Inspection on 10/08/07 for Holmwood

This inspection was carried out on 10th August 2007.

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 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

Holmwood 05/08/08

Holmwood 21/12/06

Holmwood 27/07/06

Holmwood 11/03/06

Holmwood 04/08/05

Holmwood 21/03/05

Holmwood 10/06/04

Holmwood 17/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Holmwood 39 Chine Walk West Parley Ferndown Dorset BH22 8PR Lead Inspector Anne Weston Key Unannounced Inspection 10th August 2007 11:00 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 Holmwood DS0000026820.V348163.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 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. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmwood Address 39 Chine Walk West Parley Ferndown Dorset BH22 8PR 01202 593662 NO FAX 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) Mrs Margaret Anne Gallagher Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 double rooms Date of last inspection 21st December 2006 Brief Description of the Service: Holmwood Care Home is owned and managed by Mrs Gallagher, it is registered to accommodate a maximum of 13 older people in nine single and two double rooms. The home normally operates with all rooms occupied singly. Nine of the bedrooms, all with en-suite baths or showers, are situated on the ground floor; the remaining two rooms are located on the first floor. The communal lounges and dining room are on the ground floor. There is no passenger lift or stair lift so those people accommodated on the first floor need to be mobile enough to manage the stairs. The home usually accommodates the more independent person, although full time care is provided. The back garden has established shrubs, hedges and trees providing a sheltered environment. There is garden seating on the patio. The front garden has mature trees and shrubs; a gravelled car parking area is available for visitors and staff to use. The home is situated in a quiet road a short drive away from the centre of Ferndown, which has a good selection of shops and local amenities. The fees per week are: £375 - £495 For interested consumers the web link to the Office of Fair Trading which is concerned with value for money and fair terms of contracts is: www.oft.gov.uk Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit to the home on the 10th August 2007 was carried out as part of a statutory key inspection which included a review of two previous recommendations. The inspection visits covered two days, the visit on the second day, the 23rd August 2007 was announced, the inspection process took a total of 18.5 hours. The premises were inspected, this included communal areas and a sample of bedrooms. A range of records and related documentation were examined. Time was spent in discussion with the owner, Mrs Gallagher and also with care staff. At the time of the inspection ten people were accommodated in the home, nine of these people were spoken with, both in the lounge and in their own rooms. The Annual Quality Assurance Assessment (AQAA) has not been submitted. What the service does well: Holmwood provides a homely, relaxed and friendly environment. Care staff were observed treating people with courtesy and kindness, there were enough staff on duty to meet peoples’ needs. Examples of experiences from different people included: “Staff quite pleasant” “I like living here” “The staff are very nice, very good to me, if I need anything staff will get it” “I’m quite happy and satisfied” Assessments of care needs were carried out with people before they moved into the home and people were assured that their care needs would be met. The home meet the care needs of people who have low dependency needs. Medication policy and procedures ensure the safety of people is promoted. Open visiting arrangements are in place, visitors felt welcomed into the home. Areas available to people are generally clean and well maintained. Peoples’ rooms are homely, comfortable and well personalised. The food in the home is of satisfactory quality and meets the dietary needs of people. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 6 People can be confident that their complaints will be listened to and acted upon. Quality assurance systems are in place with annual data gathered to monitor the quality of the service. What has improved since the last inspection? What they could do better: Care plans need improving as some important information about specialist care needs was missing on some of the care plans. This meant care staff did not always have the necessary information to enable them to provide people with the right care. Discussion was held with Mrs Gallagher about the importance of using care plans as daily working documents that give clear direction to care staff about how they need to deliver care. The home are putting some people who have medium to high dependency needs at risk by not properly identifying their health and social care needs and not showing how specific health needs are being met. The home must ensure there is increased consultation with people about their opportunity to be involved in more meaningful daytime activity. Some staff said they did not remember receiving training on safeguarding adults. It is important for all staff to receive updated safeguarding adults training so that they are enabled to recognise signs and symptoms of abuse and know how to deal with any suspicion or allegation of abuse. There is no comprehensive training plan and some important training in relation to health and safety and food hygiene was out of date. This is important to be put right so people who use the service can be confident that there is a competent well trained staff team. The laundry area is below standard. Infection control procedures in relation to the laundry area, including hand decontamination facilities must be addressed as a matter of priority. Incorrect handling and laundering can pose an infection hazard. One en-suite shower facility was not in working order. This must be repaired. The poor recruitment practices are a matter of serious concern. Mrs Gallagher is advised to read the CSCI ‘Safe and Sound’ report which highlights the importance of robust recruitment and vetting practices. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 7 The shortfalls in staff training, recruitment and record keeping are a matter of serious concern. Consideration will be given to taking enforcement action if training standards, recruitment practices and record keeping continue to be poor. 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. The summary of this inspection report can be made available in other formats on request. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Assessments of care needs were carried out with people before they moved into the home to make sure their care needs were identified and could be met by the home. EVIDENCE: Discussion was held with one person (and their visiting relative) who had recently moved into the home. This discussion and examination of care records showed that Mrs Gallagher had visited this person and their relative at home to carry out an assessment of their care needs. This meant Mrs Gallagher was able to assure the person and their family that the home would be able to meet their identified care needs. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 10 Mrs Gallagher confirmed she always carries out a care assessment with people before they move into the home. Mrs Gallagher talked about the assessment as an ongoing process and said that information about individual preferences and daily living choices continued to be gathered when a person had moved in and was getting used to living in the home. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans and health care practices do not always promote safe care, potentially placing people at risk. Medication policy and procedures ensure the safety of people is promoted. People felt comfortable with the staff approach and were generally satisfied with the way that staff delivered their care and respected their dignity. EVIDENCE: The care records of three people were examined and discussion was held with Mrs Gallagher about care planning. Care plans did not always show the changes with individual care needs and did not give information on how individual needs were being monitored. For example with one person there was a lack of information about their confusion and how this impacted on their behaviour. There was a lack of information about another person who had special needs in relation to skin care. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 12 People have access to health care services. Care records evidenced visits by health professionals. One person was receiving regular visits from the community nursing service so a particular health need could be properly managed. There was no record of how health care was being delivered by the home, under instruction from the community nursing service, to show the person was receiving the right care in relation to their skin condition. Most people living in the home have low dependency needs, these people said they generally receive the care and support that they need. The home operates a monitored dosage system for dispensing medicines from Boots who provide support and advice with medication systems. Medicines were securely stored. A sample of printed Medication Administration Record charts were examined. Records were well maintained showing receipt and administration of medicines, any allergies were properly recorded. People said that that staff were kind and staff were observed to be interacting with people in a friendly and caring manner. Refer to the summary for examples of peoples’ experiences. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The activities programme needs development so that people are offered the opportunity to pursue individual interests. Open visiting arrangements are in place, people are able to maintain contact with visitors, as they wished. The flexibility of the home gives people control over the things which matter to them. A balanced repetitive diet is provided with choices offered. EVIDENCE: People said that there were not a lot of activities, there was bingo once a week. One person said that “It is boring being on your own so much, there is bingo, I always join in”. This person said they would enjoy a quiz. Discussion was held with Mrs Gallagher about the lack of activities, she was advised that improvements need to be made with involving people in meaningful daytime activities of their own choice, and according to their individual interests and capability. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 14 Observation and contact with people and a visiting relative confirmed that people maintained contact with friends and family, as they wished. Visiting is open and flexible and visitors are welcomed into the home. One person talked about their days out that they enjoyed with their daughter. People confirmed they are able to exercise choice in their daily living routine, for example choosing to spend time in their own room or in the communal areas. One person explained that “You can do your own thing”. Examples of people’s experiences about food included: “Food is adequate” “Food quite good, but basic” “My favourite is roast” “I’m quite happy with the food” “Food is like a boarding house – it’s edible” Much discussion was held with Mrs Gallagher about provision of food. She said how hard she tries to provide a variety and range of choice and showed the tea time menu which had a range of choices. She said that a roast dinner is a favourite with people so a roast is provided about three times a week. There was evidence from observation and from food records that individual preferences were catered for, for example one person did not like the main pudding of the day so had their preferred option of a banana, another person did not have any gravy with their roast chicken dinner as this was their preference. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can be confident that their complaints will be listened to and acted upon. People are not fully safeguarded as not all care staff demonstrated that they had received training in the prevention of abuse. EVIDENCE: The home has a complaints procedure and people said they would feel able to complain to Mrs Gallagher if they were not satisfied. One person said if they had a complaint they would speak to their daughter who would help deal with anything that was wrong. The home have not received any written complaints, Mrs Gallagher said any areas of dissatisfaction are resolved daily. The Commission has received one complaint, this related to unmet health and personal care needs. Requirements have been made to make sure that the home addresses shortfalls with health and personal care needs. The home had received a number of compliments thanking Mrs Gallagher and the staff for their care and help. The home has a policy on adult protection. Discussion with some staff members demonstrated they did not remember receiving training in relation to safeguarding adults. The importance of refresher training for staff was Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 16 discussed with Mrs Gallagher who confirmed she will arrange for all staff to receive updated safeguarding adults training. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained with the exception of the laundry area which is below standard. EVIDENCE: Improvements with the environment noted during the previous inspection have been sustained. People expressed satisfaction with their rooms which were well personalised according to individual preferences. For example one person said “I love my room it’s bright all day, it’s lovely”. Discussion was held with Mrs Gallagher and staff about smoke free premises, they all confirmed that staff are not allowed to smoke in the home and that staff smoked outside. A smoking policy is in place. Mrs Gallagher talked about her plans to have a driveway put in. One room had an en-suite shower which was not in working Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 18 order. The patio area had weeds growing through the paving and was unswept and unkempt. This was brought to the attention of Mrs Gallagher and she was advised to make sure that this neglect is rectified so that the grounds are kept tidy and attractive. Contact with Dorset Fire and Rescue Service showed that they had carried out a fire safety audit on 13 August 2007 which showed satisfactory fire safety standards were being maintained. Care staff carry out cleaning as part of their duties, inspection of the premises showed the home was generally clean. The laundry room consists of a domestic washing machine in a walk in cupboard area. Laundry is either line dried outside or dried over the banisters or in the upstairs sleep-in room. The lack of suitable laundry facilities was discussed with Mrs Gallagher who said she hopes to do an extension in the future which will include a laundry room and two extra bedrooms. There did not appear to be a clear system in place for handling clean and dirty washing. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience poor quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing arrangements mean there are enough staff to meet peoples’ needs. Recruitment practices need improving as people are placed at risk through lack of protection. Not all care staff had received ongoing refresher training. This means people cannot be confident that staff are well trained. EVIDENCE: There are enough staff on duty to meet the needs of the people living in the home. There is a core group of staff that have worked in the home for a number of years. Two members of staff are always on duty, during the night this consists of one waking member of night staff and one sleep-in member of night staff. Most people do not need to use the call bell system much as they are able to maintain their independence. At the time of the inspection all the people living in the home were independently mobile, some people used a walking aid to assist with their mobility. People generally made positive comments about staff, for example one person said “Staff are absolutely lovely, couldn’t do more for you, always popping in and out so you’re never lonely”. Examination of two staff files showed that required pre-employment checks had not always been properly completed. On one file there was no evidence of Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 20 an application form, references or Criminal Records Bureau (CRB) check. On the other file a pre-existing Criminal records Bureau check was not valid and there was only evidence of one telephone reference, there was no date on this reference. Mrs Gallagher said she was not aware that CRB checks were not portable. Observation showed that staff had not been properly trained in health and safety, for example staff were wearing flip flops which are not safe footwear. Contact with the Public Health Department showed that Mrs Gallagher had not demonstrated that staff had received training in food hygiene when a food safety visit was carried out on 26 March 2007. There was still no evidence to show that staff had received food hygiene training and care staff routinely prepare and serve meals as part of their duties. There were no reliable records about the staff training that has been undertaken. Mrs Gallagher produced a list of monthly training topics but there was no evidence to show which staff members had attended the monthly training or the content of the training delivered. Mrs Gallagher confirmed that there are two members of staff who have obtained National Vocational Qualification (NVQ) Level 3 in Care but there were no available records to show how many staff were trained in NVQs. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Mrs Gallagher has the experience and ability to manage the home. Record keeping needs improvement to show effective management is in place. Working practices do not always ensure that the health, safety and welfare of people and staff are promoted and protected. EVIDENCE: Mrs Gallagher has owned the home for a number of years and has day-to-day control. There are clear lines of accountability when Mrs Gallagher is not in the home; one of the staff members on duty takes responsibility for the shift. People generally spoke highly about Mrs Gallagher and said she was kind and Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 22 approachable. For example one person said “Margaret (Mrs Gallagher) is lovely, so kind, she is kind to everyone”. Mrs Gallagher has been made aware of the enforcement policy of the Commission and has said that she will ensure the requirements set during this inspection are met. Quality assurance systems are in place with annual data gathered to monitor the quality of the service. A quality assurance project had been completed in relation to people’s satisfaction with food which showed overall satisfaction with food provision. Mrs Gallagher confirmed that she does not handle any people’s finances and that all people who use the service either manage their own financial affairs or have a representative to assist them. On the first day of the inspection the hot water temperature was too hot at 53°C to be safe. Mrs Gallagher quickly put this right and when the hot water was rechecked on the second day of inspection there was a safe temperature of 43°C. Contact with the Public Health Department showed that when they carried out a food safety visit on 26 March 2007 a food safety management pack had been left with Mrs Gallagher to enable her to follow clear procedures in relation to food hygiene. Mrs Gallagher was not able to evidence that she was implementing the recommended food safety procedures. As reliable training records were not available the home was not able to evidence that all staff have up to date mandatory health and safety training in infection control and basic food hygiene. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 Care plans must be more accurate and give clear information about what action staff need to take in order to meet peoples’ care needs, including mental health needs and skin care. To ensure that the health needs of people can continue to be met at the home the registered person must ensure that the person’s assessment is kept under review and revised at any time when it is necessary to do so, having regard to any change of circumstances. People must be consulted about their opportunity for involvement in meaningful daytime activities of their own choice, and according to their individual interests and capability. The shower facility that is broken must be repaired and maintained in good working order. The laundry area must be improved and kept in a good state of repair and: • be kept clean DS0000026820.V348163.R01.S.doc Timescale for action 31/12/07 2 OP8 14(2) 31/10/07 3 OP12 16(2) (m) & (n) 30/11/07 5 6 OP19 OP26 23(c) 13(3) and 23 31/10/07 31/10/07 Holmwood Version 5.2 Page 25 and be reasonably decorated. The laundry area floor finishes should be impermeable and these and wall finishes be readily cleanable. Risk management procedures for handling laundry, including hand decontamination facilities must be introduced to show that there is correct handling to prevent the spread of infection. All required pre-employment checks, as listed in Schedule 2 must be completed before staff are employed. There must be evidence that retrospective checks have been completed with those staff who have started work without all the right checks. There must be evidence to show that staff have received training appropriate to the work they carry out, for example as staff prepare and serve all meals they must be trained in food hygiene. Mrs Gallagher must discharge her responsibilities fully by complying with the requirements in the set timescales. There must be evidence to show that food is safely managed in accordance with the Public Health Department guidance. • 7 OP29 19 31/10/07 8 OP30 18 31/10/07 9 OP31 10(1) 31/12/07 10 OP38 16 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 26 1 OP28 The registered provider should submit an action plan to the Commission detailing arrangements for 50 of care staff to achieve National Vocational Qualification (NVQ) level 2. Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Holmwood DS0000026820.V348163.R01.S.doc Version 5.2 Page 28 - 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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