Inspection on 04/05/05 for Granville Court 4

This inspection was carried out on 4th May 2005.

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

Granville Court 4 23/09/08

Granville Court 4 07/06/07

Granville Court 4 12/12/05

Granville Court 4 25/11/04

Granville Court 4 16/07/04

Granville Court 4 20/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 4 Granville Court The Esplanade Hornsea East Yorkshire HU18 1NQ Lead Inspector Sarah Sadler Unannouced 4 May 2005 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 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 Stationary 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. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 4 Granville Court Address The Esplanade Hornsea East Yorkshire HU18 1NQ 01964 532160 01964 534495 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) East Riding of Yorkshire Council Mrs Moira Gillyon Care Home 20 Category(ies) of LD Learning disability 20 registration, with number PD Physical disability 20 of places LD(E) Learning dis - over 65 PD(E) Physical dis - over 65 PD Physical disability 4 LD Learning disability 4 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To offer respite care to service users aged 16-18 (those in transition from childrens services to adult services). Date of last inspection 20 November 2004 Brief Description of the Service: 4 Granville Court is a purpose built care home offering up to twenty placements to adults both under and over the age of 65 years (male and female) who have a learning disability. The home is situated in the seaside town of Hornsea and is positioned close to the sea front, the local shops and amenities. Accommodation at the home is in three small units, called bungalows. Each service user has a single room. The bungalows have a lounge/dining area and a small kitchen on each unit and service users have access to a large communal activity room and a smaller ‘snoozelem’. This is a room that contains specialist equipment for sensory stimulation. The home has a spacious courtyard area with seating that is enclosed and secure with good access, including people in wheelchairs or with mobility problems. The home is owned by a multi agency organisation, which includes Social Services and the Local Health Authority, and is know as the Spice Trust Project. The registered provider is the East Riding of Yorkshire Council. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was completed as part of the programme of inspections for the year 2005-2006. It was an unannounced inspection undertaken by one inspector, Sarah Sadler. The inspection day lasted from 9.00 am until 6.00pm with a previous half day preparation also undertaken. During the inspection a tour of the premises was completed, and time was spent with service users in the communal areas of the home observing their daily lives. Further time was spent reading service users’ care plans and files. Discussions were held with the manager and staff throughout the day. What the service does well: What has improved since the last inspection? What they could do better: 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 6 Service users could access more activities. Recording keeping should be improved. The decoration and some of the furnishings are becoming ready for updating. 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. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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 standard(s) 1,5 Prospective service users are provided with the home’s statement of purpose, service users’ guide and service users’ contract to assist in their choosing of the home. EVIDENCE: The statement of purpose, service users’ guide and service users’ contract have not been amended since the last inspection and continue to contain the majority but not all of the required information. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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 standard(s) 6,7,9 Service user needs are not fully met, as these needs are not consistently reviewed and care plans updated. Service users are supported to make choices in their lives. Service users are not supported to take up to date risks in their lives. EVIDENCE: Service user care records contain individual plans of care that detail the needs of the service user. Some care records have been reviewed in the last month. However, this was not consistent and records were not all reviewed on a monthly basis. Service users’ files did not all contain evidence of care management reviews. Staff confirmed that service users are supported by a named nurse and key worker. Staff were observed to support a service user in making choices, this service user will raise their hand if they do/do not wish to complete something. Staff were observed to react and understand the needs of a service user who did not have formal speech but communicated though verbalising. Staff were observed to ask service users if they wished to watch television/stay in bed. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 10 Service user care plans do not reflect the choices that service users make in their everyday lives. Service user care plans continue to contain risk assessments. These risk assessments are not regularly reviewed. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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 standard(s) 12,13,14,15,17 Service users’ social needs are not fully being met as a result of their wishes not being recorded. Activities have increased but could be further developed. Service users are supported to maintain a healthy diet. EVIDENCE: Discussion with the nurse in charge reflected that the home has established is a link person with the local adult education centre. With a view to service users attending in the future. The times that staff are on duty has altered since the last inspection and there is now a core 2 hour period each day that facilitates people being supported to access their local community. The local Lions club is developing a sensory garden. Service user daily notes reflect that service users go for walks and to a coffee morning. However, this may only be once a week. Staff discussed that a service user attends a local dance activity and service users have recently been to Blackpool on holiday. The holiday is not part of the basic contract price of residing in the home. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 12 Staff were seen to sit with service users spending time prior to lunch relaxing and chatting. Other staff were observed in the afternoon undertaking a craft activity with a service user. Staff confirmed that access to transport has improved and service users may now use taxis. Staff discussed that there is a music therapy session once per week that service users enjoy. Records of service users’ likes and dislikes are being developed and are completed for some service users. There is no policy to support service users and staff should a service user wish to develop an intimate personal relationship. The nurse in charge described how menus are planned with the staff team, dietician and speech and language therapist. The menus are rotational and service users are offered choices. Food was observed to be well presented and food tasted was of a good quality. Mealtimes were relaxed with service users being given individual support with their dietary needs. Service users’ weight is monitored monthly. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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 standard(s) 20,21 Service users receive the medication they require to maintain their health. Service users’ wishes regarding terminal illness and for after they have died are not recorded. EVIDENCE: Service users are supported by registered nurses with their medication. Service user records reflected that all medications entering, administered and leaving the home are recorded and signed for. The service user guide expresses that service users may if they feel able to, self medicate. The nurse in charge confirmed that there have been no alterations to the medication policy since the last inspection. The medication policy does not detail the actions to be taken, including risk assessment for those service users wishing to self medicate. The policy does not detail what actions to take to record new medicines into the home. The nurse in charge detailed that no actions have been taken to identify the wishes of service users if they become terminally ill or pass away. Recent experiences with this have reflected that the families of the service users make the decisions regarding funeral arrangements. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 14 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 standard(s) Neither of these two standards was assessed. EVIDENCE: 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 15 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 standard(s) 24,25,26,27,28,29,30 Service users live in a clean, warm home that allows them access to their community and the privacy of individual personalised rooms. EVIDENCE: The home continues to offer single bedrooms to service users. These are decorated with personal items of the service users, reflecting their individual personalities. There are no records that service users are offered a choice of items in their room as per those listed in National Minimum Standard 26.2. There continues to be a communal lounge/dining area with kitchen to the rear, a bathroom, toilets and sluice/storage area. The home is clean throughout with no offensive odours. The decoration of the home is in need of renewal and the nurse in charge and staff confirmed that this is being addressed by the Local Authority and they are on a ‘waiting list’. The majority of the furnishings were of a good quality. However many of these are now worn and nearing the time for replacement. There is a staff call system in place that was observed to work and tested during the inspection. Staff were observed to utilise mobility equipment that is regularly maintained. There are specialist mattresses and baths in place. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 16 Service users have become involved in the forthcoming commemorative celebrations for VE Day and lounges have decorations to reflect this. Laundry facilities are situated away from the main areas of the home, not intruding on the daily lives of service users. There continues to be professional washing machines, with staff employed to manage the laundry and cleaning of the home. The nurse in charge received confirmation during the inspection that the work required for the home to meet the Water Supply (Water Fittings) Regulations 1999 is to take place next week. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35,36 Service users needs are not fully met as staff are not fully trained and supervised. Service users are not adequately supported and protected by the recruitment practices in the home. EVIDENCE: Staff files now contain some evidence of the training staff have undertaken in the past. Recent training is limited and the nurse in charge has completed an audit of the requirements of individual and the staff team as a whole with regards to their training needs. The nurse in charge confirmed that less than 50 of the staff team hold a National Vocational Qualification at level 2 or above. Discussions with staff found that staff had an understanding of service users day to day needs and experience of the client group as a whole. Staff files included copies of Criminal Records Bureau checks, but they did not contain all of the required documents, for example, employment references. Staff are not employed in accordance with the GSCC code of conduct. Staff are employed both by the NHS and Social Services, the recruitment documents for the NHS staff are not shared with the home and cannot be verified. Staff files reflected that staff are undertaking induction training and staff confirmed that Learning Disability Award Framework training is undertaken. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 18 Staff confirmed that they have undertaken continence management training this year and have completed forms to undertake further training courses. Staff training records reflected some staff have undertaken specialist training , for example, epilepsy management and postural management. However only three staff have undertaken moving and handling training, this is a potential hazard for staff and service users. Discussion with a staff member reflected that supervision is occurring every six to eight weeks. Staff files contained very limited evidence that supervision is taking place or that it meets the requirements of the National Minimum Standards. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41,42 The failure to provide consistent management oversight compromises the ability to ensure that the needs of the service users are met. Quality assurance systems do not seek a full picture of life in the home. Service users’ health and safety needs are not always fully met. EVIDENCE: The nurse in charge and manager on duty confirmed that the registered manager has almost completed a National Vocational Qualification level 4 in management. Notification that the registered manager was absent from the home for a period of six months was not received by the Commission for Social Care Inspection and no other additional management support was offered to the home. There are a number of outstanding requirements from the previous inspection. A manager from another service has recently commenced working 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 20 in the home and will remain for three months, this is to assist in the administration and development of policies. Regulation 26 reports confirming that the necessary visit had been undertaken as to the requirements were not available within the home. The nurse in charge confirmed that the quality assurance system has not been developed to include the views of stakeholders, or family and friends of service users. Staff have not yet signed to confirm that they have read or received the polices and procedures. Not all service user records are up to date. A daily report is completed that summarises any occurrences within the home. This is a communal record for all service users, communal recording should not take place. There are systems in the home to assure the safety of the service users. These include regular checks of the fire equipment, emergency lighting, electrical wiring and maintenance of lifts/baths. Staff have not undertaken training regarding safe working practices, for example, moving and handling. There is a fire risk assessment that does not include a plan of the home and no records of fire drills were available. At the previous inspection a door was found to be held open by unauthorised means, this was also the case at this inspection and again this was rectified at the time of the inspection. The last visit to the home form the fire office detailed that some exits were blocked and these were rectified at the time of his visit. No exits were found to be blocked. The nurse in charge confirmed that the home had received a visit from the environmental health officer in approximately December of last year, although no letter confirming this visit was available. Risk assessments for safe working practices are not in place and the manager confirmed that a risk assessment for the use of VDU equipment is to be developed. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 x x x 1 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 2 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 1 Standard No 11 12 13 14 15 16 17 x 1 3 2 2 x 3 Standard No 31 32 33 34 35 36 Score x 2 x 1 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 4 Granville Court Score x x 2 2 Standard No 37 38 39 40 41 42 43 Score 1 x 2 2 2 1 x J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 22 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. Standard 1 Regulation 4,5,6 Requirement The registered provider must ensure that the statement of purpose covers all of the required areas. This requirement has been brought forward from the previous inspection with a compliance date of 25th December 2004. The registered person must ensure that the service user guide covers all of the required areas. This requirement has ben brought forward from the previous inspection with a complaince date of 25th December 2004. The registered provider must ensure that the service users contract contains all of the required information.This is an ongoing requirement with a previous compliance date of 30th March 2004. The registered provider must ensure that service user care plans are up to date. The registered provider must ensure that assessments of service users are regularly reviewed. This is an ongiong requirement with a previous Timescale for action 30th May 2005. 2. 1 4,5,6 30th May 2005. 3. 5 4,5,17 30th May 2005. 4. 5. 6 9 17 13,14 30th May 2005. 30th May 2005. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 23 6. 12 12 7. 30 13(3) 8. 32 18 9. 34 10,12,13, 17,18,19, 21,22,24 & 26 10. 34 18(4) 11. 35 4,10,12,1 7,18,19,2 4,26 12. 36 4,10,12,1 7,18,21,2 2,24 & 26 compliance date of 25th December 2004. The registered person must ensure that service users are supported to undertake educational and leisure activities. The registered provider must ensure that the home complies with the Water Supply (Water Fittings ) Regulations 1999. This is an ongoing requirement with a previous compliance date of 25th February 2005. The registered provider must ensure that staff are trained in the moving and handling of service users. The registered provider must hold all staff files at the home, which contain the information required in accordance with schedule 4 of the Care Homes Regulations 2001 to fully comply with the requirements of standard 34.1 to 34.8 and the associated Care Homes Regulations 2001. This is an ongoing requirement with a previous compliance date of 30th March 2004. and 25th December 2004. The registered provider must ensure that staff are employed in accordance with the GSCC code of conduct. The registered provider must ensure a staff training and development programme. That ensures the training needs of the staff team are met. This is an ongoing requirement with a previous compliance date of 15th September 2004 and 25th December 2004. The registered provider must develop and implement a programme of staff supervision and staff appraisal to fully 30th June 2005. 30th May 2005. 30th June 2005. 30th May 2005. 30th June 2005. 30th May 2005. 30th May 2005. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 24 13. 37 38 14. 15. 37 42 26 23(4) 16. 17. 42 42 12,13 12,13 comply with the requirements of the standard 36.1-36.8 of the National Minimum Standards and the associated Care Homes Regulations 2001.This is an ongoing requiremen with a previous compliance date of 30th March 2004. The registered provider must ensure that absences of 28days or more of the registered provider or registered manager are notified to the commission. The registered provider must ensure that the requirements of Regualtion 26 visits are met. The registered provider must ensure that practices within the home comply with the requirements of the Local Fire Authority. The registered provider must ensure that staff are trained in safe working practices. The registrered provider must ensure that risk assessments for safe working practices are undertaken, in place home, and regualalry reviewed. 30th May 2005. 30th June 2005. 30th June 2005. 30th June 2005. 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. 2. 3. 4. 5. 6. Refer to Standard 6 7 7 8 14 14 Good Practice Recommendations Service user plans should be reviewed on a monthly basis. Service users involvement in the recruitment of staff should be further developed Service users should have greater access to their finances. Service user choices should be recorded in individual files. Service users should have their annual holiday included as part of the basic contract price of residing in the home. Service user leisure activities should meet service user J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 25 4 Granville Court 7. 8. 15 20 9. 10. 11. 12. 13. 14. 15. 16. 21 24 26 32 37 39 40 41 wishes. A policy to support service users wishing to develop an intimate personal relationship should be developed. The medication policy should clearly describe the actions to be taken for the recording of medications entering the home and for the assessment to be undertaken for those service users wishing to self medicate. Service users wishes regarding terminal illness and funerals should be recorded. The furnishings and fittings should be reviewd and replaced as required. Service users rooms should include all the items required by the National Minimum Standard. The registered provider should consider how it would meet the requirement of 50 of care staff in the home achieve a National Vocational Qualification (NVQ) 2 by 2005. The registered manager should achieve an NVQ 4 by 2005. The quality assurance system should include all of the areas recommended by the National Minimum Standard. All staff should confirm that they have read and understood the policies and procedures within the home. Communal records should not be utilised. 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection First Floor Unit 3 Hesslewood Country Office Park Ferriby Road Hessle East Yorkshire HU13 0QF 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 4 Granville Court J53_s41493_Granville Court 4_v223488_040505_stage 4.doc Version 1.30 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!