal support each resident required and provided details of how this support was to be delivered. Staff told the inspector the routines were flexible and were primarily designed to meet the needs of the residents and their plans for the day. Healthcare needs were appropriately assessed and were included in the care plan. There was evidence to indicate the residents had access to NHS services and the advice of specialist services had been sought as necessary for example Psychology. Since the last inspection the policies and procedures relating to medication had been revised and updated and were reflective of the arrangements in place at Gorse Hill. The home operated a monitored dosage system for the administration of medication dispensed into individual blister packs. It was noted that the controlled drugs register was complete and up to date and all Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 15 staff designated to administer medication had received accredited training. Appropriate recording keeping was in place, however, in one instance not all information had been transcribed from the prescription label onto the medication administration record, protocols were not in place for all variable dose medication and medication prescribed “as necessary” and the returns record was not completed contemporaneously. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 16 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 Systems had been established to ensure any concerns of residents would be acted upon. Appropriate procedures and staff training opportunities were in place to respond to any allegations or suspicions of abuse. EVIDENCE: It was part of usual practice in the home for the registered manager and staff to listen to and act on the views and concerns of residents before they developed into problems and formal complaints. This was achieved during daily conversation and one to one discussion with residents and their key workers. The complaints procedure was included in the service users guide and was verbally explained to residents as necessary. The procedure included the assurance that residents and their families would not be victimised for making a complaint. The residents were familiar with the complaints process and had used it to voice their views. The registered manager had maintained a record of complaints along with details of the investigation and outcome. There were letters on file to indicate the complainant had received feedback. A copy of “No Secrets in Lancashire” (The Joint Strategy for the Protection of Vulnerable Adults) was available, along with a specific procedure setting out the required response in the event of any allegations or suspicion of abuse. Since the last inspection, the procedure had been updated to clearly state it is the responsibility of the registered manager to instigate the adult protection procedures in the event of any incident or allegation of harm to the residents. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 17 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, 25, 26, 27, 28 and 30 The residents were provided with a spacious, comfortable, safe and wellmaintained home. EVIDENCE: Gorse Hill is a large detached house set in it’s own grounds. It is located in a residential area approximately one and a half miles from Burnley town centre. The bedrooms are all single occupancy, with some rooms taking the form of small flat, with kitchen and living areas. All bedrooms have an ensuite bathroom. Communal space is provided in a large sitting dining room, a smaller lounge, a quiet lounge, kitchen and a crafts room. All rooms provide facilities in excess of the National Minimum Standards. The bedrooms had been decorated and furnished according to personal taste. Two residents said they liked their rooms, which they thought were comfortable and spacious. Residents were able to bring in personal belongings, many of which were displayed in their rooms. Residents were able to use their rooms at any time, should they wish to spend time pursuing their own activities. As such, the activities plans incorporated free time for them to fill as they pleased. One resident said he liked to watch DVD’s and videos in his room. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 18 The home had a good standard of cleanliness in all areas seen. The grounds were well-maintained and provided plenty of space for any outdoor activities such as football. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 19 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): 31, 32, 33, 34, 35 and 36 The recruitment procedures were thorough and ensured the protection of residents at the home. Good arrangements were in place for the induction of new staff. The wide range of training opportunities gave the staff a good understanding of their role and the needs of the residents. However, the systems in place to support staff on an individual basis should be improved. EVIDENCE: Staff had been issued with a job description, which was commensurate with their role as part of the recruitment process. The care records demonstrated that staff were familiar with their own knowledge and skill limitations and knew when it was appropriate to involve someone else with more specific expertise, for instance a doctor or psychologist. From discussions with staff during the inspection, it was evident they had a good understanding of the residents’ needs and knew the residents’ well. Staff referred to the residents in respectful terms and were observed to interact in a positive and pleasant way. The staffing levels were above the minimum levels identified on the certificate of registration. The level of staffing in place was determined by the needs of the residents and contractual agreements. The recruitment and selection procedure of new staff was underpinned by the organisation’s Equal Opportunities Policy. The recruitment procedures included completion of an application form, face-to –face interview, obtaining two Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 20 written references and a POVA first and CRB check. The files of three employees were checked. These showed that the procedures had been followed and all relevant details had been obtained. Staff had received induction training which was the equivalent to “Skills for Care” (formerly TOPSS) training. This training was supplemented with additional training on the management of challenging behaviour. Each member of staff had a training assessment and profile and there was an overall training development plan for the staff team as a whole. It was evident staff had access to a broad range of training courses, however, none of the staff had received equal opportunities training. At the time of the inspection nine staff had completed NVQ level 2 and a further fifteen staff were working towards NVQ either 2, 3 and 4. This equated to 33 of the care staff were trained to NVQ level 2 or above, which was an increase of 11 since the last inspection. Staff meetings were held on a regular basis with records indicating that six meetings had been held in the last 12 months. The meetings gave staff the opportunity to share experiences and develop teamwork. The staff received supervision, but had not had six supervision sessions in the last year and not all staff had received an appraisal. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 21 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, 38, 39, 41 and 43 The management approach promoted positive relationships between the staff and residents and the overall atmosphere was open and friendly. Quality monitoring systems must be improved in order to monitor outcomes for residents. EVIDENCE: Since the last inspection, the registered manager had left the employment of the home. The deputy manager was temporarily acting as the manager, until the new manager had come into post. The management approach was consultative and there were systems in place to consult both staff and residents. Relationships within the home were positive and staff spoke about the residents with respect. The deputy manager continued to complete the monthly audit as part of the quality assurance processes. However, an annual development plan based on continuous self-monitoring had not been developed. Satisfaction questionnaires were distributed every month in order to consult the residents, Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 22 however at the time of the inspection the overall results had not been collated and residents had not received any feedback. Satisfaction surveys had been distributed to residents’ families, but the results had not been collated. All regulatory records seen were complete, up to date and kept in accordance with the Regulations. The home had public and employers liability insurance cover in place against loss or damage to the assets of the business and business interuption costs. A business and financial plan was not available for the forthcoming year. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 23 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 2 2 3 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 X 3 X 2 Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 24 Yes Are there any outstanding requirements from the last inspection? 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. 2. Standard YA1 YA3 Regulation 5 14 Requirement Each resident must be provided with a personal copy of the service users guide. The registered person must confirm in writing to prospective residents that having regard to the assessment the home is suitable for meeting their needs. The medication administration record must accurately reflect the prescribers instructions. Any changes in these instructions must be clearly documented on the record. The medication “returns” record must be completed contemporaneously so as to ensure that all tablets are accounted for. Staff must receive individual supervision sessions a minimum of six times a year. (Previous timescale of immediate). An annual development plan must be produced based on a systematic cycle of planning, action and review and based on outcomes for residents. (Previous timescale of 01/10/06 – not met). DS0000055145.V271611.R01.S.doc Timescale for action 15/02/06 02/08/05 3. YA20 13 (2) 02/08/05 4. YA20 13 (2) 15/01/06 5. YA36 18 15/01/06 6. YA39 24 31/03/06 Gorse Hill Version 5.1 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 1. 2. 3. 4. 5. Refer to Standard YA20 YA35 YA32 YA36 YA39 YA43 Good Practice Recommendations Protocols should be devised for all variable dose medication and medication prescribed “as necessary”. All staff should receive equal opportunities training, including disability equality training, race equality and antiracism training. 50 of care staff should be trained up to NVQ level 2 by 2005. All staff should have an annual appraisal with their line manager to review performance against job description and agree career development plans. The results of surveys should be collated and published and made available to residents, their representatives and other interested parties including the CSCI. A financial and business plan should be devised for the home and the service, which is open to CSCI inspection and reviewed annually. Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Gorse Hill DS0000055145.V271611.R01.S.doc Version 5.1 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!