Inspection on 26/09/06 for Holmdale Care Home

This inspection was carried out on 26th September 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Holmdale Care Home 18/07/07

Holmdale Care Home 15/11/05

Holmdale Care Home 24/02/05

Holmdale Care Home 10/08/04

Holmdale Care Home 03/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Holmdale Care Home 2a Companys Close Weston Village Runcorn Cheshire WA7 4NA Lead Inspector Maureen Brown Key Unannounced Inspection 26th September 2006 09:25 Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmdale Care Home Address 2a Companys Close Weston Village Runcorn Cheshire WA7 4NA 01928 581448 01928 589946 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) www.c-i-c.co.uk. Community Integrated Care Julie Ann Bradshaw Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of six service users to include: * Up to 6 service users in the category of LD (Learning Disability) excluding dementia. 15th November 2005 Date of last inspection Brief Description of the Service: Holmdale is a residential care home providing personal care for 6 adults with learning disabilities. At the time of this visit 4 adults were living at Holmdale. Holmdale is owned and managed by Community Integrated Care, a not for profit organisation. The home is located in the Weston Point area of Runcorn, near to a local shop and pub. Car parking is available to the front and side of the building. A small garden and patio area to the rear are fully accessible to the service users. The staff team comprises of a registered manager who is supported by a deputy manager, ten support workers and a cleaner. The home is a purpose built dormer bungalow with only staff facilities upstairs. Residents’ accommodation is on the ground floor. All the bedrooms are single with fitted bedroom furniture. There are no en-suite facilities. There are two assisted bathrooms plus a separate assisted toilet within easy reach of bedrooms and day areas. There is a large lounge/dining room, a kitchen and a utility room. The fees at Holmdale range from £329.00 to £357.20 per week. Fees are calculated on individual assessment. Optional extras include CD’s, Videos, DVD’s, holidays, magazines, clothing, toiletries and hairdressing. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited without an appointment on 26 September 2006. The visit took six and a half hours. The inspector spent an hour planning the visit, which was part of the key inspection. Information reviewed included: • • • The previous inspection report; Service history; and Other information received about the service since the last inspection on 15 November 2005. The site visit included a tour of the communal areas and some bedrooms, inspection of records and discussions with residents, the registered manager and the support workers on duty. Twenty-six out of forty-three standards were assessed and most were met. All the key standards were assessed. Requirements made at the previous inspection had been met. None of the service users have verbal communication skills. Staff interpret body language to ensure service users needs are met. Surveys were made available for service users, relatives and other professionals to complete. Three service user surveys and one relative survey had been received. Staff commented that “ the support given by the deputy manager has been excellent”, “the team work well together”, “I have enjoyed the NVQ training” and “the residents are well looked after”. Service users and relatives commented that “I can do what I want each day”, “I would let a member of staff know if I was not happy”, “staff are aware of the non-verbal cues” and “the service users are well cared for”. Feedback was given to the deputy manager at the end of the site visit. What the service does well: Overall, the home had met most of the National Minimum Standards and the quality rating for Holmdale is good. • The home has an established staff team who are keen for high standards to be maintained. This meant that the staff team was adequately meeting the complex needs of the residents. Residents’ care plans and case notes were well documented and reflected the individual residents’ needs. This meant that residents were well supported by the staff team. DS0000005143.V307866.R01.S.doc Version 5.2 Page 6 • Holmdale Care Home • The home maintains good standards within the home. This meant that residents were living in an adequate environment and checks were in place to show that residents and staff safety was protected. The staff managed daily activities and entertainments well and residents confirmed that they were pleased with the choices on offer. • What has improved since the last inspection? The previous requirements made had been met at the time of this site visit. These included: • All residents’ health care needs were being met and regular check-ups had been undertaken. This had improved the quality of healthcare being received by the residents. Half the care staff were now qualified to NVQ level II in care. Two other staff were undertaking NVQ level II at the time of this visit. This meant that well-trained staff supported residents. • What they could do better: Overall, the home was meeting most of the National Minimum Standards. However there were some things that were seen that could be done better to ensure the residents were fully supported. • The statement of purpose and service users guide should be kept under review so that service users and their representatives have up to date information with regard to the home. The views of service users and their representatives must be taken into account regarding the running of the home. So that the service delivery is led by the service users views and therefore have an impact on the service provided. The accident and incident records must be held in line with the Data Protection Act 1998, to ensure that people’s identity remains confidential. Annual review plans should be produced in respect of health care issues for each service user. To ensure that annual appointments are kept up to date. Annual staff appraisals should be carried out to ensure that staff are well supervised. • • • • Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 7 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. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. Sufficient information is provided for residents to make a decision about moving into the home. EVIDENCE: Information about the home was in the statement of purpose and function and residents’ guide, which was available within a bound folder. A copy was available by the front door. The information included details of the mission statement and philosophy of care, role of the key worker, staff structure and terms and conditions of residence. The last inspection report was included. Throughout this folder were photos of residents and staff taking part in various activities. The information provided a full picture of the home. A requirement was made with regard to reviewing the statement of purpose and service users guide. The deputy manager said each resident is assessed prior to admission and this information forms the basis of the person’s plan of care. Records showed that residents were assessed prior to admission and most residents had lived at the home for many years. This assessment ensures that resident’s needs could be met by the home. Visits prior to admission are documented and these started with short visits and lead to overnight stays. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. Residents and relatives were satisfied with the support they received from the manager and staff. EVIDENCE: Samples of two residents’ files were seen. These were presented in individual ring binders and contained all the information necessary for staff to care for the residents. Included is a copy of the terms and conditions of residence, care plan sheets and risk assessments. The care plans were written in consultation with the residents and their families and were based on their assessed needs and risks. These were reviewed on a monthly basis. A relative comment sheet showed their knowledge and involvement in the care plan process. Care plans were accurate, well recorded and documents were kept safe and secure in a locked cupboard. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 15, 16 & 17 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. Residents’ were able to take part in a range of activities. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: The residents’ plan reflects the range of activities undertaken which included a “lifestyle” programme of mainly daily living activities, such as baking, beauty treatments, videos, DVD’s, listening to music, passive exercise, sensory stimulation and individual time with staff members. Activities outside the home included shopping, visits to the cinema, bowling, meals out, visits to the hydrotherapy pool, holidays, going for walks and visits to the local pub. On the day of this visit the residents went out to Marina Village and along the canal side. Daily routines of residents were clearly documented in the care plans seen and the plans were well written. Residents access the local community with their own adapted transport. Staff said that some residents received visits from family members and that they enjoyed these visits. Residents could see visitors within their own room Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 12 or in the shared living areas. No separate space is available for this purpose. At the moment the home has two vacancies. The deputy manager said that they had been using one of the bedrooms as another lounge or activity room and this had proved very popular. She confirmed that a proposal to Community Integrated Care for a change of use for this room had been submitted. During a tour of the home some residents were seen spending time alone in their rooms whilst others were enjoying social contact with others in the lounge/dining area. Educational needs of service users had been addressed. Contact with local colleges confirmed that they had not been able to offer suitable courses. However, the local visual impairment team had visited and provided “victor readers” with a wide choice of novels. Residents confirmed they had “enjoyed listening to the books”. Also the residents were involved in “SPACE”, which is a building that has ball pools, bubble tubes, large snoozelum and other activities. One-hour sessions are booked and at present on a monthly basis. All residents attend. Residents spoken to said, “it was great there”. A two-week menu of meals was seen. These showed a diet with a variety of meat, fish and cheese was provided to residents. Fruit and vegetables were provided in a variety of ways, for example, mango and papaya smoothie, strawberries and yoghurt, roasted vegetables and homemade soup. Support workers prepared the residents meals. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 the following standard(s): 18, 19 & 20 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Residents were dressed differently according to their own choice. Personal support was provided in private and the residents had a designated key worker. All aids and adaptations required for the residents were provided. Various types of equipment were available for residents’ support and use, such as tracking equipment in the bathroom and a shower and changing trolley. Visits to health professionals were recorded in the care plans, including visits to GP’s, opticians, chiropodists and dentists, which were now up to date following a previous requirement. A new annual review plan was seen on one care plan. This enabled staff to monitor when annual appointments were due. It is recommended this be completed for all residents. The deputy manager said a carer always attended appointments with residents. The medication system is kept in a locked steel cupboard within a kitchen cupboard. A monitored dosage system was used and all medication was stored appropriately. The medication administration sheets seen were signed and up Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 14 to date. Drugs are returned on a monthly basis. Staff are trained in medication awareness. Staff files examined showed medication training undertaken. A medication policy, patient leaflets and guidance for medication to be taken when required were available. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. Residents and relatives were satisfied with the support they received from the manager and staff. Clear policies and procedures were in place to ensure that residents were protected from abuse, neglect and self-harm. EVIDENCE: The home’s Protection of Vulnerable Adults Policy was seen and this was consistent with the “No Secrets” guidance from the Department of Health. A copy of the Local Authority Adult Protection policy was available within the home and accessible to staff. The home’s whistle blowing policy was seen. The deputy manager said that staff had undertaken training on Adult Protection, which was covered by a video, talks and the staff reading the Protection of Vulnerable Adults policy and guidance. Staff confirmed that they had received this training, and were able to demonstrate what to do if there was a suspicion of abuse. This was also covered in the induction process. The complaints procedure was seen and this contained details of the Commission and the ombudsman. CSCI or the home had not received any complaints since the last inspection. Service users confirmed they would contact the manager if they had any problems. This was also confirmed through surveys provided by relatives. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. The home provides a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style with additional equipment such as grab bars in toilets and bathrooms, rails along corridors and moving and handling equipment provided to meet each person’s needs. The décor in bedrooms was to resident’s personal tastes and preference and the residents and staff confirmed this. During the tour the kitchen was visited. This was clean and tidy. Records were seen of fridge, freezer and hot food temperatures. This ensures that correct temperatures are being maintained. One bedroom was in the process of being decorated ready for a new person to be admitted. The home was clean, tidy and free from unpleasant smells. The garden area in general was neat and tidy. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. Records were maintained in a satisfactory manner and service users are protected by the homes recruitment policy and practices. EVIDENCE: At the time of this inspection the agreed staffing levels were met. One person was on duty in the home at the time of this inspection and three residents were out with staff members. The deputy manager said that a member of staff is on waking duty each night. The staff team was well established. They had a range of experience and this was complimented by mandatory courses undertaken, such as moving and handling and food hygiene. Other relevant courses were also available, such as Adult protection and Cerebral Palsy. Five out of ten staff had completed NVQ level II and two staff were working towards this award. The deputy had completed NVQ level III. The manager had the Registered Mangers Award. The recruitment procedure ensures that the staff are suitable to work with vulnerable people. Four staff files were examined and these showed that all relevant pre-employment checks were carried out. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 18 Staff meetings were held on a regular basis. The last one was held on 14 August 2006. Issues discussed included care reviews, welcoming new members, training, health and safety, staff issues and service users holidays. The previous staff meeting was held on 21 June 2006 and was attended by five staff. The manager also attends managers meetings and feeds this information back to the staff team. The last meeting was on 25 July 2006. Day to day supervision of the staff team is good. Staff commented that they received good support from the deputy manager. Formal supervision was up to date and records were seen. It was recommended that annual appraisals should be undertaken with the staff team. At the time of this visit the Deputy Manager was in charge of the home. She stated that following a period of sick leave the registered manager had submitted her resignation. CSCI were waiting for formal notification of this and procedure that would be in place during the absence of a manager. During discussions with the staff team they said, “the atmosphere at Holmdale is relaxed and there are lots of different activities for service users to do”, “had good support from the deputy manager”, “I enjoy my work” and “it is very rewarding”. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42 Quality in this area outcome is adequate. This judgement was made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are not currently obtained and do not influence the running of the home. Fully supervised staff support service users. The deputy manager provides clear leadership to the staff team EVIDENCE: Safe working practices were in place to ensure the health, safety and welfare of the residents. These included visits from the fire safety officer and the environmental health officer, which had been completed satisfactorily. The gas safety, electrical safety and insurance certificates were in place and up to date. Fire alarm tests were being undertaken on a weekly basis and records kept. Emergency lighting tests were also being carried out on a monthly basis with records kept. All staff had received fire awareness training. Accident and incident record books were seen. These were not in line with the Data Protection Act 1998. The information within the records could be seen by Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 20 other parties and is therefore not confidential. New books in line with the Data Protection Act were available but not used. A requirement was made to use these in future. The deputy manager does provide clear leadership to the staff team. Day to day supervision appears to be good and the staff team confirmed the deputy gives good support. A selection of policies and procedures were examined. These were up to date. A quality assurance process was in place. Discussions regarding this were held with the deputy manager. The process had not been undertaken for some time (December 2004). The company completed this, rather that specifically at the home. The results of the survey indicated that service users were happy with the care they received and the food and premises were good. Relatives confirmed they were happy with the care provided and staff said they were also satisfied with their role. A requirement was made to ensure that the management takes the views of service users and their representatives into account regarding the running of the home. Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 3 3 2 X Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 22 No 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 YA1 Regulation 6(a) Requirement Timescale for action 30/12/06 2. YA39 24 (2)(b) 3. YA42 17(2) Sch.4 (12(a, b)) The registered person must ensure the statement of purpose and service users guide is kept under review. The registered person must 30/12/06 ensure that the views of service users and their representatives are taken into account regarding the running of the home. The registered person must 30/12/06 ensure that accident and incident records are held in line with the Data Protection Act 1998. 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. Refer to Standard YA19 YA36 Good Practice Recommendations The registered person should ensure that annual review plans are produced in respect of health care issues for each service user. The registered person should ensure that annual staff appraisals are carried out. DS0000005143.V307866.R01.S.doc Version 5.2 Page 23 Holmdale Care Home Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holmdale Care Home DS0000005143.V307866.R01.S.doc Version 5.2 Page 24 - 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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