Inspection on 31/10/06 for Ladyfield House

This inspection was carried out on 31st October 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ladyfield House 23/04/06

Ladyfield House 01/12/05

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Larchfield Manor

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ladyfield House Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR Lead Inspector Janet McBride Key Unannounced Inspection 31st October 2006 8:50am 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 Ladyfield House DS0000065777.V308938.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. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ladyfield House Address Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR 0207 9293444 NONE NONE www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited 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 Angela Turner Care Home 50 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may accommodate 26 service users on the Salvin Wing in the category of (OP) or PD(E) The home may accommodate 24 service users on the Hewitt Wing in the category DE(E) 23rd April 2006 Date of last inspection Brief Description of the Service: Ladyfield Nursing home offering service users residential or nursing care, and can accommodate fifty residents. The home was purpose built in 1993, and is situated in the Kiveton area of Rotherham, the home has two units; Salvin wing provides nursing and residential care, and Hewitt wing provides residential EMI care. Accommodation is provided in forty-six single rooms and two double rooms, with each unit having its own lounge and dining areas. The home has a garden with a patio area at the rear of the home, which is enclosed for the safety of residents. Car parking spaces are available at the front of the home. Fees range from Nursing Care £344 - £430 plus free nursing band. Dementia Care £370 - £385, Residential Care £ 329 - £375 per week, as at 1st October 2006 and additional charges are made for hairdressing from £5:00, Chiropody from £9:50, Optical, Dental services, specialised toiletries, and magazines etc. Information about the service is available to residents and their families via the home’s Statement of Purpose and the Service User Guide, which are in each bedroom. The home is not on a direct bus service route and is a distance from the main road. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this Key Unannounced Inspection, which took place on the 31st of October 2006 for 8 hours. The home is registered for 50 beds; at the time of Inspection 47 residents were residing in the home. Pre-inspection work was carried out for example, analysis of notifications, complaints and any other relevant documentation. During the inspection documentation and records were examined for example, medication, complaints, accident records, staff rotas, staff training files and case tracking of two residents care plans, which were cross-referenced with any other relevant documentation for those residents. A tour of the premises and direct observation of staff interaction with residents throughout the visit. Information was gathered from as many different individuals as possible that had contact with the residents, for example individual interviews with members of staff, including the manager. Talking to some of the residents within the home and feedback from relatives and visitors on the day. The inspectors would like to thank all the staff and residents for their cooperation in the Inspection process, and any issues or concerns that were raised were discussed with the manager and operations manager at the end of the Inspection. What the service does well: What has improved since the last inspection? Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 6 The company and the manager have taken action on all of the requirements with the exception of two, laundry facilities and contracts for residents, however they are working towards making satisfactory progress to address both these issues. This inspection found the company continue to make developments within the home to ensure progress and consistency and that standards are being maintained. 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. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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 Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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): 2 and 3. Quality in this outcome area is Adequate. This judgement has been made using the available evidence in records, interviewing staff, residents and visitors on the day. Residents within the home and prospective service users do have up to date information regarding the registered provider, and records show residents are fully assessed prior to moving into the home, with other professionals involved if needed. New residents have up to date contract/statement of terms and conditions with the home. However, the new company have not yet issued contracts/terms and conditions of residency to existing residents. EVIDENCE: The home has a Statement of Purpose, which has up to date information and is available in the office and in each bedroom of all residents to read. Discussions with residents, family and staff they confirmed that the Service User Guide is given to prospective residents and/or relatives, copies were observed in resident’s bedrooms. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 9 As new residents are admitted they are issued with contracts/statement of terms and conditions from Southern Cross, but as a result of the recent take over of Ashbourne by Southern Cross not all residents had contracts/terms and conditions with Southern Cross. The company needs to ensure that all existing residents be issued with up to date contracts/statement of terms and conditions of residency. Pre-admission assessment is undertaken and this was recorded within the individual residents care file to ensure that the home can meet their needs. Records show and discussions with residents and families confirmed that the home welcomed visits before admission to assess the quality, facilities and suitability of the home. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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. Quality in this outcome area is Good. This judgement has been made using the available evidence in various documents and records including a visit to the service. Resident’s receive health and personal care based on their individual needs, and care planning systems are sufficiently detailed to enable staff to deliver the care. Residents who have specific identified needs have these met and good health is promoted. EVIDENCE: Two care plans were case tracked one on each of the two units; these had been changed to the Southern Cross format. Records examined and discussion with the staff confirmed resident’s healthcare needs are assessed and set out in a plan to enable staff to deliver their care. One issue raised was the filing cabinet containing confidential records was not locked, although these cabinets are kept in nurse’s office the doors are left open. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 11 The nurses are able to carry out nursing requirements for those residents who fall into the nursing category and district nurses also attend the home to carry out any procedures that require a nurse for residents on the residential unit. One comment from a resident “staff are on the ball with getting the doctor when needed”. Residents have access to health care services, and there was evidence that residents are referred to other health professionals when required. The EMI unit also have access to a Consultant Psychiatrist and CPN services when required. Diet and weight are carefully assessed and the home have been involved in a project to combat weight loss, this was called the “Rosie Red project” special plates were used to identify those residents at risk of weight loss, these residents would be weighed weekly and a record made of food and fluid intake per day. This project was on display in the reception area of the home to inform relatives with a full explanation of the project and how it works, this is going to be evaluated when finished. Residents can also access dental, optical and chiropody services when appropriate, one resident commented, “Lady comes to cut my nails when needed”. Accident records were examined and records show that staff complete appropriate documentation, these reports are analysed by the manager on a monthly basis. Staff complete a transfer form that gives details of residents care needs and the reason for any visit to A & E, they also contain an observation record, which is completed for 24 hours. When residents are sent to A & E. Medication records were discussed with the manager and the person in charge of each unit and observation of medicines being given to residents on the EMI unit. Policies and procedures were discussed with members of staff on both units, qualified nurses have responsibility for administering medications on the nursing and residential unit, and senior care staff administer medicines to the residents on the EMI unit. One resident self administrates and the appropriate records are in place, with safe storage of medication. An audit of the records and stock checked on the day were all found satisfactory. Privacy and dignity was discussed with the staff, and observation of interaction between staff and residents on the day. Staff interviewed gave good examples of how they upheld residents privacy and dignity, e.g. always perform personal tasks in private, explain what they are doing and give a choice of who performs that task either male or female. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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, 14 and 15. Quality in this outcome area is Good. This judgement has been made using the available evidence, interviewing staff, residents including observation at mealtimes. Residents do receive a wholesome and appealing balanced diet with a varied selection of food available. Social interaction on the day provided stimulation and interest for those residents that took part. EVIDENCE: Routines of daily living appeared flexible, observed activities being carried out on the EMI unit in the morning and on the nursing and residential unit in the afternoon were appropriate for the resident group on each unit. Discussion with the homes activities organiser, confirmed she has done some specialist training to ensure that she delivers appropriate activities on the EMI unit. She normally spends half a day on each unit and has a range of activities, which vary for each unit. There is activities plan on the notice board in the home. When residents are first admitted she involves families, they are asked about the resident’s interests likes and dislikes, and are involved in care planning when possible. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 13 There is a church service held in the home once a month. Residents and or relatives are asked about the resident’s religious/spiritual needs as part of the admission process, so that the staff can contact the local religious representative to visit if that’s the resident’s choice. Staff were observed offering residents choice and staff interviewed stated they encourage residents to make a choices about various things. Feedback from residents stating, “Staff very good and take care of me”. “Staff go out of their way for us”. “Go to bed at night and know I’m safe”. “I have my hair done every week”. The comments were consistently positive. Relatives spoken to confirm they can visit at any time, one relative did raise concerns about the home having another new manager, but feel he’s very approachable. Meetings for relatives have been held and it is the intention of the manager to have these meetings on a monthly basis. Both breakfast and lunchtime was observed and a number of residents were spoken to about food within the home. Everyone who commented on the food “said they looked forward to meal times “ and “they liked the choices offered, if not given an alternative choice”. “No grumbles about food, I think we are very fortunate”. Menus offered a balanced and varied diet and all residents have nutritional assessment completed and dietician is used when needed. Observation at mealtime showed it was unhurried and relaxed with some residents needing assistance; staff ensured this was given individually; dining tables were set with tablecloths, cutlery and condiments. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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. Quality in this outcome area is Good. This judgement has been made using the available evidence in records, interviewing staff, residents and visitors on the day. Residents and relatives are provided with information to enable them to raise concerns or complaints about the home and their care. Adult protection policies, procedures and training for staff are in place at the home. EVIDENCE: The home’s complaints policy and procedure is accessible to all residents and visitors, this was confirmed when speaking to visitors on the day. The home had one complaint since the last inspection, this was discussed with the manager and records examined. Records show that this complaint had been fully investigated by the provider and the Commission for Social Care Inspection and upheld, with feedback to the complainant. Although a number of requirements would normally had been served on the home the company and the manager were very proactive in addressing the issues raised, and as part of their investigation had put changes in place to improve the quality and delivery of care. The way they managed the care policies and procedures within the home, had brought about the required changes. Commission for Social Care Inspection are satisfied that the service provider has appropriately addressed the issues raised in the complaint. CSCI have continued to monitor the situation to ensure progress and consistency, and that standards are being maintained. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 15 On this key inspection no complaints were made and no issues were raised either by residents or relatives, all were aware of the complaints procedure. The home has policies and procedures for adult protection staff confirm they are aware of these polices and procedures and training sessions had taken place. Staff had knowledge and understanding of adult protection issues including whistle blowing policy, and who to report this to if required. No referrals had been made to adult protection since the last Inspection. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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, 24 and 26. Quality in this outcome area is Adequate. This judgement has been made by a visit to the service talking to visitors and tour of the premises. General appearance of the home has improved with some decoration, and new furniture in the lounges. The company and the manager is actively working to improve the environment and the furnishings and fittings in the home. EVIDENCE: The home has two units and communal space is available on each of the units, which includes various lounge and dining areas. A tour of the premises found the general appearance of the home adequate, however the company is actively working to improve the environment, e.g. carpets replaced in some bedrooms, new armchairs and small tables and improved lighting had been fitted to the corridor areas. The television reception within the home is poor and some action as been taken, which as improved the reception a little, but the company are waiting Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 17 for quotes to improve this further to ensure a good reception to all television sets. Bedrooms were seen on both units, some of these were homely and personalised; others looked a little sparse but were clean and welcoming. Issues highlighted on the last inspection regarding beds have been addressed, the beds that required headboards have had them fitted, and the old metal type beds are being replaced over a period of time. Vanity units in some bedrooms are broken and required replacing, some drawers require attention and chairs within some bedrooms were very marked and dirty. The use of bedrails was discussed with the manager who stated that the company do try to minimise risks of falls by using low beds and crash mats within the home. A number of toiletries are left in bedrooms on the EMI unit this may place residents at unnecessary risk. Issues regarding laundry facilities remain the same (requirement made on the last inspection not addressed). Possible the increase in occupancy has put a strain on laundry facilities. Plans have been drawn to improve the facilities but no date for the work to commence has been given, therefore this issue requires resolving as soon as possible. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is Good. This judgement has been made using the available evidence in records, interviewing staff and a visit to the service. There was appropriate staffing and skill mix, to meet resident’s care needs, and on going development of staff to ensure they have the skills and knowledge to carry out their role. EVIDENCE: The new manager has only been in post for six weeks and is going through the Commission for Social Care Inspection application process to be the homes registered manager. The staffing structure within the home is that they have a manager, deputy manager, unit manger on EMI, unit housekeeper, handyman, administrator and activities person along with kitchen, care and domestic staff. Staffing rota seen shows appropriate staff on duty, but the home do use agency staff at times for nurse cover. Training was discussed with the manager and staff also a copy of training matrix was available, this showed that staff can access NVQ training and some staff had already completed NVQ 2, and other members of staff are working towards achieving the award which includes some of the domestic staff members who are currently undertaking NVQ level 1 training. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 19 From interviewing staff and observation on the day it was noted that a number of staff that work on the EMI unit had not completed dementia training or challenging behaviour, therefore staff did not have the necessary skills for their work. This issue was raised with the manager and operations manager, who will address this deficiency and plan appropriate training courses. Samples of staff files were examined, three files were checked, and these were new staff at the home. It was evident that the home operates a through recruitment procedure, based on equal opportunities and ensues the protection of service users; e.g. two written reference, gaps in employment checked, CRB and POVA checks completed, PIN and qualifications of nurses, and, ID documentation of each member of staff was also in files. All residents, relatives and visitors spoken to said that they felt confident with the manager and staff, they went on to say that they felt that all members of staff were very approachable and extremely thoughtful. Residents were very positive when being ask about staff, saying they were kind, good at their jobs and had no complaints. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 20 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, 36 and 38. Quality in this outcome area is Good. This judgement has been made using the available evidence in records, talking to staff and a visit to the service. Residents live in a home that is managed to ensure their safety and welfare are promoted and protected, and records required by regulation and for their protection are maintained. EVIDENCE: The appointed manager stated he his aware of his responsibilities and aims to run the home in the best interest of residents. In the six weeks he has been in post he’s made himself available to residents, staff and visitors to listen to any issues or concerns and try and address them. Records were available to show that quality assurance checks are carried out, Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 21 for example provider monitoring visits, records of resident/relative meetings and audits of care plans, accident reports. Supervision sessions and appraisal of staff were discussed with the manager and this requirement made on the last inspection and as been addressed satisfactory, and staff that were interviewed confirmed these had taken place. Finances and financial recording were discussed with the homes administrator and three residents’ records and balances were checked all were found correct; they are stored separately with accurate recording of transactions and receipts kept. Some residents control their own finances, with the help of their families. Health and safety was discussed with the manager, staff and records checked also observation of staff using equipment. All of which was found satisfactory, with staff being aware of health and safety policy and procedures, records seen were all up to date and satisfactory, with up to date current certificates for lift and hoists within the home. Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 22 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 23 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 OP2 Regulation 6(a) Requirement The contracts/statement of terms and conditions for service users must be issued to all service users. (Timescale of 01/06/06 not met) Timescale for action 01/01/07 2 3 OP7 OP19 17(1) 16(2)(m)( n) 23(2)(b) Care plans; records must be kept 01/12/06 secure. Take action to ensure that 01/01/07 television reception for service users is improved. Premises must be kept in good repair with regards to identified issues in bedrooms that require replacement of broken furniture by the 31/1/07,also a through clean of chairs. 31/01/07 4 OP24 5 OP24 13(4)(c) 6 OP26 16(2)(e) Toiletries in bedrooms must have 01/12/06 risk assessments completed to ensure they are free from avoidable risks. The laundry facilities must meet 01/02/07 service users needs. (Timescale of 01/08/05 and 01/01/06 and 01/09/06 not met.) Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 24 7 OP28 18(1)(c) A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) must be achieved excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of care staff who are registered nurses. (Timescale of 01/09/06 not met.) Staff must have the appropriate training for the work they perform for example, Dementia training and challenging behaviour for staff that work on the EMI unit. 31/03/07 8 OP30 18(1)(c) 31/01/07 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 Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Ladyfield House DS0000065777.V308938.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!