Inspection on 21/06/06 for Hilbre Court

This inspection was carried out on 21st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hilbre Court 12/02/08

Hilbre Court 20/06/07

Hilbre Court 20/02/07

Hilbre Court 01/03/06

Hilbre Court 07/11/05

Hilbre Court 01/02/05

Hilbre Court 28/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hilbre Court 2 Barton Road Hoylake Wirral CH47 1HH Lead Inspector Peter Cresswell Key Unannounced Inspection 21st June 2006 9:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hilbre Court Address 2 Barton Road Hoylake Wirral CH47 1HH 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) 0151 632 2220 Mrs Delrose Haynes-McManus Miss Tracey Dawson Care Home 14 Category(ies) of Dementia - over 65 years of age (14) registration, with number of places Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of persons for whom residential accommodation (with both board and care) is provided at any one time is fourteen (14). Only elderly persons with mental disorder may be accommodated. Date of last inspection 1st March 2006 Brief Description of the Service: Hilbre Court is large detached property with a pleasant, secluded garden at the rear. The seafront, public transport and shops in Hoylake town centre are a short walk from the home. The home provides care and personal support for fourteen older persons with dementia. There are eight single rooms and three that can be shared; all of them have an en-suite toilet facility. There is a passenger lift to the first floor. On the ground floor there are two lounges and a separate dining room. A small extension has been built to the side of the building, creating some extra space in the dining room and improved laundry facilities. Fees for Hilbre Court start at £360 a week. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced visit the inspector talked to the Registered Manager, members of staff, several residents and a relative. The inspector toured the whole building and inspected documents including policies, care plans, safety records and staff records. The Registered Manager partially completed a Pre Inspection Questionnaire though it was not received by the inspector before the site visit. One relative returned a survey form on behalf of a resident. The inspection lasted six hours. What the service does well: What has improved since the last inspection? 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. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. Quality in this outcome area is adequate. Residents are properly assessed before being admitted, ensuring that the service can meet their needs. The Statement of Purpose and service user guide are inadequate, meaning that prospective residents and their relatives do not have access to satisfactory information about the home. EVIDENCE: Hilbre Court’s Statement of Purpose is currently being revised as it is out of date and does not contain all of the information required by the regulations. This has been outstanding at the last two inspections. The home’s service user guide is also inaccurate, out of date and must therefore be updated. The existing guide includes much information that is not strictly necessary but does not include all of the items required by the regulations and standards. Residents are assessed by the Registered Manager before they are admitted and an assessment for the newest resident was on file. The file also contained a detailed account of how the resident was admitted following a visit with her relatives. One of this resident’s relatives confirmed that the admission had been handled sensitively by the home, though he had some criticisms of the Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 8 local authority’s role. Hilbre Court does not provide intermediate care so Standard 6 does not apply. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is adequate. Care plans set out how the home meets residents’ needs, though they need to be systematically reviewed. Residents’ interests are protected by the efficient storage and administration of medication. EVIDENCE: There are detailed care plans in place for each resident, dealing with separate aspects of a resident’s life, such as communication and nutrition. Nutritional assessments are also done. The Registered Manager reviews care plans every month and these reviews were recorded on many files. However, some of the care plans the inspector looked at had not been reviewed for some time. If the Registered Manager drew up a written schedule for reviews it would help her to check that all cases are systematically reviewed. The manager rewrites care plans by hand when significant changes are necessary as they are not written on a computer. Daily reports are made by staff for each resident and separate records are kept of visits by GPs, nurses and other medical professionals. It may help the daily write-up process if a brief summary of each care plan was filed with the report sheets. None of the residents deal with their own medication. The home uses a monitored dosage system, where most tablets are dispensed by the Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 10 pharmacist in personalised blister packs. Controlled drugs are kept in a Controlled Drugs cabinet and their administration is recorded in a CD register, with each dose being countersigned by a second member of staff. As it happens, none of the drugs being administered in this way at the time of the site visit are in fact listed as Controlled Drugs but the home cannot be criticised for taking additional security measures. The records checked were found to be accurately recorded, and all medication was securely stored. At the last inspection the Registered Person was required to put screens in all shared rooms to ensure that personal care could be provided in private. A screen has been placed in one room but the two other shared rooms do not have screens. This is unacceptable and suitable screens or other measures must be put in place as soon as possible. There was information on file about residents’ wishes when they die and the manager described how this mater is dealt with sensitively. Terminally ill residents are kept at Hilbre Court for as long as the home can meet their needs. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. Friends and relatives are made welcome in the home, ensuring that residents can remain in touch with their families if they want to. A varied, well-cooked menu is provided, ensuring that residents receive balanced, nutritious diet. EVIDENCE: Care plans list the activities which residents enjoy but the home does not yet employ a dedicated activities organiser. Activities which the residents enjoy include looking at videos, television and make up sessions. Staff take residents to local shops and the promenade and spend some time talking to them. A hairdresser visits once a week. Relatives and friends are always welcome in the home and a visiting relative confirmed that he always receives a warm welcome and a cup of tea on his regular visits. Other relatives also visited during the inspection and it was clear that staff made them welcome. One relative completed a survey form on behalf of a resident and was generally happy with the care provided, though felt that there were few activities arranged. The home still does not have a permanent chef and most of the cooking is done by the manager, with the assistance of other staff. The food prepared on the day of the inspection was of good quality and the residents said that they enjoyed the food in the home. Meals are liquidised or cut up to help residents to eat if that is needed and there is always a choice of at least two sweets. The Registered Manager said that in her experience the residents at Hilbre Court enjoy sweets and puddings more than the main Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 12 meals. If residents do not like the main meal on offer then the manager will prepare something of their choice, but she said that she knows the residents very well and the menu is based around their likes and dislikes. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is adequate. Hilbre Court has policies and procedures to protect residents from abuse. EVIDENCE: Hilbre Court has appropriate procedures for complaints and the protection of residents from abuse. The complaints procedure has been rewritten to include the name and contact details of the Commission for Social Care Inspection. There have been no complaints since the last inspection. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area was good. The home is clean, comfortable, well maintained and well furnished, though there are three shared bedrooms. EVIDENCE: Hilbre Court is generally well maintained and has a homely atmosphere. The larger lounge is less used by the residents, partly because the smaller lounge overlooks the main corridor and residents like to see the comings and goings and be near to staff. Both are well furnished, though the bay in the larger lounge needs some redecoration. There is a large, attractive garden to the rear of the home and residents said that they enjoy using it in good weather, though this was not the case on the day of the inspection. There was plenty of new, attractive garden furniture on the patio. An extension has been built to the dining room since the last inspection. It is not quite completed yet as it needs to be decorated, as does part of the dining room. The extension has provided space for a large, additional table and as it has a Perspex roof it allows additional light in to the dining room. The extension includes additional laundry facilities. Most laundry will still need to be taken through the dining room, so the Registered Manager should complete a risk assessment setting out how and when dirty laundry is carried through this area. The Commission Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 15 for Social Care Inspection was not notified of the proposed extension and the Registered Person must in future notify the Commission of any significant alterations and extensions to the premises. Most bedrooms are bright and spacious, though in general they could do with redecoration and brightening up. Some of the furniture needs to be replaced or repaired. All rooms have ensuite toilets, though one room does not have a wash hand basin. The following minor work is required: * bedside cabinet in the shared room on the ground floor needs to be repaired, as does the base to one of the beds. * the door needs to be put back on the wardrobe in room 9. * bay wall in the main lounge must be redecorated. * the sideboard in the main lounge must be repaired. Three bedrooms are shared and anyone sharing should be given the opportunity to move into a single room should the opportunity arise. Hot water did not appear to be available in any of the bedrooms, even after the taps had been allowed to run for some time. This issue was raised at the last inspection and the Registered Person should investigate the situation to see what the problem is so that it can be resolved. There are two bathrooms, both with assisted bathing equipment. The home was extremely clean and was entirely odour-free. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area was poor. Staff were caring and efficient during the inspection but it was not evident that all of the appropriate checks had been carried out on all staff to ensure that residents are cared for by suitable staff at all times. Staff receive training to help ensure their competence but the home does not yet have sufficient trained care staff. EVIDENCE: In September 2004 the Commission for Social Care Inspection told the Registered Person that there should be three care staff on duty at all times. The current rota provides for three care staff between 10am and 8pm, but out of those hours (early morning and late evening) there are only two carers on duty. At night there is one waking member of staff and one sleeping in. A cleaner is employed for eight hours a week and night staff are expected to do some cleaning. There has been no chef at the home for some time and most of the cooking is done by the manager. Staffing therefore falls short of what is required and the Registered Person needs to review the staffing situation, in particular to ensure that the manager is able to concentrate on management duties rather than cooking. Some training is provided and new staff receive induction training. Two care staff have NVQ3 and three others are studying for the qualification, but no staff have NVQ2. The home was advised by its training agency that some staff with overseas qualifications should go straight to NVQ3 in the light of their experience. It may be that some of the overseas staff’s qualifications can be officially recognised as equivalent to NVQ and the Registered Person should consult NARIC (the government agency for the recognition of overseas qualifications; www.naric.org.uk) for advice on this issue. In the absence of such recognition the home remains short of the Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 17 national standard of 50 qualified care staff. The Registered Manager has begun to compile records of the training that staff have done and that which they need but this is still at an early stage and is a further example of the need for her to be able to spend more time on management duties. There was evidence to show that some applications had been submitted for Criminal Records Bureau (CRB) checks on existing staff, but these had not yet all been received. According to information sent to the Commission for Social Care Inspection after the inspection there are still seven staff who do not have a CRTB certificate and have not applied for. One new member of staff had started work since the last inspection and that person had started work without a fresh CRB check or a check against the Protection Of Vulnerable Adults (POVA) register. In a telephone call following the inspection the Registered Person said that this member of staff had a CRB check from previous employment and she understood this to be adequate. Since the introduction of the POVA scheme, CRB checks have not been portable between different employers in these circumstances. The Care Standards Act requires that new staff have a CRB check and are checked against the POVA list before offered employment; an old CRB does not provide this. It is therefore essential that all new staff are cleared against the POVA list, using the POVA First system, before they are allowed to work in the home. Once POVA clearance has been received the member of staff may start work under supervision. Recruitment files were not available at the time of the inspection and will be examined at the next key inspection to ensure that all appropriate checks are made on staff, including obtaining references and the other information set out in Schedule 2 of the Care Homes Regulations. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37, 38. Quality in this outcome area was adequate. The home’s day to day management rightly focuses on the interests of the residents but the lack of some documentation, in particular an electrical safety certificate, potentially places the residents at risk. EVIDENCE: The manager was recently registered with the Commission for Social Care Inspection. She has recently achieved an NVQ3 and is starting a course for NVQ4 later in the year. The Registered Manager has a very “hands on” style and communicates her enthusiasm and commitment to her staff. She has begun some staff appraisals, based on training needs, and needs to extend this to a system of formal, recorded supervision. The home’s Statement of Purpose states that the home has an annual development plan and publishes the results of service user surveys. This does not in fact appear to be the case and Hilbre Court does not have a formal quality assurance procedure though the Registered Manager gets a lot of informal feedback from friends and relatives of the residents. She takes this information into account in running Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 19 their home but it is not a recorded system. The Registered Person visits the home at least every week but does not prepare a written report as required by the Care Homes Regulations. In view of the absence of a quality assurance system the Registered Person should forward copies of the reports made under Regulation 26 to the Commission for Social Care Inspection. Accidents are recorded in an Accident Book, but the individual pages should be removed from the book and filed together separately to enable the home to comply with the Data Protection Act. Fire safety checks are carried out but are not clearly recorded and the Registered Manager may find it helpful to use a new Fire Safety log book for this purpose. The home still does not have an electrical safety certificate despite this being required at the last inspection. This potentially puts the residents at risk and a safety certificate must be obtained without delay. A fire safety risk assessment has been completed. The Registered Person told the inspector that the Fire Prevention Officer had visited to assess the new extension and had required that a new roof be fitted and that the windows be made of reinforced glass. The written report was not available. The Registered Person must carry out the requirements of the Fire Safety Officer without delay. The kitchen and dry stores were well organised and clean. The Registered Manager may wish to discuss with the Environmental Health Officer using the new food safety procedures contained in ‘Better Business, Safer Food’. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x x 2 3 2 Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Requirement The Registered Person shall ensure that the home’s Statement of Purpose and service user guide are reviewed and amended to ensure that they contain all of the matters set out in the regulations. (Originally required in 2005). The Registered Person must keep the residents’ plans under review and should carry out such reviews at least once a month. The Registered Person must ensure that the home is conducted in a manner which respects the privacy and dignity of the residents and must therefore provide privacy screens for service users in shared bedrooms. (Originally required in 2005). The Registered Person must ensure that the premises are kept in a good state of repair and must therefore ensure that: * repair or replace the bedside DS0000018895.V290071.R01.S.doc Timescale for action 01/10/06 3. OP7 15 01/10/06 4. OP10 12, 16(c) 01/08/06 5. OP19 23 01/11/06 Hilbre Court Version 5.1 Page 22 cabinet and the base to one of the beds in the shared room on the ground floor; * replace the door on the wardrobe in room 9; * redecorate the bay wall in the main lounge; * repair the sideboard in the main lounge . In general, some of the bedroom furniture and décor is looking a little worn and should be replaced through a planned renewal programme to maintain the quality of the residents’ environment. 6. OP21 23(2)(j) The Registered Person must 01/10/06 ensure that wash-basins are fitted with an adequate hot water supply and must therefore arrange for the hot water supply to be adjusted to provide hot water within a reasonable time. The Registered Person shall 01/11/06 ensure that at all times staff are employed in such numbers as are appropriate for the welfare of residents and must therefore review staffing levels and ensure that sufficient, suitable staff are employed to prepare the residents’ meals without impinging on direct care of the residents.. 22/06/06 The registered shall not employ a person to work at the home unless the person is fit to do so and must therefore ensure that satisfactory CRB and POVA checks are carried out on all staff and no staff begin work at the home under any circumstances unless they have been checked against the POVA register. All other checks required by Schedule 2 to the Regulations DS0000018895.V290071.R01.S.doc Version 5.1 Page 23 7. OP27 18 8. OP29 19 Hilbre Court must be obtained. (Originally required in 2005). 9. OP33 24 The registered person must establish a system to review the quality of care provided at the care home at regular intervals. (Originally required by 30/01/06). The registered person must visit the home least once a month, prepare a written report on the conduct of the care home and supply a copy of the report of their findings to the Commission for Social Care Inspection. (Originally required by 30/04/06). The Registered Person must ensure that staff are appropriately supervised. 01/10/06 10. OP33 26 01/08/06 11. OP36 18 01/11/06 12. OP38 39(h) 13. OP38 23(4) The Registered Person shall give 22/06/06 notice in writing to the Commission for Social Care Inspection if the premises are to be significantly altered or extended. The Registered Person shall take 01/08/06 adequate precautions against the risk of fire and must therefore ensure that: * fire safety precautions required by the fire authority in respect of the dining room extension are carried out; * an up to date electrical safety certificate is obtained. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 24 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 Refer to Standard OP12 OP28 OP38 Good Practice Recommendations The Registered Person should consider the appointment of a dedicated activities organiser who does not have other care responsibilities. Steps need to be taken to increase the number of care staff with NVQ2 in order to meet the standard of 50 of care staff with this qualification (or equivalent). The Registered Manager should carry out a risk assessment on the transport of dirty laundry through the dining room to the new laundry facility. Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Hilbre Court DS0000018895.V290071.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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