Inspection on 11/08/05 for Holmewood EMI Resource Centre

This inspection was carried out on 11th August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holmewood EMI Resource Centre 18/10/07

Holmewood EMI Resource Centre 10/11/06

Holmewood EMI Resource Centre 09/03/06

Holmewood EMI Resource Centre 15/03/05

Holmewood EMI Resource Centre 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Holmewood EMI Resource Centre 67 Fell Lane Keighley West yorkshire BD22 6AB Lead Inspector Steve Marsh Unannounced 11 August 2005 th 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. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Holmewood EMI Resource Centre Address 67 Fell Lane Keighley BD22 6AB 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) 01535 602997 01535 691095 City of Bradford Metropolitan District Council Dept of Social Services Denise Hurd Care Home Only 32 Category(ies) of Dementia (2) Dementia Over 65 (30) registration, with number of places Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/03/05 Brief Description of the Service: Holmewood Resource Centre is situated in a residential area of Keighley about one mile from the town centre. The home is run by the Local Authority and provides long-stay, short stay and respite care for peope with a diagnosis of dementia or a dementia type illness. There is also a day centre within the resource centre, which at present is not required to be registered or inspected by the Commission. Care is provided on two levels, in four separate units (three long-stay) each with a designated staff team. Each unit has a communal lounge/dining room and toilet/bathroom facilites are conveniently located throughout the building. The home is on a main bus route and there is parking to the front of the property. There is ramped access to the main door of the home and a passenger lift available to the bedrooms and other facilities on the first floor of the building. The home stands within its own grounds and there is a well established sensory garden for the residents to enjoy during the summer months. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection visit for the year 2005/06, and was carried out by one Inspector over a period of approximately eight hours. The last inspection of this service was in March 2005 and the main purpose of this visit was to assess the homes progress in meeting the requirements and recommendations made at that time. The methodology used in this inspection included the examinations of records, observation of work practices, discussion’s with service users, visitors and staff and a tour of the building. Due to their illness (dementia) some residents were unable to express their views and/or opinions about the home, however those that were able felt that the staff team provided a very good standard of care. Comment cards were provided for the service users and/or their relatives to enable them to share their views of the service with the Commission. Comments received in this way will be fed back to the registered manager of the home without revealing the identity of the respondent. This was the Inspectors first visit to Holmewood Resource Centre and therefore he would like to take the opportunity to thank the assistant unit manager, members of the staff team, residents and visitors who participated in the inspection process for their co-operation. Feedback was given to Mrs Christine Harrison (assistant unit manager) at the end of the visit. Requirements and recommendations from this inspection are detailed at the end of the report. What the service does well: The home provides a safe, pleasant and comfortable environment for the service users and the staff team are approachable and have a genuine understanding of their needs. The admission procedure for the home is thorough and the manager will not admit service users unless she feels that the staff team can provide the level of care/support they require. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 6 The service users healthcare needs are met, and any problems are identified at an early stage and a referral made to the appropriate professional agency i.e. general practitioner, district-nursing service. Members of staff encourage the service users to make as many decisions as possible in relation to their daily lives and activities/outings are organised in line with their wishes. There is a commitment to providing staff training, both to meet the needs of the service users and for personal development, which represents good practice. What has improved since the last inspection? What they could do better: The manager needs to ensure that all care plans are reviewed monthly and are signed and dated. Nutritional assessments must be completed for all new admissions to the home, especially when there are concerns regarding weight loss or poor appetite. Members of the senior staff team need to be more vigilant when giving medication and ensure that the medication administration record sheet is signed or coded. In addition a stock control system needs to be put in place for all common remedies. To meet the National Minimum Standards the registered manager of the home needs to have achieved a National Vocational Qualification (NVQ) at level 4 in management and care (or equivalent) by the end of 2005. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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 Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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) 1,3,4,5 Service users and/or their relatives are provided with sufficient information to enable them to make an informed decision about the home. The admission procedure is good and includes pre-admission assessment visits, introductory visits and trial periods if appropriate. EVIDENCE: The assistant unit manager confirmed that there had been no changes to the homes statement of purpose and a copy of the new service user guide was made available to the Inspector on the day of the visit. The records examined provided evidence that pre-admission assessment visits are carried out to see prospective service users either in their own home or temporary place of residence, and the needs identified during this visit are reflected in their initial care plan. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 10 The assistant unit manager confirmed that all referrals to the home continue to come through the Care Management Team and quite often, prospective service users are already known to the staff, having previously attended the day centre. Allocation meetings are held for long-stay beds but direct referrals are taken for short stays and respite care placements. All long-stay admissions are therefore planned, however the home does respond to crisis situations and will take emergency admissions into respite care beds providing the staff team are able to meet their needs. In addition to the pre-admission assessment visit, service users and /or their relatives are also invited to visit the home prior to admission to view the accommodation, meet the other service users and staff and stay for a meal if they wish to do so. Relatives spoken to confirmed that the staff had been very helpful when they had initially visited the home, had shown them around, answered any questions and provided general information about the care/services provided. Long-stay service users are also able to move into the home for a trial period to enable them and/or their relatives make an informed decision about their future care. It is however acknowledged that for some service users diagnosed with dementia this might not always be appropriate as they may actually become more confused or disorientated. The trial period usually lasts for about six weeks, following which a review meeting is held and the placement discussed with all parties involved in the referral/assessment process including the service user (if appropriate) and their relatives. Staff training continues to be encouraged at the home both to meet the needs of the service users and for personal development. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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) 7,8,9,10 Records and reports about the service users welfare show that their healthcare needs are met and any problems are identified at an early stage and a referral made to the appropriate professional agency i.e. general practitioner, district nursing service etc. However, the staff must be more vigilant when completing care plans and ensure that all relevant information is recorded, and they are reviewed at least monthly in line with the National Minimum Standards. The manager also needs to ensure that senior members of staff follow the correct procedures when administering medication to safeguard the service users. EVIDENCE: Care plans have been completed for all service users and there is sufficient evidence in the documentation to show that residents (if appropriate) and/or their relatives are involved in the care planning process. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 12 It was however noted that some entries in the care plans had not been signed or dated and for one recently admitted service user no nutritional assessment had been completed on admission even though there had been recent concerns about their weight and poor diet. In addition it was also noted that the care plan had not been reviewed monthly as required and therefore these matters must be addressed. All service users are registered with a general practitioner and have access to the full range of NHS services. Service users who do not live in the area but are admitted to the home for respite care or a short stay are registered with a local practice on a temporary basis unless their general practitioner will travel to see them The home also works closely with the Mental Health Team based at Airedale Hospital and other healthcare professionals. At the present time one service user is receiving treatment from the district nursing service for a pressure sore, and the care plan in place indicated that a pressure-relieving mattress had been provided as required. Relatives spoken to on the day confirmed that prompt medical attention was always received by the service users if they were ill, which they found very reassuring. Relatives also said that they were kept informed of any changes in the service users general health and were given the opportunity to meet healthcare professional involved in their care if they wished to do so. All medical examinations are carried out in the service users own bedroom, and it was obvious through observation and discussion with the staff that they treat the service users with respect, and maintain their dignity when assisting them with personal care. On reviewing the medication system in place, discrepancies were noted on all four units whereby staff had not signed or coded the medication administration record (MAR) sheet correctly. In addition a stock control system must be started for all common remedies held at the home. The assistant unit manager confirmed that the staff team continue to monitor the general health of service users taking long-term medication and the pharmacist and/or their general practitioner are contacted if concerns are raised. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 13 Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 14 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) 12,13,15 The home offers a range of social and leisure activities and service users are encouraged to make informed decisions about their lifestyle within the limitations of their illness. Meals appear nourishing and take into account the likes and dislikes of the service users. EVIDENCE: The daily routines of the home appear flexible and are based around the needs of the service users. The home employs two activities co-ordinators one being based in the day centre and one having the responsibility of provided activities for the services users living at the home. Service users living at the home on a long or short term basis are however able to use the facilities in the day centre if they wish to do so, and the centre is also used by them in the evenings and weekends for social events and entertainment. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 15 On the day of the visit the monthly church service was being held in the day centre for the service users and the assistant unit manager confirmed that religious leaders from all denominations visit the home on a regular basis. In addition the home would also make arrangements for service users to attend church if they wished to do so. A mini bus is based at the home and is used for outings to places of interest etc when not required by the day care service. Service users and relatives spoken to appeared very happy with the level of activities/outings organised and felt that with the exception of nursing care the home provided the complete care package for people diagnosed with dementia or a dementia type illness The assistant unit manager confirmed that the home has strong links with the local community and the service users use the shops and other facilities in the area and support community events. Relatives and friends are welcome to visit the home at any time but are asked to try and avoid mealtimes if possible. Relatives confirmed that they were able to see the service users in their own rooms if they wished to do so and were always made to feel very welcome and offered light refreshment. The meals at the home where described by the service users as very good and they confirmed that an alternative was always offered if they did not like what was on the menu. Service users requiring assistance/prompting with their meals receive the support needed to ensure that they eat a nutritious and balanced diet. Hot and cold drinks are freely available to the services users both day and night. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 16 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) 16,18 Robust complaint and adult protection policies and procedures ensure that the service users are listened to, and protected from any form of abuse. EVIDENCE: The home has a complaints procedure and relatives spoken to said that they were aware of the procedure and knew what to do if they were unhappy with the care /service provided. The assistant unit manager confirmed that no complaints had been received since the last inspection visit. Policies and procedures are in place at the home in relation to adult protection and there is an ongoing programme of staff training provided by the Bradford Social Services Workforce Development Unit. Members of staff confirmed that they were aware of the homes policy on “whistle blowing” and their responsibility to safeguard the service users from all forms of abuse. The assistant unit manager is also aware of the Protection Of Vulnerable Adults register and the implications this has had on the homes staff recruitment, selection and disciplinary procedures. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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) 19,20,21,22,24,26 The home provides a pleasant and safe environment for the service users and there is an ongoing programme of refurbishment and renewal to ensure that the present standards are maintained. EVIDENCE: Both internally and externally the home is well maintained and the assistant unit manager confirmed that there is an ongoing programme of refurbishment and renewal. As previously mentioned in this report the home is split into four separate units (wings) each unit providing accommodation for eight service users in both single and double bedrooms. In addition each wing has a well furnished communal lounge/dining area and well equipped bathroom and toilet facilities. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 18 Bedrooms are pleasantly furnished and the service users are encouraged to bring personal possessions in to the home to make their rooms look homely and individual. Residents and relatives spoken to said that they where very happy with the standard of accommodation and found that the small group living arrangement worked well. On the day of the visit there was an odour problem on the short stay/respite care unit, however, this had been caused by a service user leaving the taps on a few days earlier causing some carpets to suffer water damage. This matter was being dealt with on the day of the visit and preparations where being made to have the carpet professionally cleaned or replaced. With the exception of the above all areas of the home were clean and tidy and no unpleasant odours were noted. Handrails are provided on corridors and staircases to assist more frail service users and grab rails are provided in bathrooms/toilets as required. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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) 27,28,29,30 Service users are supported and protected by a robust staff recruitment and selection procedure, which includes Criminal Record Bureau checks. Staff numbers and the experience/skill mix within the staff team ensure that the needs of the service users are met. However, the manager must ensure that the number of staff on wakeful night duty is increased to three to safeguard the service users. EVIDENCE: A rota for the week of inspection was taken which showed that sufficient care staff are employed on day duty to meet the needs of the service users. However, the Commission still has concerns regarding the night staffing arrangements at the home, and require that a minimum of three wakeful night staff are employed, instead of the present arrangement of two wakeful night staff and a senior member of staff being on-call from home. The assistant unit manager confirmed that the organisation is presently restructuring and it was anticipated that the night staffing arrangement would be addressed as part of this restructure. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 20 Cleaning and catering staff are employed in sufficient numbers to ensure that the service users dietary needs are met, and the home is kept clean and free from unpleasant odours. The staff recruitment and selection procedures are thorough and the home is supported by the Bradford Social Services Human Resource Department when dealing with staffing issues. The assistant unit manager confirmed that all new members of staff receive induction and foundation training, and then study for a National Vocational Qualification (NVQ) at level two or above depending on the post they hold. At the present time sixteen members of the care staff team have achieved a NVQ at level two and further members of staff are studying for the qualification. Additional training both to meet the needs of the service users and for personal development is also encouraged and the staff training records reviewed gave clear evidence of the homes commitment to training. Members of care staff spoken to also confirmed that the Social Services provided very good training opportunities and the manager always supported them when applying to attend training courses. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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) 31,32,33,36,38 Although the manager is not going to study for a National Vocational Qualification (NVQ) because of her impending retirement, she is very competent and has the skills and experience to affectively manage the home. Policies and procedures are in place to ensure the health and safety of the service users, visitors and members of the staff team. EVIDENCE: Mrs Denise Hird is the registered manager of the home and she communicates a clear sense of direction and leadership to the staff team. However, although a very competent manager Mrs Hird has not commenced studying for a National Vocational Qualification in management and care, the recognised qualification for the post she holds, as she is looking to retire within the next year. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 22 Members of the staff team confirmed that Mrs Hird has an approachable and open management style and supports them in their work. Staff also said that there was a good atmosphere at the home and all members of staff worked together for the benefit of the service users. To ensure that all members of staff are kept informed of any changes within the home/organisation, staff meetings are held on each of the four units approximately every eight weeks and full staff meetings are held as and when required. In addition all members of care staff receive one-to-one formal supervision on at least a two monthly basis in line with the National Minimum Standards. Relatives also confirmed that they were kept informed any changes, which affected the running of the home and a carer group meetings are held at regular intervals throughout the year. Bradford Social Services has recognised quality assurance monitoring systems in place, however it was recommended to the assistant unit manager that the home not only seek the views and opinions of the service users and/or relatives but also other professional who access the service i.e. social workers, general practitioners, district nurses etc. The assistant unit manager was reminded that results of any survey carried out by the home should be made available to all interested parties including the Commission. Policies and procedures are in place to ensure the health and safety of the service users, visitors and staff and are audited and reviewed on a regular basis to ensure that they meet with present legislation. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 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. 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 x 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 4 3 x x 3 x 3 Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 24 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 OP7 Regulation 15 Requirement The registered manager must ensure that all care plans are reviewed at least monthly. All entries in the care plans must be signed and dated. The registered amanager must ensure that nutritional screening is undertaken for all service users on admission. The registered manager must ensure that senior members of the staff team sign or code the medication administration record sheets appropriately. A stock control system is required for all common remedies held at the home.. The registered provider must ensure that three members of wakeful night staff are on duty at all times, to ensure that the service users are not placed at risk. The registered provider must ensure that the registered manager obtains a National Vocational Qualification (NVQ) at level four in management and care (or equivalent). Timescale for action 30/09/05 2. OP8 12 3. OP9 13(2) Immediate as agreed on day of inspection. Immediate as agreed on day of inspection. 4. OP27 18 31/10/05 5. OP31 9(2) 31/12/05 Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP33 Good Practice Recommendations Quality assurance surveys should include not only the views and opinions of the service users and/or their relatives but also other stakeholders in the community. Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Aire House Town street Rodley Leeds LS13 1HP 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 Holmewood EMI Resource Centre J52 J03 S33522 Holmewood V185521 140705 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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