Inspection on 25/08/05 for Homestead Care Home (Brownhills) Ltd

This inspection was carried out on 25th August 2005.

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

The inspector 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

Homestead Care Home (Brownhills)... 24/01/08

Homestead Care Home (Brownhills)... 21/02/06

Homestead Care Home (Brownhills)... 11/01/05

Homestead Care Home (Brownhills)... 06/09/04

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

CARE HOMES FOR OLDER PEOPLE Homestead Care Home 208 Ogley Road Brownhills, Walsall West Midlands. WS8 6AN Lead Inspector Lesley Webb Unannounced 25 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Homestead Care Home Address 208 Ogley Road Brownhills Walsall West Midlands. WS8 6AN 01543 360120 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) Homestead Care Home (Brownhills) Ltd. Mrs Mandy Kunkel Care Home 30 Category(ies) of Dementia (30) registration, with number of places Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11th January 2005 Brief Description of the Service: The Homestead is a private and purpose built residential care home providing specialised care for elderly people suffering from past and present mental illness. The home provides all aspects of care on a twenty four hour basis. It is situated in the Brownhills area of Walsall and within easy reach of bus routes into Walsall. There are two separate lounge areas, one being used for residents who are frailer and more dependent and a day room that the home uses as a hair salon,and for holding reviews and private meetings. Bedrooms are located on both the ground and first floor, with bathing and toilet facilities located throughout the home. All residents are offered single room accommodation, some of which have en-suite facilities. There is a well-kept garden for residents use at the rear of the premises and parking facilities to the side of the home. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived unannounced at 8.45am and stayed until 5.30pm. During the visit the inspector spoke to residents, sat observing care practices, interviewed staff and looked at records before giving feedback to the assistant managers. In addition to this information that was sent to CSCI by the registered manager was used when assessing how the home is maintaining standards and meeting its aims and objectives. Prior to the inspection twelve service user and six relative comment cards were received by the inspector, all of which praised the service provided by the Homestead. For example one stated, “The home is excellently run, the staff are always willing to talk and I know my father is happy living there”. On the day of inspection the registered manager was on leave from the home. The inspector was shown full co-operation throughout the visit by the assistant managers and all staff on duty and by the end of the visit was satisfied that in general the home provides a very good service. What the service does well: When asking service users what they thought the best thing was about the home the inspector received an abundance of replies relating to the staff and management. For example one person stated, “ the staff and manager are lovely” and another person said, “ the staff do anything for you, they are always smiling”. The inspector found that these comments confirmed evidence found throughout the inspection where staff were observed treating service users with respect and talking to individuals in a relaxed and informal manner. The inspector also found that care plans maintained within the home are very good, ensuring that staff who work at the Homestead have sufficient information about individuals to give the appropriate levels of care. Additional praise was also given by the families of service users about how they are kept informed and made welcome when visiting. For example one relative stated, “Whenever I visit I’m always made to feel very welcome. Staff always keep me informed of what’s happened to my father, they understand how important this is”. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 6 The building is furnished and maintained to a very high standard, creating a pleasant place for service users to live. What has improved since the last inspection? What they could do better: Further work must be undertaken to ensure all staff attend training specific to the needs of some of the residents, including dementia care, continence management and adult protection. These training requirements must be given priority in order that the staff skills and knowledge complements the needs of the people living at the home. Improvements must also be made in the homes assessments for the use of wheelchairs and service users nutritional needs, again to ensure that service users needs are met in full. Staffing levels generally are maintained to an acceptable level, but must be monitored with additional care staff allocated to shifts when the manager is on leave and the assistant manager is then responsible for running the home, reducing the number of staff available to care for service users. Advice must be sought from the Infection Control Advisor regarding the homes practices for sanitising commodes, to ensure they comply with legal requirements. Please contact the provider for advice of actions taken in response to this Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 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 Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 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) 3 and 6. The home must improve its pre-admissions procedures to ensure staff have sufficient knowledge to meet the needs of service users. EVIDENCE: Documents were viewed for the newest service user to have moved into the home. These included a pre-admission assessment and a Community Care Assessment (CCA) completed by the placing authority. The National Minimum Standards state that a Community Care Assessment is sufficient to meet Standard 3 however the inspector instructed that the home should still complete its own pre-admission assessment as the information contained within the CCA was not sufficient to enable staff to meet the persons needs. The inspector also instructed that the pre-admission assessment should cover all aspects of Standard 3.3 of the National Minimum Standards. When asking staff about the needs of this service user they were unable to explain making comments such as, “he’s only been here a day so we don’t know anything about him” and “we are still getting to know him”. The home does not offer intermediate care. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 10 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 and 10. Generally care plans provide staff with the information they need to satisfactorily meet service users needs. Improvements to mobility and nutritional screening processes must be made to ensure service users health needs are assessed and monitored in full. Personal support in this home is offered in such a way as to promote and protect service users privacy and dignity. EVIDENCE: The inspector interviewed 3 members of staff, all of whom could explain aims or goals detailed in service users plans of care, when they are reviewed and by whom. When sitting observing care practices the inspector noted that a service user was being assisted around the home using another service users wheelchair. When looking at the care plan for this person no evidence could be found that confirmed that this person has been assessed for a wheelchair by a suitably qualified person. The care plan also stated that the service user should be encouraged to mobilise as much as possible and to have the correct staff Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 11 assistance. The inspector was concerned that the use of a wheelchair could reduce the service users mobility and/or if a full assessment had not been completed a wheelchair that does not meet that persons needs could potentially place the individual at risk. The inspector also raised concerns that the practice of using a wheelchair for someone whose care plan does not state they require it could be due to staffing levels (see standard 27). Staff confirmed that several service users did not have their own wheelchairs, had not been assessed and used communal chairs to aid their mobility. All care plans that were sampled contained assessments for the prevention of falls, continence, pressure sore management and moving and handling, however no evidence could be found of nutritional assessments being completed. Staff informed the inspector that Dietary input is arranged for service users if concerns are identified. The inspector instructed that nutritional assessments should form part the care planning process for everyone, to ensure a proactive approach to health care monitoring takes place and to ensure previously unidentified conditions are identified and the appropriate action taken. In addition to care plans each file sampled contained Essential Lifestyle Plans (a form of Person Centred Planning). None of these documents had been completed appropriately with staff confirming that formal training had not been undertaken in order that they had the appropriate knowledge to complete these documents. Discussions with staff also confirmed that they did not understand the difference between Dementia Care Mapping and Person Centred Planning, further evidence that demonstrated why the Essential Lifestyle Plans had not been completed correctly. Throughout the inspection staff were observed treating service users with dignity and respecting their rights to privacy. For example staff were witnessed knocking on bedroom and bathroom doors before entering and talking in a respectful manner to service users. These practices were further reinforced as the norm by staff when interviewed. For example one person stated, “its important to listen to what residents have to say, to be sure they want my help and to act on their wishes” and another said, “I always like to talk to residents to find out their feelings, even if someone has communication problems I never assume they have not got feelings”. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14. Improvements in the recording of activities now demonstrate that the home provides daily variations and subjects of interest for the people living there. The atmosphere within the home is friendly and welcoming towards visitors, creating an inclusive place for service users to live. Practices within the home demonstrate that service users are encouraged to exercise choice and control over their lives. EVIDENCE: Since the last inspection the home has improved its recordings of activities so that they are now recorded in detail, evaluated and linked to service users interests detailed within their care plans. All staff interviewed confirmed that service users are able to take part in the local community. For example one person stated, “ some of our ladies go across the road to the shops, some use the hairdressers, we have annual outings and we recently had a BBQ where we invited families and friends. During the inspection a local vicar visited the Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 13 home giving a service, which included singing. Many of the service users were observed to enjoy this activity, joining in with hymns and prayer. The inspector also spoke to two families visiting at the time of the inspection, both of which confirmed that they are made to feel welcome and were happy with care provided by the home. When asking staff how they support service users to maintain links with their families a variety of examples were given including, “when they visit we offer drinks, answer any questions they may have and show to the quiet lounge if they want privacy”. A Requirement identified in the previous inspection to introduce risk assessments that validate why service users do not manage their own financial affairs has now been met, with all service user files sampled containing evidence of this process. Also the home now completes annual audits of service users inventories, with records maintained. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home has an excellent complaints system with evidence that issues are listened to and acted upon. Further training is required for staff to ensure they have sufficient knowledge of Adult Protection issues in order to protect service users from abuse. EVIDENCE: Since the last inspection one complaint has been received by CSCI relating to a service user who was found wandering outside of the home which was upheld and one complaint has been raised directly with the manager of the home relating to care, environment and staff which has been addressed. The homes complaint procedures are robust, with detailed investigations and outcomes recorded. All service users that the inspector spoke to stated that they would approach either a senior on duty or the manager if they were unhappy about anything. Using the line management structure to complain was re-enforced by all staff interviewed when asked how they make sure a service users complaints are dealt with everyone replied, “See the assistant managers or manager”. When asking staff how they ensure service users are protected from abuse staffs responses varied with some unable to answer and others explaining some forms of abuse. No staff that was interviewed demonstrated sufficient knowledge and understanding of adult protection despite some staff stating they have undertaken training in this area. Training records for the staff that were interviewed did not contain certificates for Adult Protection or Physical Aggression training. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 15 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 and 26. The standard of the environment within this home is good, providing service users with an attractive and homely place to live. Infection control measures, although improved still require attention to ensure staff and service users are not placed at risk. EVIDENCE: When walking around the home the inspector activated the emergency call system within one of the toilets. It took staff several minutes to locate the source of activation as the rooms were incorrectly recorded on the alarm panel. The inspector instructed that this be rectified urgently as it had the potential to place service users at risk. Since the last inspection previous Requirements relating to the laundry room have been met. This has been refurbished and now meets infection control Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 16 standards. When talking to staff and looking at cleaning products and practices for commodes within the home the inspector was concerned that these did not comply with legislation and good practice guidelines and instructed the home that advise must be sought from the Infection Control Advisor for the NHS. Also since the last inspection a bathroom has been refurbished and replaced with a walk in shower. The inspector congratulated the home on the improvement of this facility as it now assisted those with mobility needs but was also decorated in such a way as to feel welcoming and homely. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30. Generally staffing levels are maintained to a satisfactory level, however improvements would improve consistency of care to service users. Further work must be undertaken to ensure staff receive the appropriate training and support in order to fulfil their roles and meet the needs of service users. EVIDENCE: As mentioned in the summary of this report the registered manager was on leave when the inspection took place leaving four care staff on duty one of which was the assistant manager. Records and discussions with staff confirmed that when the manager is on leave care staffing levels are not increased to compensate for the assistant manager being taken off the floor to undertake managerial duties. The inspector raised concerns about this practice for two reasons, firstly on three separate occasions during a fifteen minute period the inspector witnessed service users with high dependency levels being left unattended in the main lounge due to insufficient staffing and secondly from 2pm the home does not have kitchen staff on duty resulting in a member of the care staff having to undertake these duties when service users require their evening meal, potentially leaving two carers available for up to thirty service users if the assistant manager is undertaking duties such as assisting visitors, answering the phone etc. As the home is registered for 30 dementia care service users a minimum of four care staff should be on duty with additional staff to undertake managerial and kitchen tasks. The inspector discussed the Residential Staffing Forum with the registered proprietor as Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 18 figures supplied by the home, as minimums required do not meet those recommended within the Forum. The inspector explained that a further meeting would be arranged with the registered manager to discuss this issue. It was also noted when examining rotas that on occasions ‘tippex’ and pencil had been used; this must not occur as these are legal documents that must be retained in their original format. A previous Requirement to ensure staff training and performance appraisals are completed in full has now been met, with all files sampled containing evidence of this occurring. The inspector was pleased to find that twelve care staff hold NVQ levels 2 or 3 and all other staff are either in the process of completing or due to enrol. Discussions with staff confirmed that they undertake a variety of training including dementia, risk assessments and continence however only one of the three staff files sampled contained certificates that validated these discussions. Due to the home being registered for dementia care, when interviewing staff specific questions were asked relating to this condition and care given, the environment and activities. All staff interviewed demonstrated knowledge of care practices for example one person stated, “communication and memory loss affect service users every day life, so we have to keep repeating things and explain what we are doing. It’s important that they are reassured. Just because they cant remember things doesn’t mean they shouldn’t be informed and involved in decisions”. Some staff were less certain about activities and the environment when considering service users with dementia and were unable to demonstrate knowledge in this area. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 19 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) 37 and 38. Generally records maintained within the home ensure the protection of vulnerable adults. Management practices within the home promote and safeguard the health, safety and welfare of service users, staff and visitors. EVIDENCE: The inspector viewed the homes policy relating to missing service users due to an incident earlier in the year (see Standard 16) and found that this was not detailed and did not support practices within the home. Staff informed the inspector that this gave “just a basic outline of what should be done”. The inspector instructed that this must be amended to ensure everyone was fully aware of his or her roles and responsibilities. Several other policies and procedures were sampled at random and found to be relevant to practices and services provided within the home. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 20 Documentary evidence supplied by the home prior to the inspection demonstrated that all records pertaining to the maintenance of the building and the health and safety of staff and service users are being met. A previous Requirement to ensure safe working risk assessments cover all aspects of Standards 38.2 and 38.3 of the National Minimum Standards has now been met. All three staff files sampled contained certificates that validated they attend mandatory training for fire, first aid, food hygiene, infection control and moving and handling. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 21 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 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x 2 3 Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 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 OP3 Regulation 14 Requirement Pre-admission assessments must cover all aspects of Standard 3.3 of the National Minimum Standards Service users who use wheelchairs must be assessed by a qualified person as requiring this facility and records maintained in the plan of care The practice of using communal wheelchairs must cease, with risk assessments implemented until such time as individual assessments for service users have been completed Essential Lifestyle Plans must be completed correctly Nutrional screening must be undertaken on admission for all service users All staff must undertake Adult Protection training, with certificates maintained on file All staff must undertake Physical Aggression training, with certificates maintained on file All rooms (including bathrooms and toilets) must be correctly recorded on the emergancy alarm panel The home must seek advice from Timescale for action 31/12/05 2. OP7 15 31/12/05 3. OP7 15 31/08/05 4. 5. 6. 7. 8. OP7 OP8 OP18 OP18 OP19 15 12(1) 10(1) 10(1) 16(1) 31/12/05 31/12/05 31/12/05 31/12/05 Immediate 9. OP26 13(3) 31/12/05 Page 23 Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 10. OP27 18(1) 11. OP27 18(1) 12. OP27 18(1) 13. 14. OP27 OP30 18(1) 18(1) 15. 16. OP30 OP30 18(1) 18(1) 17. 18. OP37 OP37 17 17 the Infection Control Advisor in relation to cleaning products and practices for sanitising commodes Additional care staff must be allocated to all shifts when the assistant managers cover the managers absences/leave from the home The ratios of care staff to service users must be determined according to the assessed needs of service users, in accordance with guidance recommended by the Department of Health staff must be on duty seven days a week to prepare and serve evening meals in addition to four care staff Tippex and pencil must not be used on staff rotas All staff must undertake comprehensive dementia training, with certificates maintained on file All staff must undertake continence training, with certificates maintained on file Any staff that complete Essential Lifestyle Plans must undertake training in this process, with certificates maintained on file The homes missing persons policy must be updated CSCI must be notified in writing of all incidents as listed in Regulation 37 of the Care Homes Regulations 2001 31/08/05 31/08/05 31/12/05 31/08/05 31/12/05 31/12/05 31/12/05 31/08/05 Immediate 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 E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 24 Homestead Care Home 1. Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection West Point Mucklow Office Park Mucklow Hill Halesowen. B62 8DA 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 Homestead Care Home E55 S57030 Homestead Care Home V245989 250805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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