Inspection on 21/08/07 for Manor View Nursing Home

This inspection was carried out on 21st August 2007.

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

Manor View Nursing Home 04/08/08

Manor View Nursing Home 26/09/06

Manor View Nursing Home 06/04/06

Manor View Nursing Home 07/10/05

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

CARE HOMES FOR OLDER PEOPLE Manor View Nursing Home 19 Manor Rd Hatfield Doncaster South Yorkshire DN7 6BH Lead Inspector Valerie Hoyle Key Unannounced Inspection 08:30 21st August 2007 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 Manor View Nursing Home DS0000065195.V346711.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. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor View Nursing Home Address 19 Manor Rd Hatfield Doncaster South Yorkshire DN7 6BH 01302 350877 01302 843807 manor.view@fshc.co.uk www.fshc.co.uk Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) Post Vacant Care Home 54 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) Category(ies) of Dementia - over 65 years of age (54), Mental registration, with number disorder, excluding learning disability or of places dementia (40) Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. One specific service user under the age of 65, named on variation application dated 16th March 2004, may reside at the home. One specific service user under the age of 65, named on variation application dated 23rd June 2004, may reside at the home. One specific service user under the age of 65, named on variation application dated 5th June 2006, may reside at the home. 26th September 2006 Date of last inspection Brief Description of the Service: Manor View is situated in the village of Hatfield, nearby are shops and a public library. There is easy access to the bus service into the centre of Doncaster, which is a few miles away. The home is divided into two separate units. The main unit (Manor View) provides nursing/residential care for older people with dementia and can accommodate 40 service users. Manor View is a two-storey building with bedrooms on both the ground and first floor. The second unit, (formerly known, as Church View) is a purpose built small care home providing accommodation for fourteen older people with dementia. Secure gardens are provided for both units with easy access for residents. Information gained on the 21st August 2007 indicate the current fees range from £416.15 for residential care and £590 for nursing care, additional charges include private chiropody, hairdressing, and outings. The home provides information to people and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in the entrance for visitors to read. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 13.5 hours (two days), this included a partial inspection of the both units (Manor View, Church View). Three peoples care plans and supporting documentation were examined. Two people who use the service, eight relatives and five staff were spoken to during the visit; their views are included throughout the report. Occupancy at the home remains high at both units with all 14 beds occupied at Church View, and 33 beds occupied at Manor View. One CSCI service users questionnaires were sent to the home and returned. Five health and social care professional surveys were sent but none returned. Four relatives questionnaires were sent and returned. The information has been collated and their views are contained within this report. Three peoples care plans were examined and policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Nine staff recruitment and training records were examined to ensure people who use the service are protected. Helen Hartman was appointed as manager in May 2007. She has not yet submitted an application to Commission for Social Care Inspection to be the registered manager. She was present throughout this visit and assisted with the inspection process. She had completed and returned the Annual Quality Assurance Assessment (AQAA) dated July 2007, and the information gained is included in this report. What the service does well: All new people admitted to the home received a comprehensive assessment to determine how their care needs would be met. Surveys received said that they received sufficient information to enable them to make decisions about placements at the home. Surveys also said that they were confident that staff could meet the needs of their relative. A well-motivated, enthusiastic member of staff arranged activities at the home, which were specific to the individual needs of people who use the service. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Although improvements had been made to areas of the home, there remain a number of outstanding requirements that had not been actioned. A commitment from the organisation to fully refurbish all bedrooms at Manor View was made at previous inspections, although it is clear that some rooms still contain old furniture that was in poor repair. Drawer fronts were missing from sets of drawers and some carpets were dirty. Relatives said bedrooms smelt stale and furniture was in poor repair. The Kitchen at Church View is extremely poor with most of the equipment broken. Some of the kitchen units had been removed because they were unsafe. A visitor to the home raised concerns with the inspector about having to stay to look after her relative while staff washed pots in the kitchen because the dishwasher was not working, and had not worked for a considerable length of time. Staffing levels were poor. A number of days were identified on the rota where staffing was reduced to unsafe levels. There had been a high turnover of staff, and new staff had not gained the necessary skills and competences to ensure people were cared for and protected. Medication procedures were generally well managed, although stock levels for a number of prescribed items were high. The storeroom was not suitable for storage of medicines. Care plans lacked detail, to enable staff to support people with mental health problems. Some doors used as means of escape needed attention for the safety of people who use the service. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 7 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. Manor View Nursing Home DS0000065195.V346711.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 Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs could be met. EVIDENCE: All new people receive a full comprehensive needs assessment before admission; this was carried out by the manager who had the required skills and competencies. The service was efficient in obtaining a summary of any assessment undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what they needed to do to ensure people’s needs were met. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 10 Three assessments were examined and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the manager and staff carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans generally provided staff with sufficient information to meet the needs of people who use the service. Medication policies and procedures were generally well managed ensuring the safe administration of medication. EVIDENCE: Three care plans were examined; they contained sufficient information, although some areas of the plans required updating to reflect changes to peoples care needs. Two care plans examined did not give clear guidance to staff to ensure they could manage the mental health needs of people who use the service. The registered nurses had responsibility for compiling the care plans, although the introduction of a new format means that some care plans had not been transferred. This potentially poses significant risk to people who use the service when information is not up to date. Staff was observed interacting with people who use the service, although some conversation was inappropriate and did not maintain the persons dignity. Some Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 12 staff did not show any understanding on how to manage people’s mental health care needs. A number of people were agitated for long periods of time, with very little intervention from staff. Staff did not have skills to communicate effectively with people living at the home to reduce their anxiety and negative mood. Records examined and discussion with the staff confirmed some aspects of people’s healthcare needs were met. The qualified nurses were able to carry out nursing requirements for those people who fall into the nursing category. District nurses also attend the home to carry out injections, take bloods and attend to dressing for people who were assessed as requiring residential care. Administration of medication procedures were generally well managed although there were poor facilities in the home for the storage of medicines. This puts the people at risk of receiving medication that may be unsafe. The walls of the store had flaking paint and there was an unpleasant smell in the room. Stock levels gave cause for concern, in particular stocks of medication indicated that people do not receive medication as prescribed. Records examined were accurate and the medication was safely administered, although the inspector found medication in the store cupboard that was not recorded on the medication administration record (M A R). The organisation had recently introduced a new induction programme, which ensures staff had clear understanding of the rights of people who use the service. Privacy and dignity is covered in the first modules of the induction that meets the ‘Skills for Care’ standards. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to take part in social activities supported by staff. Mealtimes were well managed and visiting was flexible. EVIDENCE: Activities were arranged to meet the needs of people who use the service. The activity co-ordinator was very motivated and was able to describe activities organised which included trips to the local pub, and day trip to Cleethorpes. There were plans for a tea dance in September, and new garden furniture means that people can enjoy sitting in the garden. Crafts and video afternoons appeared to be enjoyed by a number of people. Mealtimes were well managed by staff who had a good understanding of people’s dietary needs. Staff were seen giving assistance in an unobtrusive way, however a number of people were fed while sitting in the lounge, which means people remain in the same position for long periods, which may lead to problem with their skin. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 14 People were actively encouraged to keep in contact with family and friends living in the community. Visitors were welcome at any time and facilities were available for them to have a drink or a meal with the people who use the service. People can choose to entertain visitors in their own rooms or perhaps a lounge or garden areas. Visitors to the home expressed concerns about clothing that had been damaged; while others said staffing levels appeared inadequate. One relative said the home often had offensive odours, although that had improved since a new carpet had been fitted in the main lounge. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service could access the complaints procedures and the manager ensures any concerns were recorded and investigated appropriately. Adult protection policies, procedures and training of staff promote the protection of people from abuse. EVIDENCE: There was a complaints procedure that was available to people who use the service and visitors to the home. The procedure was also referred to in the service users guide, identifying the stages to follow; this included the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure. Examination of the complaints records showed that there had been three complaints recorded since the last visit to the home. Records examined showed that the complaints had been investigated appropriately, to the satisfaction of the complainant. The Commission for Social Care Inspection had received one anonymous complaint, investigated as part of the inspection. Information received raised concerns about staffing levels, toileting regimes, and unpleasant odours throughout the home. From the documentation examined and a partial tour of the building, the inspector was able to uphold the complaint. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 16 Commission for Social Care Inspection surveys received confirmed that people who use the service know what to do if they had any concerns, although one relative said she had made a complaint but had received no response. One relative said she had made a complaint about the laundry service and was awaiting a response. There was a comprehensive Adult Abuse and Whistleblowing policy and staff follow the procedures to those standards. The manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. There had been three referrals made to social services protection of vulnerable adults team, although no outcomes had been reached as they continue to be investigated. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider continues their refurbishment of the home to ensure the environment is safe and suitable for service users to spend their time. EVIDENCE: The registered providers continue to refurbish both units, although some essential work in the kitchen at Church View and some bedrooms at Manor View had not been completed. A new carpet had been fitted in the lounge area, and new flooring and dining furniture enhances the areas for the people who use the service. Bathing facilities at both units had been improved to ensure suitable provision was provided. Storage units in the refurbished bathrooms were unsafe (Church View) and need to be secured to the wall. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 18 Bathrooms were generally untidy with old furniture and unused equipment. Two toilets on the ground floor at Manor View were out of order and sluicing facilities did not have a locked door, which potentially poses a risk to people who use the service. Some areas and bedrooms were untidy with people’s belongings were left lying around the room; some furniture remains in poor repair with drawer fronts missing and some light bulbs need replacing. Some bedrooms had offensive odours, although the manager said cleaning regimes had not changed. Staffing levels are not sufficient to maintain a clean odour free environment. Some fire doors raised serious concerns for the safety of people who use the service. The manager was made aware of the doors leading from the dining area, and had organised repair. The patio doors at Church View could not be opened, as they were unsafe. They would be used as a means of escape in case of an emergency, therefore poses significant risk to people who use the service. The kitchen at Church View had not been refurbished and remains outstanding from previous inspections. The units are in an extremely poor condition and staff was expected to hand wash dirty dishes, as the dishwasher had not worked for a good length of time. For health and hygiene reasons this work must be actioned with some urgency. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29,30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were insufficient staff in both numbers and skill mix to support people who use the service. Recruitment policies were followed ensuring the safety and protection of people who use the service. EVIDENCE: Staff rotas examined showed a number of occasions when levels were insufficient. Visitors said often when they visit staffing levels were such that they felt that care given to their relatives was not good. A complaint received by Commission for Social Care Inspection also indicated that levels were insufficient. One relative (Church View) said she sometimes extended her stay, while staff were busy washing teapots. There was a good recruitment procedure that clearly defined the process, which is followed. The procedure was followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of services and for the protection of residents. Nine new staff had been employed at the home; their recruitment files were examined and contained all the necessary employment checks including references and CRB checks. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 20 Observation of staff during the inspection raised concerns about the skills and competencies of new staff working at the home. Staff appeared to have little awareness of the needs of people who were in an agitated mood. There was a good induction programme and the inspector was able to examine a completed induction workbook. The training plan indicated that some refresher training required updating. Due to the high turnover of staff the home continues to work towards achieving NVQ awards in care, only 3 staff had the required qualification. The manager said the nurses continue to develop their own knowledge, by attending relevant training courses. PIN numbers for the registered nurses were examined and were current. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home had changed. The new manager was efficient and effective at developing services. Health and safety procedures were well managed. EVIDENCE: The manager had overall responsibility for the two units, although there was a care manager to oversee the day-to-day management of Church View. Residents/relatives meetings were used to gain the views of people who use the service. This included suggestions for menus and activity programme. People who use the service would find it difficult to complete a survey due to their limited capacity; therefore relative’s surveys should be used to gain views Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 22 on the service. The registered provider undertakes a monthly quality audit at the home and the reports were available for inspection. Accident reports were analysed by the manager to ensure risk assessments were developed where required, to minimise risks to people at the home. Maintenance and service records examined were up to date and current to the services provided. The required health and safety policies and procedures relevant notices were displayed Fire safety procedures were in place; although staff required refresher training. The maintenance person was responsible for arranging the training. Service records were examined and were current, although two fire doors required urgent attention, to ensure people were safe. The manager had actioned the repair during the inspection, although the repair had not been completed by the end of the inspection. People were unable to manage their own finances due to limited capacity; some relatives hold responsibility for this. The administrator told the inspector how bank accounts were held on behalf of service users; one is an interest bearing account, although other accounts were pooled but had individual records to determine balances. Manor View Nursing Home DS0000065195.V346711.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 X X X X 2 STAFFING Standard No Score 27 2 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 X X 2 Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 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 OP7 Regulation 15 Requirement Care plans must have full information to give staff direction with regard to meet the, psychological and mental health needs of people who use the service. Stock levels of medication must be kept to a minimum. The store room must be made suitable for the safe storage of medicines. A record of administration must be made on the MAR for all medicines prescribed. This demonstrates that residents are getting their medication as prescribed The refurbishment of the home must continue to ensure all furniture is safe and fit for purpose. The kitchen at Church View must be refurbished or existing facilities made safe. (timescale 01/11/06 not met) DS0000065195.V346711.R01.S.doc Timescale for action 01/12/07 2. OP9 13 01/10/07 3. OP9 13 18/09/07 4. OP19 23(2)(c) 01/10/07 5. OP19 23(2)(c) 01/10/07 Manor View Nursing Home Version 5.2 Page 25 6. OP21 13 Sluices must be locked, for the safety and protection of the people who use the service. The home must be kept free from offensive odours, clean, and hygienic at all times. Sufficient staff in numbers and skill mix must be on duty at all times to ensure people’s needs are met. Each member of staff must be assessed and a specific training programme implemented. The training must be specific to meet the needs of the service users. All staff must be suitably qualified, competent and experienced to meet the health, safety and welfare of the service user. A manager must submit an application for registration with the Commission for Social Care Inspection must be submitted. Fire doors (Manor View) and doors used as a means of escape (Church View) in case of emergency must be repaired or replaced. Written confirmation of the action taken must be sent to Commission for Social Care Inspection by 22/09/07 18/09/07 7. OP26 16 01/10/07 8. OP27 18 18/09/07 9. OP30 18 01/10/07 10. OP31 8 01/11/07 11. OP38 23 18/09/07 Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 26 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 of 50 of staff who are NVQ level 2 qualified should be employed at the home. Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Manor View Nursing Home DS0000065195.V346711.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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