Inspection on 09/01/08 for Mallands Care Home

This inspection was carried out on 9th January 2008.

CSCI found this care home to be providing an Adequate service.

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

Mallands Care Home 08/03/09

Mallands Care Home 12/06/07

Mallands Care Home 22/08/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mallands Care Home Odle Hill Abbotskerswell Newton Abbot Devon TQ12 5NL Lead Inspector Margaret Crowley Unannounced Inspection 10.30a 9 January 2008 th 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 Mallands Care Home DS0000067260.V352344.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. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mallands Care Home Address Odle Hill Abbotskerswell Newton Abbot Devon TQ12 5NL 01626 366244 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) Mallands Care Ltd Vacancy Care Home 38 Category(ies) of Dementia - over 65 years of age (38), Old age, registration, with number not falling within any other category (38), of places Physical disability over 65 years of age (38) Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 38 service users aged over 65 years may be accommodated in the category of Old Age A maximum of 38 service users aged over 65 years may be accommodated in the category of Physical disability (PD(E)) A maximum of 38 service users aged over 65 years may be accommodated in the category of Dementia (DE(E)) 12th June 2007 Date of last inspection Brief Description of the Service: Mallands is registered to provide care for 38 older people who may also have a physical disability and/or dementia. It is a large detached older property with a purpose built extension and provides accommodation on the ground and first floors. The ground floor has spacious communal rooms including 2 lounges, one of which overlooks the garden, and a dining room. All bedrooms have en suite facilities or an adjacent toilet. There are two passenger lifts for people who are unable to use the stairs. The home provides aids and adaptations to meet people’s needs including grab rails, mobile hoists, adapted baths and a walk-in shower room. At the front of the house there is level access to a pleasant garden and seating areas. Mallands is located on the outskirts of the village of Abbotskerswell, Newton Abbot. There are local shops, a church and a public house within the village and a wide range of amenities in Newton Abbot. Fees currently range from£395-425 Written information is provided for people considering going to live at Mallands and those who are resident. A copy of the most recent CSCI inspection report is available. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and took place over 6 hours on 9th January 2008. Mr Leadbetter, the responsible individual for Mallands Care Ltd, was available for part of the inspection. Assistance was provided from the two administrators of the home and the assistant care managers. The home does not currently have a registered manager. The previous registered manager resigned in May 2007. An acting manager was appointed in July 2007, but she resigned in January 2008. She was not on duty on the day of the inspection, but was spoken to subsequently via the telephone. Prior to the inspection the proprietors provided CSCI with written information about how they maintain a safe environment, train and support staff, and seek the views of the people who live at the home to improve the quality of care provided. We sent out surveys to gain the views of people living in the home, relatives, staff, and visiting professionals. Feedback was received from 6 people who live in the home, 8 relatives and 3 staff. Feedback was also received from 3 visiting health professionals There were 29 people resident in the home during the inspection and 3 people were in hospital. In addition, there were 3 people present who receive day care. Many people were spoken with, including 4 in more depth regarding the lifestyle in the home and the care services they receive. Staff were observed and spoken with in the course of their daily duties. Opportunity was taken to observe the general overall care provided. The views of the people spoken with and those who replied to surveys are reflected throughout the report. In addition, a tour of the premises was made and records were inspected, including care, medication and staff records. To complete this report we considered progress made since the last key inspections on 12th June 2007 and a random inspection on 18th September 2007. What the service does well: People who live at the home praised the staff and said “they talk to people nicely, they are always considerate and discreet” and “I am exceedingly happy here, staff go out of their way to be helpful” Relatives commented that Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 6 “I always feel very welcome, staff are friendly, kind and helpful” and “they always have time for residents and are willing to help with their needs in any way” Many people living at Mallands have previously lived in the village of Abbotskerswell and the surrounding area and the home provides a resource for the locality. People are encouraged to maintain contact with family and friends. Visitors to the home value the friendly atmosphere. Mallands is spacious, well maintained, and homely. People enjoy the attractive and well-maintained gardens, which have level lawns and paths where they can walk. Many people praised the meals, which were described as “always very good”. The meals seen provided during the inspection were appetising and of a good standard. A varied, wholesome and balanced diet is provided. What has improved since the last inspection? Improvements have been made in the way that people’s care needs are assessed, addressed and recorded. People living in the home have a plan of care that contains guidance for staff in how to provide the care required. The plan of care is reviewed regularly with the person concerned or their relative, if they wish to participate. Care records have been improved and those seen were co-ordinated and accessible for staff providing care and visiting professionals There was a clear training plan on display to ensure that staff attend and receive training. New staff receive an improved induction. A system of regular supervision and an annual appraisal has been implemented with care staff. There is an ongoing programme of re-decoration and renewal to ensure that the premises are maintained to a good standard. Some bedrooms have had new carpets fitted and new beds have been provided. A new fire risk assessment has been completed, which includes evacuation plans for people living in the home. Risk assessments are now undertaken regarding people’s safety in leaving the premises unaccompanied. Additional safety gates have been installed. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive information to assist them in choosing to live at Mallands, and pre-admission assessments of their needs have been improved to assist in planning for their care. EVIDENCE: Two people who had come to stay at the home recently were spoken with. They said that staff were welcoming and helpful at the time they moved in. They confirmed they had received written information about the services provided. This is given to people considering moving to the home, and is available in people’s rooms. One person who was staying for respite following a period in hospital, said she was “exceedingly happy “ with the choice that her family had made on her behalf. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 10 Records inspected of people admitted recently showed evidence of a preadmission assessment undertaken of the person’s needs. The manager or an assistant manger undertakes this and visits the person in hospital of their own home. A new, improved admission assessment is now in use. Those seen indicated where and when the assessment had been undertaken. They contained clear information about the person’s needs and how the needs should be met. A letter was sent to the person, or their representative confirming that their needs could be met and a contract or statement of terms and conditions issued. Mallands does not provide intermediate care. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans now contain clear guidance for staff and are reviewed regularly to ensure that people living in the home receive consistent care. EVIDENCE: People living at the home and their relatives made positive comments about the care given and many praised the staff for their kindness and attention to their needs. They said that care staff provided personal care sensitively and their privacy was respected. We observed staff assisting people in a warm, attentive and friendly manner and showing consideration when helping them at mealtimes. The improvements seen in plans of care at the time of the random inspection in September 2007 have been sustained. There are systems in place to ensure that people living in the home have a care plan, which is reviewed and updated on a monthly basis. Any changes to the care plan are highlighted in red to ensure that care staff see them. Care plans and risk assessments inspected Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 12 provided sufficient information to enable the person’s health and personal care needs to be addressed. They also contained details of the person’s former life, their interests, likes and dislikes and preferred routines. Dietary preferences and needs were recorded. People’s weight is monitored on a monthly basis and appropriate action had been taken to address concerns identified. Fluid and food intake is monitored and recorded when necessary. Evidence was seen that people living in the home or their relatives are now enabled to take part in the review process if they choose. A person’s records inspected showed that bed sides were in use for their safetey. Although the agreement of the person’s relative had been sought, professionals involved in the person’s care had not been consulted as to whether this form of restraint was appropriate. The improvement in the accessibility and storage of care records seen at the random inspection has been maintained. Each person’s records were coordinated in a personal file and stored in a locked cabinet. Information held included the assessment, risk assessment, care plan and reviews, daily records and visits by professionals. Day and night-time records are now completed consecutively by care staff in handwritten records. Records are no longer held on computer. This means that information can be accessed at all times by care staff and visiting professionals. Positive feedback was received from two general practitioners regarding the skills and the caring approach of the former acting manager and the assistant care managers, and the manner in which the wishes of people living in the home are respected. They said appropriate referrals were made for urgent reviews. Feedback from the district nursing service also indicated they were receiving appropriate referrals, usually in a timely manner, but this occasionally varied. Health professionals also commented on the need for all care staff to have the opportunity to develop their skills in all aspects of care. The home’s system for the administration of medicines was inspected. Medication administration records were satisfactory and medicines were stored securely. The administration of controlled drugs was recorded and stored appropriately. The home has recently changed its pharmacy supplier and there has been teething problems with the supply of medication in monitored dosage packs. This has caused extra time for senior staff in recording the receipt of medication and in administering it. The assistant manager said that the management was keeping this under review. Staff who administer medication have received in–house training and have completed a distance learning course. Further training had been arranged via the new pharmacy. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Mallands have activities available and are now supported to exercise more choice and control over their lives. EVIDENCE: A programme of activities is provided which includes games such as bingo, scrabble, and trips out. Themed events, chosen by the more able people take place both indoors and in the garden when weather permits. These have included a recent visit from the donkey sanctuary. A regular newsletter is produced which contains photographs of the events. Daily activities are displayed in reception. On the day of the inspection three people went out for a trip to the moor with a member of staff. These opportunities are now offered more frequently. Staff were observed to spend time talking informally with people in the lounges and to offer activities. Care plans examined showed that the person or their relative had been consulted regarding their choice of daily routine. People spoken to said that they could choose whether they spend time in their own room or communal Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 14 rooms. It was observed that more people were exercising this choice than on previous visits to the home and were enjoying time spent in their room reading or watching their own choice of television programmes. The home now provides what is called “Quality Time” which is individual time spent with people and is particularly focused on those who are less able or less sociable. Relatives and said that they are made welcome at all times. Some people living in the home said they enjoy seeing family and friends who live locally locally. A small number of older people visit Mallands for day care. One person spoken with said that she welcomed the opportunity this gave her to spend her day with an old friend who is now resident, and to have assistance in having a bath. People said that the food was always very good. They said that the cook knows their preferences and that an alternative to the main meal was always available. People are consulted regarding suggestions for changes in the menu. Special diets are catered for and dietary requirements were recorded in the kitchen. The meals seen during the inspection looked appetising and were of a good standard. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems are in place to address concerns and complaints. Full recruitment checks are not always made for non-uk staff to ensure people are safe. EVIDENCE: The home has a written complaints procedure, which is contained in the service users’ guide that is given to every person, and is also on display. Feedback questionnaires from people living in the home and comments made indicated that they were aware of how to complain. They would raise concerns with senior care staff or the management, or ask a relative to raise concerns on their behalf. The management have not received any complaints since the last inspection and nor has CSCI. The home has an adult protection policy and procedure. Staff have received inhouse training in helping them to understand what abuse is and the warning signs. Staff spoken with said they had recently attended the safeguarding adults training organised by social services and found it valuable in raising their awareness and understanding more about what they should do if they suspect abuse. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 16 An inspection of staff recruitment records showed that full enquiries had not been made for non-UK staff. These must be made prior to staff being employed at the home to ensure they are suitable to work with vulnerable people. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in an attractive, comfortable and well maintained home EVIDENCE: Mallands is decorated in a homely style and has pleasant communal areas and attractive level gardens for people to enjoy. There is an ongoing programme of maintenance and renewal. The home has its own maintenance worker and routine maintenance work is attended to systematically. A tour of the premises took place and most bedrooms were seen. They were found to be well decorated, clean, comfortable and personalised to the person’s individual taste. People living in the home and relatives commented on the cleanliness and the quality of the accommodation. A small number of wheelchairs continue to be stored in bedrooms of limited size, which reduces the accessible space for the person occupying the room. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 18 The premises were clean, hygienic and free from unpleasant odours throughout. A new washing machine with a sluice programme has been installed in the laundry. Outside improvements have been made in the security of the garden area. A new fence and a gate have been erected to the upper garden area. A gate has also been fitted to the main entrance, which the proprietors said will be kept closed at off peak hours. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards27,28,29,30.Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although more staff training has been introduced, the staff group that has a limited number of people with qualifications and experience. EVIDENCE: Communication seen between staff and people living in the home during the inspection was friendly, caring and courteous. People said that staff were kind and helpful, and relatives confirmed this. The responsible individual said that there always sufficient skilled and experienced staff on duty to meet people’s needs by day and night, and that staffing levels are kept under review. Additional staff have been recruited since the inspection in September 2007, when a requirement was made to review of staffing levels. However, feedback indicated that there are sometimes difficulties in providing staff cover at weekends. An improved system to identify and address staff’s individual training needs was implemented by the former acting manager. A clear, co-ordinated training plan was on display to ensure that staff attend and receive training. This included mandatory training in safe working practices and training in the care of people with dementia and safeguarding adults. An improved system of induction for new staff has been introduced using the Skills for Care specifications. A system of regular supervision for care staff has been Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 20 introduced and records are kept of this. The acting manager had also undertaken annual appraisals with staff. Only 20 of the care staff have the National Vocational Qualification in Care at level 2 or above. This continues to be well below the 50 required to meet the National Minimum Standard for care homes. The administrator said that the home has difficulty in recruiting and retaining staff with the qualification. The home cares for people with high levels of need as demonstrated in the number of notifications to CSCI of serious incidents, illnesses and deaths. This has implications for the skills, training, experience and numbers of staff employed, particularly as there continues to be a high turnover in staff. Health professionals commented on the need for all care staff to have the opportunity to develop their skills in all aspects of care. An inspection of staff records showed that although Criminal Records Bureau disclosures and references had been applied for in a timely manner within the UK, full checks had not be made in respect of non-UK staff from the previous country in which they lived, including staff from both within and outside the European Community. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although progress has been made in the management of care services, the home is again without a manager, which is disruptive for people living in the home and staff morale. EVIDENCE: There has been no manager registered with CSCI since the former registered manager resigned in May 2007. An acting manager was appointed in July 2007, but she resigned in January 2008. Since the last key inspection the home has made significant progress in addressing concerns and requirements. The former acting manager had initiated changes in care practice, staff training and supervision. The change in manager is unsettling for people living in the home and staff. Feedback received indicated that care management team needed more support from the registered providers. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 22 At the time of writing this report, Mr Leadbetter, the responsible individual said that action was being taken to recruit a new manager and they hoped to make an early appointment. In the interim the two assistant care managers were managing the care service with support from the two administrators and the directors. Additional care staff would be available to ease the workload. There are regular quality surveys undertaken and the views of people living in the home and their relatives are actively sought. A periodic newsletter has been introduced to keep people informed. The home has minimal involvement with people’s financial affairs. Either the person or more usually a relative or a representative manage this. Evidence was seen that payments made by the administrator on behalf of a person are invoiced monthly to the person or their relative/representative. Routine health and safety maintenance processes are managed satisfactorily. Evidence was seen of regular checks and tests completed in respect of fire safety, electrical, gas water systems and lifts and hoists. A new fire risk assessment has been completed, which includes evacuation plans for people living in the home. All people living in the home now have a risk assessment regarding their ability to go outside the premises unaccompanied and safety gates have been installed following previous concerns. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 2 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no 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 OP29 Regulation 19(1) Schedule 4 Requirement A full recruitment process must followed and the necessary checks and references obtained for all staff before they commence work. This is to confirm the person is suitable to be working with potentially vulnerable people. Timescale for action 09/03/08 2 OP8 13(7) Bed sides must be used only 09/03/08 with the agreement of professionals involved in a person’s care, the person, and/or their representative to ensure that they are an appropriate measure for the person’s care. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations A minimum ratio of 50 members of care staff, excluding the Registered Manager, should be qualified to NVQ Level 2 or above. Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mallands Care Home DS0000067260.V352344.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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