Inspection on 05/04/05 for Hartisca House

This inspection was carried out on 5th April 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

Hartisca House 23/05/07

Hartisca House 27/06/06

Hartisca House 15/09/05

Hartisca House 02/12/04

Hartisca House 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Hartisca House Hartwell Road Burley Leeds LS6 1RY Lead Inspector Sue Dunn Unanounced 05 April 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 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. Hartisca House Version 1.10 Page 3 SERVICE INFORMATION Name of service Hartisca House Address Hartwell Road, Burley, Leeds, West Yorkshire, LS6 1RY (0113) 2426919 0113) 2426871 hartisca@schl.co.uk Southern Cross Healthcare Services Limited 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) Mrs Edna Patricia Woellner Care Home 26 Category(ies) of Dementia (26) registration, with number of places Hartisca House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/12/04 Brief Description of the Service: Hartisca House provides care for older people with dementia. The home was purpose built as a care home, though not specifically designed for the care of people with dementia. Bedrooms meet the minimum size requirements and some have en-suite facilities. The ratio of double to single occupancy rooms is satisfactory. The home is built on two floors with passenger lift access to the first floor. Each floor has a lounge and dining area with food and laundry services being provided from a central area on the ground floor. Sixteen people are accommodated on the first floor and ten on the ground floor. The building does not provide an area where residents can wander freely. A very small, enclosed patio area in front of the building has been made into a more secure area which can be used during the good weather. The home is situated in the Burley area of Leeds, within walking distance of shops, a day centre, church and park. The city centre is a short bus ride away.Because of the vulnerability of the client group external doors are alarmed and the front door can only be opened by staff. Hartisca House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on the first inspection to be undertaken during this inspection year (April 2005- March 2006). The inspection was unannounced and undertaken by one inspector who arrived at the home at 11am and spent 5.45 hours in the home. The process of the inspection entailed the following:The care files of three people most recently admitted to the home were inspected. Eight service users, (including the three whose care plans had been inspected), a visitor, four staff and the manager were spoken with. The inspector observed service users and saw staff carrying out their duties in the communal areas of the home. A brief inspection of the building included a random selection of rooms and a check on the quality of the bed linen. Health and Safety check records were examined The inspector has visited the home for several years and drew on information already known about the home . What the service does well: The manager has a good sense of humour and enthusiastic style of management. She keeps her knowledge about the care of people with dementia up to date and is currently undertaking a Diploma in Dementia Care at Bradford University. She is attempting to introduce practice from the course into the home to improve the quality of life for people living in the home. The manager has tried to improve what is a less than ideal building and introduce training for staff specific to the care needs of people with dementia. The catering arrangements provide an assorted range of meals and snacks at regular intervals throughout the day. This includes fresh fruit and food which is convenient for those people prone to wander. Service users walk about freely within the confines of the building and are recognised by the manager as individual personalities. Staff appear calm and unhurried and try to give one to one attention if service users become particularly agitated and anxious Hartisca House Version 1.10 Page 6 What has improved since the last inspection? What they could do better: The Manager has the knowledge and skills to develop the home to improve the quality of life for the service users. If her standards of care are to be met at all times she needs the commitment of all staff to support her Staff need to understand why they record information and how that information relates to the lifestyle and quality of life for each service user. The section in care files for Health care records could be improved to include eye, dental and any other services related to health care. Daily records in care files must be stored in a way which makes them easy to read and cross reference with current care plans and health care. Care plans must provide a clear picture of each persons level of understanding and how staff need to communicate. Staff should be more observant to the ways in which people attempt to communicate their feelings, and respond appropriately. More attention must be given to personal care and hair care made into more of a pleasurable social activity. In order to maintain the well being of service users social life could be more imaginative and individually tailored to the knowledge, skills and past interests of each person living in the home. Staff should ensure that the radio and TV are used in the interests of the service users and be aware of the negative impact of loud background noises. Some of the care staff could be more welcoming towards visitors to the home. Hartisca House Version 1.10 Page 7 Wherever possible the rota should include a mixture of staff with dementia specific training on each shift. The level of odour control in the home must be of a consistently high standard to ensure there are no unpleasant smells in the home. The toilet tissue used in the home is very thin and the sheets very small. The home should provide a better quality of tissue for the benefit of the service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hartisca House Version 1.10 Page 8 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 Standards Statutory Requirements Identified During the Inspection Hartisca House Version 1.10 Page 9 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 standard(s) 1,2, 3, 4 and 5 Information from some other agencies before admission did not provide the home with enough information about the person being assessed to enable them to know if care needs could be met. Pre admission assessments done by the home in the manager’s absence did not meet the standard set by the manager therefore it was not clear how care needs were to be met. Information describing the home and advising people what to expect of the service was available in the entrance area. The quality and content of the information was good. EVIDENCE: Care files contained pre admission assessments from other agencies and done by the home. Two of the former gave a good picture of each of the individuals needs, though could have gone further in providing some background life history relevant to each personality and their care needs. One was very poor, being so impersonal as to be of little use as an assessment. The same was noted in the pre admission assessments carried out by the home. Two done by the manager were relevant and reached a conclusion stating what would be required to meet care needs. One completed by another Hartisca House Version 1.10 Page 10 member of staff lacked depth, made no reference to cognitive abilities and did not state what would be required to meet the person’s needs based on the type of dementia diagnosed. None of the assessments made any reference to the arrangements for a pre admission visit or the outcome of such a visit to show that people had seen the home before moving in. However, a relative confirmed that she had been guided by a social worker, visited the home and made a choice based on convenient proximity for visiting. The organisation is in the process of amending the contracts of terms and conditions of occupancy in line with a recent report by the Office of Fair Trading. The inspector observed relatives being given a contract to sign with the opportunity to read and discuss the contents. The home has a comprehensive information pack located in the entrance area. This gives the reader a good picture of what to expect, a brief explanation of dementia and how to make a complaint if needed. Hartisca House Version 1.10 Page 11 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 standard(s) 7,8,9,11 Staff have received training in the administration of medication to give them the knowledge to perform this task to a satisfactory standard for the safety of residents. Records of health care were not easy to find in the care files examined. This could lead to some health needs being overlooked. Risk assessment and management should be started at the time of admission in order to minimise any unnecessary restrictions to choice and independence. Overall people were neatly dressed but more attention should be given to the details of personal care. . EVIDENCE: Service users appeared neatly dressed in clothing appropriate to their personal tastes. The men were shaved and some of the ladies had been having their hair washed and set by the hairdresser. However, the people who had not had their hair done by the hairdresser, who only visits the home once a week, appeared unkempt. This was discussed with the manager, as hair washing and setting does not appear to be included in the personal care support undertaken by staff. A complaint to staff about a person being unshaven was met with a defensive reply. It was said that this would not have been a problem had a satisfactory explanation been given. Hartisca House Version 1.10 Page 12 Care plans did not clearly indicate if any needs for dental or eye care had been identified, or appointments arranged. This information could not be found in the daily notes which were held in loose leaf format in a plastic wallet. A system for the safe storage and accessibility of this information was discussed with the manager. Staff recorded information in care files. A care worker confirmed that a need identified as part of a pre admission assessment had been met , though there was no record of this in the care file. Dates on risk assessments showed none had been done at the time of admission therefore residents may be at higher risk of accidents during the early days of admission to the home. The manager stated that all staff who manage medication have received training from a recognised source. This was confirmed in all but one case by the training records. The process of administration was not observed during this inspection. The manager stated the home is unable to provide a satisfactory level of care for people who are in the last days of their lives. Hartisca House Version 1.10 Page 13 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 standard(s) 12, 13 and 15 Daily social and recreational activities for the majority of people lacked creativity given the special needs of the services users. Closer supervision of staff practices is required if staff are to understand how their own actions can and the environment can affect the well being of the people in their care. There has been progress in the way the home tries to ensure people have a well balanced diet. Healthy snacks during the course of the day tempt those people who may be reluctant to eat at mealtimes. Whilst acknowledging the fact that care staff may have felt nervous during the inspectors visit some staff did not appear particularly friendly or welcoming . EVIDENCE: The manager stated that the person who was employed to do activities was absent from work and one of the senior care staff is to take over responsibility for organising this. The inspector spent some time talking to residents and observing practices and saw little evidence of activities or stimulation. A board game had been set up on a table in the dining area ( which is open plan with the only lounge) but was not being used. Pop music from the radio was conflicting with the background noise of the cleaning equipment and creating a rather stressful atmosphere in which it was difficult to talk. Several residents responded well to Hartisca House Version 1.10 Page 14 conversation about their and interests. A single member of staff was attempting to serve morning drinks and snacks and could not, at the same time, respond effectively to the needs of one person who was restless and anxious. Later in the day, however a member of staff improved the state of well being of a person who was becoming increasingly agitated by going out on a short outing to a local cafe. The inspector was informed that at times a visitor felt uncomfortable and unwelcome as some staff do not talk. This could lead to the resident being visited less frequently. The ground floor lounge had more residents and visitors than the chairs could accommodate. This left one visitor having to sit on a coffee table and the atmosphere appeared strained. A small lounge which can be used by visitors doubles as a hairdressing room, this was in use. The only stimulation evident in the hairdressing room was provided by a radio playing pop music which conflicted with the noise of the driers making conversation difficult. The menus aim to provide a well balanced diet. Sandwiches, biscuits, yogurt and slices of fresh fruit were served with the mid morning drinks and the mid day meal offered two choices. Overall, people appeared to be enjoying the meals, though staff were seen to overlook the comments of one person, who was not satisfied with the dessert, until this was brought to their attention. Action was then taken to meet his needs. The main kitchen is on the ground floor therefore any additional drinks or food requested by people on the first floor require staff to leave the area and make a time consuming trip to the main kitchen. This reduces the number of staff and could potentially lead to people not having their needs met The manager and inspector discussed options for a solution to overcome this problem. Hartisca House Version 1.10 Page 15 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 standard(s) 16, and 18 The manager takes complaints seriously and handles them in an open and positive manner. However, staff need more training in the way they handle complaints from visitors and need to be more observant to way in which service users express their dissatisfaction on a day to day basis and respond accordingly. The home’s adult protection procedure has been followed to ensure people living in the home are protected from abuse. EVIDENCE: A copy of the home’s complaints procedure is available in the entrance area for all to see. The manager keeps a log of all complaints and how they have been handled. She feels that the service can only benefit if people feel confident enough to bring any concerns to her attention. A recent complaint submitted to the provider via the CSCI for investigation was investigated and the complainant and CSCI provided with information which answered the questions raised. The outcome of the investigation findings needs to be recorded as the complaint was not upheld. An adult protection investigation is currently underway. The home followed the correct adult protection procedures by informing and involving all the necessary people. The manager has arranged for a series of video training sessions for staff on the Protection of Vulnerable Adults. The manager has recently involved service users in designing a poster to list all the support services in the area which can be used to provide external advice and advocacy for the people who live in the home and their relatives. Hartisca House Version 1.10 Page 16 Hartisca House Version 1.10 Page 17 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 standard(s) 19, 20, 21, 22, 24, 25, 26 The design of the home is not ideal for the group of people accommodated as the outdoor space is on a very steep slope and indoor communal space is limited. The recent programme of redecoration and refurbishment has improved the living conditions for people living and working in the home. Bedroom door do not have handles and locks are of the ‘Yale’ type making it difficult to open the doors from the inside. Door locks and handles used in the organisation’s other homes in the city are of a more suitable type. Odour control has improved but more should be done to ensure that this is consistent More could be done to make the environment more visually stimulating and to provide visual prompts to aid service users to find their way around the home. Staff should be more aware of noise and temperature levels throughout the home to keep these at a level suitable for the service users. EVIDENCE: Hartisca House Version 1.10 Page 18 The home’s maintenance person was able to show the inspector records of all the routine safety checks. The manager ensures these are carried out in his absence. A task list for the coming months shows an ongoing programme of decoration and repair. The inspector saw signs of this during a tour of the building. Bedroom doors were numbered and some doors had a photograph and the name of the person occupying the room. One service user was trying to find his room and said it would have been easier to find if his name had been on the door. The inspector was informed that service users removed this information from the doors but no attempt had been made by staff to replace it. Corridor areas have been made more interesting with memorabilia pictures and hanging plants. Though recently redecorated and carpeted these areas were already showing signs of wear and tear with scuffed walls and a discoloured carpet. There were no unpleasant odours on entering the home. Cleaning staff were in the process of cleaning bedrooms on the first floor where an odour of urine was apparent. A regular visitor to the home said that there were no unpleasant smells but other members of the family, who visited at different times had commented on an odour. The manager also confirmed that when she made a recent unexpected visit to the home there was unpleasant odour when she entered the building, due, she suspected, to the cleaning schedule not being followed in her absence. Some areas of the home were draughty as windows had been left open for ventilation until well into the afternoon. WC pans in the en suite areas are still below an acceptable standard, being stained and discoloured. The organisation feels the toilet tissue supplied to the home is adequate as there have been no complaints. The manager is carrying out a survey of views about the quality of the toilet paper since this was raised in the last inspection. Early results of this survey indicated that the tissue was only effective if several sheets were used. Hartisca House Version 1.10 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 Staff were meeting the basic care needs of service users in a kindly but task orientated way which did little to provide prompting and stimulation. The staff on each shift should have the training to understand how they can improve the quality of life and well being of individuals with memory impairment. The layout of the home, the deployment of staff and lack of dementia training leaves some staff without the skilled supervision and guidance necessary to develop good practice. The home should ensure they employ people who will stay long term in the interests of continuity and consistency of care for service users EVIDENCE: There has been a short period of relative stability within the team of care staff. The appointment of two cooks avoids the need for care staff to undertake catering duties. The home is still without a deputy with the experience and confidence to manage the home and supervise and train staff to a satisfactory standard in the absence of the manager. Attempts to appoint and retain a person with the skills to organise an activity programme for staff to undertake with residents have been disappointing. The staff rota indicated sufficient numbers of staff on duty, with arrangements made to cover a shortfall in the afternoon when someone phoned in sick. There was a diversity of cultures within the staff team. Staff training records showed that there was an induction and training programme in place to cover all the mandatory training topics but only one of the staff on duty had done any dementia training. The inspector observed staff carrying out their tasks Hartisca House Version 1.10 Page 20 calmly but failing to pick up and act on cues from service users, in response what they were trying to communicate. One person was repeatedly asked to sit down, conversation with quieter people was limited to the task in hand and another person’s comments about the food were being ignored. Hartisca House Version 1.10 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 38 The manager provides leadership and guidance to promote the interests and Health and Safety of the service users. Without the support of a similarly committed deputy and team of senior care staff to whom she can delegate, consistency of care and good practice is compromised in her absence. Staff should be experienced and knowledgeable in the care of people with dementia and able to support the manager to develop ‘person centred’ care in the home . EVIDENCE: The manager is studying for a recognised Diploma in Dementia Care. She is open to new ideas and has tried to introduce in house dementia training for staff which will improve the quality of life for service users. The home did not have another senior member of staff with the specialist background knowledge to monitor how staff put their training into practice in her absence. Hartisca House Version 1.10 Page 22 Work which had been delegated to other staff revealed mistakes in the dating of information and the content of recorded information did not have enough substance to give a picture of other than basic care needs. The manager had audited the contents of one file to ensure it contained all the factual information required. A staff meeting was arranged for shortly after the inspection. The manager planned to discuss matters highlighted during the inspection with the staff team. The organisation responsible for the home has recently merged with another group of homes leading to changes in the line management structure and support for the manager. Line management arrangements have changed several times in the time the inspector has been inspecting the home. One person in the home manages her own finances. Two administrators manage all the routine administrative work. Health and safety check records were up to date and the person who carried out this task was aware of his role and responsibilities. An environmental health officer was inspecting the building when the inspector arrived. A report is to follow. Hartisca House Version 1.10 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 3 COMPLAINTS AND PROTECTION 3 2 2 x x 3 3 3 STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x x x x 2 x 3 Hartisca House Version 1.10 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. Standard OP3 Regulation 14 Requirement Any pre admission assessment must only be accepted if it includes all the information required in 3.3 of this standard Care files must include details of mental capacity and arrangements to ensure personal care preferences are met Health care records must be easy to follow and risk assessments commenced at the time of admission based on the pre admission assessment Care files should identify the preferences and expectations of the people being cared for and care plans developed to provide a stimulating range of activities Staff must communicate and respond to service users and visitors in a way which gives assurances that needs are being met and makes families feel welcome when they visit All staff must have the ability to deal with complaints in a way which gives people confidence that they will be listened to The homes outdoor space must be accessible and suitable for the use of people living in the home Version 1.10 Timescale for action 31 July 2005 31.July 2005 By 31July 2005 2. OP7 12,15 3. OP8 12 4. OP12 12,15 31july 2005 5. OP13 12 31 July 2005 6. OP16 22 31 July 2005 31March 2007 7. OP20 23 Hartisca House Page 25 8. OP24,OP10 23 9. OP26 16 10. 11. OP27 OP30 18 18 12. OP31 18 13. OP36 BEDROOM DOOR LOCKS OF AN APPROVED TYPE AND LOCKABLE FUNITURE MUST BE PROVIDED FOR EVERY BEDROOM TOILET TISSUE MUST BE OF SUITABLE QUALITY and procedures followed to control unpleasant odours at all times There must be a suitable skill mix of staff on duty at all times All staff working in the home must have training which gives them the knowledge required to meet the needs of people with dementia The manager must have the support of a suitably trained deputy and senior staff to enable her to fulfill her duties The home must have sufficient competent senior staff to ensure formal and informal staff training and supervision is available on a continuous basis 31 March 2006 31.July 2005 31 July 2005 30 Sept 2005 31 July 2005 31 July 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. Refer to Standard OP19 Good Practice Recommendations Staff should be mindful of temperature and noise levels throughout the home at all times and the affect this has on service users Hartisca House Version 1.10 Page 26 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Hartisca House Version 1.10 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. 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