Inspection on 17/10/05 for Kestrel House

This inspection was carried out on 17th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kestrel House 06/10/09

Kestrel House 14/04/09

Kestrel House 15/04/08

Kestrel House 23/05/07

Kestrel House 18/04/06

Kestrel House 10/05/05

Kestrel House 08/11/04

Kestrel House 25/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Kestrel House 220 Willingdon Road Eastbourne East Sussex BN21 1XR Lead Inspector Debbie Calveley Unannounced Inspection 18th October 2005 10:00 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 Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kestrel House Address 220 Willingdon Road Eastbourne East Sussex BN21 1XR 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) 01323-431199 01323-649420 ANS Homes Limited Mrs Jacqueline Taylor Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That a maximum of fifty four (54) service users are admitted to the home To provide care to Service Users aged sixty five (65) years and over who are chronically ill and in receipt of NHS Continuing Care Services. To proivde care to Service Users aged between eighteen (18) and sixty-five (65) years who are chronically ill and in receipt of NHS Continuing Care Services. 10 May 2005 Date of last inspection Brief Description of the Service: Kestrel House is owned and managed by Associated Nursing Services. Kestrel House was purpose built in 1996 to accommodate fifty- four relocated patients that had been cared for in a local National Health Geriatric hospital. All residents living in this home will have been assessed as meeting the eligibility criteria for continuing care and are funded by the PCT. The accomodation comprises of forty-eight single bedrooms with ensuite facilities and three double rooms without ensuite facilities. There is ample communal space, two small lounges, one on each floor, two large dining areas with small serveries attached, again one on each floor which have recently been upgraded. On the top floor there is a second lounge and on the ground floor there is an activity room which leads out on to a paved area. There are adequate bath and shower facilities for the residents with the appropriate equipment for frail residents. Kestrel house is situated on the A22, and approximately 1-½ miles from Eastbourne town centre.There is car parking on site at the front of the home and a small garden and patio area is situated to the rear and side of the home. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 17 October 2005 at 2 pm and took place over five hours hours. Two inspectors inspected the home and conducted informal interviews with ten residents, five relatives and six members of day staff. The inspection process consisted of a tour of the building, inspection of documentation and records and focused on the delivery of care for nine residents. What the service does well: What has improved since the last inspection? The improvements to the care plans have been maintained and were found to be up to date and encompass the complex needs of the residents. The risk assessments have been expanded to encompass the complexities of the residents needs. The medication charts are being audited on a weekly basis and significant improvement has been made to the administration practices in the home, which ensures the health needs of the residents. Call bells were found in reach of the residents and those residents that do not have the capacity to ring for assistance are checked on a regular basis and this is documented. Regular supervision has been commenced. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 7 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 Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required to enable them to make an informed choice about where they live. Pre-admission assessments are completed on all residents, which assures that the needs identified can be met by the home. Residents and their families are encouraged and welcomed to visit the home prior to admission, which enables them to make an informed decision about the homes suitability. EVIDENCE: The Statement of Purpose and Service Users Guide were viewed, it was found to be up to date and contained information that prospective residents need to make an informed choice of where to live. Due to recent change of ownership of Kestrel House, these documents will need to be updated when all the information is available. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 9 Seven pre-admission assessments were viewed and were found to be completed in full, however the home need to be careful in ensuring that the residents being admitted at present meet the category of the home. The Discharge Co-ordinator from the hospital completes a full nursing assessment to ensure the service users smooth transition from hospital. Due to a quick discharge from the hospital, it is not always possible for the relatives to be present at the pre-admission assessment, but the staff continue to endeavour to promote their involvement. Three relatives stated that they had not been involved in the pre-admission assessment, but confirmed staff had made contact with them when visiting the home and involved them in the care planning. One relative said that her family had visited the prior to her mothers’ admission and found it had made the difficult transition easier. One former relative, who is now a resident himself said that knowing the staff before coming in had been very helpful to him, and made it easier to settle. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10. Staff practice and documentation reflects a sound knowledge of the residents’ healthcare needs, however the documentation in place does not fully reflect the social and communication needs of service users. There has been an improvement in the medication administration documentation and practice since the last inspection, ensuring the health and safety of the residents. The residents spoken with confirmed that they feel that they are treated with respect and their dignity is upheld. EVIDENCE: A sample of ten care plans were viewed and the improvement seen at the last inspection has been maintained. Reviews of care plans are performed monthly and this includes the update of any risk assessment such as the pressure areas and manual handling assessment, and the update of the base line observations. There is still a need to remind staff to ensure they complete fluid and turning charts as they perform the care and not at the end of a shift. There was evidence in the care plans that the home maintain a close link with the hospital tissue viability nurse and treatment initiated in hospital is Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 11 continued when the resident transfers to Kestrel House. There are four residents with tissue damage at the moment and the documentation regarding the treatment and accompanying risk assessments were found accurate and up to date. Areas that were found incorrect or poorly completed whilst viewing the care plans were discussed with the senior nurse at the time of the inspection. One relative spoken with said that she was very pleased with the care her mother was receiving and that the staff were very supportive. Two residents also said that the care they received was very good. One relative said that she felt that that the care was “pretty good”. The clinical rooms were found to be clean, tidy and well stocked. Policies and procedures for administration, receipt, storage and disposal of medicines are accessible to all staff and are updated as required. The medication administration record charts were of an improved standard and were seen to be completed correctly. However staff still need to sign and date when medications are changed by verbal order from the G.P and when a medication course is completed. Since the last inspection a weekly audit has been performed by the manager, this has been successful in improving staff documentation. Throughout the inspection the staff were observed ensuring that residents’ dignity and privacy were maintained. One resident said that the staff were “patient and kind and always made sure that she was comfortable”. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 and 14 The arrangements for leisure and social activities inside and outside of Kestrel House provide limited opportunity for mental or physical stimulation to meet the individual residents needs. Open visiting enables service users to maintain contact with families and friends. Residents are encouraged and helped to exercise choice and control over their lives. EVIDENCE: Planned activities are scheduled at present Monday to Friday 2- 4 pm. There was no evidence of one to one activities for the frailer residents and this was some thing that had previously been guaranteed. The records available for viewing need to be expanded to evidence their preferences for activities including likes and dislikes. It was disappointing that the enthusiasm and plans discussed previously had not been maintained or put in to action. The programme of activities is displayed throughout the home and was found in the individual residents rooms, it showed that there is a limited range of events over a four-week period. Four residents’ views on the activities offered were complimentary; two residents’ have made the choice not to attend the activities. One resident said that the bingo was always good fun but not often Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 13 enough. Another said that he would love to see some war memorabilia, as he had been in the war and would find it very interesting. There is evidence of representatives of different faiths visiting the home and three service users mentioned they had received communion. There is open visiting and service users are encouraged to invite friends and relatives to visit. Feedback from the residents confirmed that residents’ whenever possible choose how they spend their time, however this needs to be reflected in a social care plan, so all staff are aware. Another service user said that he was always consulted about his lifestyle, about when he gets up, goes to bed and what and where he eats. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18. The home has a satisfactory complaints system in place to manage complaints. The majority of staff has an understanding of the vulnerability of residents, which is supported by appropriate training. The present recruitment process at present does not protect residents from possible abuse. EVIDENCE: A policy and procedure is in place for dealing with complaints and this is also outlined in the statement of purpose and service users guide. The manager is aware of the timescales set down for dealing with complaints and a complaints register is available. The Adult Protection policy in the home was found to be up to date and staff interviewed was knowledgeable about the systems in place to protect vulnerable residents. There is on-going training for all staff in Adult Protection, however the training records evidenced that there are some staff that have not as yet received training in this area. The recruitment files viewed showed that staff had commenced work without the necessary 2 references received and that staff had also been employed with Criminal Record Bureau checks from their previous employment. These shortfalls have been identified at the previous inspection and remain outstanding. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 15 Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. The homes environment needs on-going maintenance and renewal in order to create a warm, safe and welcoming environment for the residents. Resident’s bedrooms are comfortable and they are able to bring in their own possessions. The residents would benefit from a review of the present cleaning systems in place in order to provide a clean and hygienic environment. EVIDENCE: The home was purpose built and designed with input from the Health Authority. There is level access to all parts of the home, the size of the corridors and rooms are spacious to allow safe movement of chairs and wheel chairs. Each floor has a dining room and two separate lounges, the dining rooms have recently been upgraded and redecorated and now presents as homely and pleasant. The lounges are due for redecoration soon. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 17 The activities room is creatively designed and well stocked and is assessable to all residents. Garden areas are attractive, well maintained and assessable to wheelchairs. There are communal bathrooms with the necessary specialised equipment to bathe residents, however two of the bathrooms were being used to store a large amount of equipment, it is a requirement that these areas be available at all times for the use of the residents. It was discussed with the manager an alternative storage area to be found. The shower room was found grubby and the showerhead was left dangling due to a broken hook, which contravenes the legionella guidelines set. The resident’s bedrooms are furnished to meet their individual needs and preferences. Some residents have individualised their room with pieces of furniture and personal paintings. Bedroom doors are not routinely provided with locks but residents are being offered the choice of one and risk assessments are in place regarding this. A lockable drawer with a key is routinely provided. The three rooms used as shared accommodation all have privacy curtains. The maintenance of the property was questionable as some residents rooms demonstrated significant wear and tear and below the expected standard. Areas of concern were shared and identified with the manager on the day of the inspection. An immediate requirement regarding these areas was left and it is also asked that a redecoration and maintenance plan be developed. Water temperatures were found inconsistent and some were in excess of 50° Celsius and some as low as 38 ° Celsius, these were identified as an immediate requirement. The home have the specialised equipment available to meet the needs of the residents. The call bells were found to be accessible for the residents, and those that do not have the mental or physical ability to ring the call bell are checked regularly and the necessary form completed. The response to call bells during the inspection were prompt. Two residents said that they were not kept waiting when needing attention. The overall cleanliness of the home has deteriorated since the last inspection and some residents’ bedrooms were found to be scruffy with a need for hovering and cleaning, especially under the beds and the walls. Certain carpets were stained, curtains were found hanging off the rails and lampshades were missing in some rooms. Two empty rooms on the second floor smelt strongly of urine. There were also rooms occupied by residents where dressing supplies and food supplements are on display on the tables and bathrooms and reducing the resident’s personal space. It is presumed they are kept there for the convenience of the staff rather than the residents. These items need to be stored appropriately in the clinical room where the temperature is regulated as per the storage instructions on the packs. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 18 The home has all relevant policies and procedures in place concerning infection control. Good practice was observed in the use of gloves and aprons. Laundry facilities are available in-house and provide a good service. There was positive feedback from service users about the standard of the laundry service. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staffing levels are adequate for the needs of the residents. Evidence that residents are supported by a team of trained and competent staff needs to be provided. The standard of vetting and recruitment practices have not improved with appropriate references and criminal record checks still not being in place and potentially leaving residents at risk. EVIDENCE: The staffing levels were seen to be sufficient for the needs of the service users on the day of the unannounced inspection. Throughout the inspection, staff were observed performing their job unhurriedly and were seen interacting positively with residents. The staff said that they felt the staffing levels were adequate to meet the needs of the residents, two residents were very complimentary regarding the staff and the care they received in the home. One heavily dependent resident who has been in the home for over a year, said that the “staff were very conscientious and helpful”. One relative said that the staff looked after her husband “very well and were very supportive to her”. A relative of a recent admission said she was surprised at the understanding shown to her and her mum, and that she had been made to feel very welcome. Another wife of a resident said the “care was excellent and the staff were looking after her husband very well”. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 20 The recruitment process for five members of staff were examined and were found incomplete as not all of them had two written references prior to commencement of employment and some Criminal Record Checks were transferred from their previous employment and not re-applied for. There was also no evidence of verbal references’ in their file. Evidence of Criminal Record Checks on all staff employed at Kestrel House need to be kept at the home and be available for inspection. There is evidence of an induction-training programme and this is completed over 6-12 weeks. Foundation training has been confirmed by the manager as having been commenced through a recognised agency. This was not evidenced at this time. Staff continue to be offered the opportunity to attend study sessions that are related to the care of the residents cared for in the home, and staff interviewed spoke of the training opportunities given to them. A staff-training list was provided on the day and gaps were identified in the mandatory training attended by staff. This needs to be updated and all staff to attend the necessary training to ensure safe practice and positive outcomes for the residents they care for. A training matrix would be beneficial to the management team so all training can be seen tracked, it was not possible to see the courses attended by staff from the information provided by the home. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. The Registered Manager has the necessary experience to manage the home. Clear professional leadership is apparent in the home. The ethos of the home is open and caring. The residents are consulted regularly about life in the home and their comments are audited. Resident’s financial interests are safeguarded by appropriate procedures in the home. EVIDENCE: Ms Potter has recently successfully completed her interview to become the Registered Manager. She has worked at Kestrel House for five years, gradually Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 22 taking on more responsibility and senior posts. She has worked closely with the previous manager for approximately eighteen months as deputy manager. Ms Potter is due to commence her management qualification soon and is aware that she needs to complete it within a designated time frame. Feedback from staff and residents confirm that this is a positive move and that Ms Potter is respected for her dedication to improving standards in the home. The formal quality assurance and quality monitoring systems in place enable the provider to critically evaluate the service and ensure it is run in resident’s best interests. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. Water delivery temperatures need to be undertaken and recorded to ensure that resident’s safety is protected. As previously mentioned all staff are required to have training in moving and handling, infection control, fire safety, POVA and food and hygiene on a regular basis, to ensure the health and safety of all residents are protected and promoted. Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 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 3 x 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 3 2 3 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 12(1) (a&b)14 (1)(d) Requirement That the residents admitted meet the registration category of the home and the home can demonstrate that they can meet the assessed needs of the residents. That all verbal orders of changes to medication are signed and dated, and that all courses of medications are signed and dated on completion. That a daily programme of suitable in-house activities based on resident’s preferences be created and implemented. That all staff receive training in protection of the vulnerable adult and are aware of the procedures in place. That the environment is well maintained and safe, that a programme of maintenance be developed. That the bathrooms are free from storage and ready for use at all times. That all water delivery temperatures are tested regularly and water is delivered DS0000014006.V249120.R01.S.doc Timescale for action 17/10/05 2 OP9 13(2) 17/10/05 3 OP12 16(2)(m) (n) 12(1)(a) 13(6) 13(4)(a) (c) 23(2)(j) 13(3)(4) (a)(c) 17/01/06 4 OP18 17/01/05 4 OP19 17/10/05 5 6 OP21 OP25 17/10/05 17/10/05 Kestrel House Version 5.0 Page 25 7 8 OP26 OP29 16(1 (2) (j) (k) 19(4)(c) Sch2 7 8 19 9 OP30 12(1)(a) (b) 10 OP38 12(1)(a) 13(4)(5) at 43 ° C. That the home is kept clean, hygienic and free from offensive odours throughout. That two written references relating to the person are obtained before commencement of employment. That Criminal Record Checks are applied and received before employment and not transferred from a previous employment. That evidence of Criminal Record Checks are available for inspection. (Previous timescale of 29/04/05 not met) That training pertinent to the needs of the residents is undertaken and evidence of the training is available for inspection. That the mandatory training is undertaken by all staff to ensure the health, welfare and safety of the residents. 17/10/05 17/10/05 17/01/06 17/01/06 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 Kestrel House DS0000014006.V249120.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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