Inspection on 08/07/05 for Millwater

This inspection was carried out on 8th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 20 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Millwater 03/03/10

Millwater 03/02/10

Millwater 01/12/09

Millwater 14/08/08

Millwater 23/08/07

Millwater 07/03/07

Millwater 25/01/06

Millwater 05/01/05

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

CARE HOME ADULTS 18-65 Millwater 164 - 168 Waterloo Road Hay Mills Yardley Birmingham, B25 8LD Lead Inspector Sean Devine Announced 8 July 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Millwater Address 164 - 168 Waterloo Road Hay Mills Yardley Birmingham B25 8LD 0121 706 3707 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) West Regent Ltd Vacant Care Home 18 Category(ies) of Care Home registration, with number of places Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 18 people who are in need of nursing care for reasons of mental health problems. (18 MD). 2. Within three months of registration that a registered manager is in full time employment. 3. In addition to the care manager and ancillary staff, minimum staffing levels are maintained to enable one first line nurse and three care assistants to be on duty during the waking day, 9am to 9pm. 4. That minimum night waking staff levels of one first line and two care assistants are on duty between 9pm and 9am. 5. That this registration, which does not meet with National Minimum Standards for Younger Adults, is approved on the understanding that the service will return to the former premises `The Royd` within a period of six months. Date of last inspection 5/1/05 Brief Description of the Service: Millwater Nursing Home has been registered to provide a temporary service for the residents of The Royd Nursing Home. Millwater will provide rehabilitative nursing care for 17 younger adults with mental health needs whilst The Royd is redeveloped and refurbished. The residents accommodation is single rooms with en-suite facilities, there is a large communal lounge and a small lounge/quiet area designated as the smoking area for service users. Dining facilities are available in two areas. The grounds are fully enclosed with access from inside the building only. There is a small area outside the main entrance for off road parking. The home is situated close to major bus routes in and out of Birmingham City Centre, local shops and amenities are within walking distance and the Swan Shopping Centre is approximately one mile away. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An application has been received at the commission from the organisation West Regent Ltd, to extend the period of time in respect of the service returning to The Royd and also to extend the time for them to recruit and have in place a registered manager. This inspection was conducted on an announced basis by one regulation inspector over a period of one day. The inspector was able to meet with residents and staff. Records pertaining to care delivery, staffing, services and health and safety were viewed. A short tour of the premises was undertaken. Comment cards received prior to the inspection from professionals who visit the home were generally complimentary of the service, however some concerns were raised that the home does not always follow up on actions following reviews of care. Residents’ opinions and views were that the home is good, that they enjoy living at the home and that the local amenities are excellent. What the service does well: What has improved since the last inspection? Residents have been encouraged to be involved in the planning of their care, they have been asked about how effective this care has been. Written care plans have been individualised to each resident, developed from an assessment of need. Risk assessments for residents are being reviewed more frequently and they have been further developed to include risks in respect of the resident’s ability to manage their own money. Infection control practice has improved. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 Residents are not provided with adequate information to ensure they can make a fully informed choice as to whether they wish to live at the home. EVIDENCE: The home has a detailed statement of purpose describing the service, resources and facilities at the home. The statement needs amendment to detail that the home does currently provide nursing care to residents. Sampled residents’ files included detailed assessments updated following the transfer to Millwater. Residents’ contracts in respect of the terms and conditions of residency refer to The Royd nursing home, the contracts need to be updated on an interim basis to reflect accommodation at Millwater. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Written care plans and their related assessments including risk management plans are inadequate to fully support individual residents to achieve their goals. EVIDENCE: Assessments of need do include adaption and loss, mental health relapse management and all activities of daily living have been recently completed. The assessments in part require further development to include specific details such as; clear instruction of exactly which areas of personal care require supervision and statements such as “goes to bed at normal time” needs to detail what is normal for each individual resident. Mental health assessments also require more information to be completed in the section called ”normal day care needs”. One dental / oral health assessment recorded referral to a dentist, however details of this referral were not available. Written care plans had been developed from these assessments, however one assessment of frequent backache had no complimentary care plan. A care plan following a recent report of high cholesterol levels was not available. Sampled files also included Care Programming Approach care plans, summaries, reviews and relapse and risk management plans. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 10 Some important information recorded at these reviews had not been developed into care plans and thus actions had not been implemented such as cooking, college courses and yoga classes. The home has developed many risk assessments for residents, these raise individual residents risks such as vulnerability, finances and safety issues in their rooms. Many risk assessments and measures to reduce risk are reviewed monthly, this must be practice for all risk assessments. Risk assessments are needed where medical tests are declined by residents such as blood tests; the risk assessment framework and management plan must include consultation with relevant healthcare professionals such as the mental health team, GP and social worker and also inform staff of signs and symptoms of toxicity. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,15,17 The home does not support residents to have all their lifestyle needs met in a safe environment, this means that the residents health maybe put at risk especially when food safety is considered. EVIDENCE: Residents informed the inspector that they are able to use many local shops, clubs and local amenities. The home also supported them with developing their cooking skills and that the weekly cooking group continues to meet. The home has not addressed requirements from the last inspection to ensure the weekly menu encourages a healthy diet, that residents have access to drink making facilities when needed and not be reliant on staff to access the main kitchen to make hot drinks. The current weekly menu does not allow residents to have an alternative choice of dinner. Written care plans are needed to define how residents are supported with cooking skills. Health and safety checks are not fully maintained in the kitchen including fridge and freezer temperatures, core food temperatures, taking food samples and completing cleaning schedules. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 12 These improvements were identified at the last inspection and records suggest that these concerns are mainly apparent when the cook is not on duty, especially as weekends. Chipped and damaged crockery needs to be replaced. One resident was very positive in respect of the social skills training group that meets once a week with activities inside and external to the home. Some residents’ activity records described leisure activities such as golf, day trips, walking and snooker. Sampled residents files all included an assessment of recreational and leisure pursuits. At the time of inspection some residents and staff were involved in a game of badminton in the garden. Residents confirmed that visiting them at the home was flexible and that the home was supportive when they visit family and friends. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 The personal and healthcare needs of residents are not fully met by the home, improvements are needed to ensure that it is safe and meets the individual residents specific needs. EVIDENCE: The residents are able to meet their own personal care needs, the staff do monitor and record residents ability and provide encouragement where needed to improve and maintain standards. Details of specific areas of need and support are needed as identified in standard six. Monitoring personal care is recorded as a measure in some relapse management plans and care programming approach documents. Some residents confirmed that they see when needed their GP and also support from their community mental health team and social workers. Some residents require health checks such as weights and blood tests, the manager confirmed that weights are required monthly, however sampled records reflect this is less frequent. Records of health visits are maintained on a separate form for staff to gather information quickly and to keep the information together. Medicine management is generally good, requirements of the last inspection have not been totally addressed. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 14 Concerns still remain in respect of the accurate recording of medicines on the MAR and ensuring the stock of medicine is accurate. Some as required medicines did not have a written protocol or a written care plan to guide and advise staff of when it should only be administered. The medicine policy could not be located at the home at the time of inspection. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home does not fully protect residents who are vulnerable from the risks of abuse. Residents are adequately supported to raise concerns in respect of their care and service provision. EVIDENCE: The homes complaint policy is visible within the home, residents have a copy in the residents guide and also information is recorded within their terms and conditions of residency. The home has policies and procedures to help protect residents from the risks of abuse, these policies do not fully comply with local multi-agency guidelines. The manager informed the inspector that a review of this policy was underway. A commitment to training staff is recorded within the policy however sampled staff files did not include evidence of such training. The home has completed risk assessments with each resident detailing why the home needs to help manage their money and records do reflect that residents’ money is being safely managed. The balance of money for one resident should be discussed with the resident and social worker to ensure it is fully secure. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home is maintained to a high standard, including décor, repairs and good infection control practices. Residents are living in a comfortable and healthy environment. EVIDENCE: The home has been decorated and furnished to a high standard throughout. The communal areas seen by the inspector have been well maintained. Furniture is of a modern design and adequate to meet individual and collective needs of the residents. All areas appeared bright and clean. Staff were observed maintaining good infection control practices, appropriate hand washing facilities are available in high risk areas such as communal toilets. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,36 The staff team is not trained, supervised and recruited to fully meet the needs and to adequately protect the safety of the residents. EVIDENCE: Staffing rosters included with the pre-inspection questionnaire indicate there is normally one trained nurse (RMN) during all day hours and a minimum of four support workers in the morning and three in the afternoon. At night one nurse and two support workers are on duty. Duty rosters do not indicate the full name of the worker or the times shift commences and finishes. The roster does not identify who cooks at the weekend, where this is nurse or a support worker, additional hours to maintain minimum staffing levels must be in place. The home has not employed a permanent domestic member of staff, this requirement is carried forward from the last inspection. The recruitment practice must be improved, some staff were recruited on the basis of a CRB photocopied from and completed by a former employer. References are taken up and application forms completed. A pre-employment health check is also completed prior to appointment. The pre-inspection questionnaire section regarding training information had not been completed, previous inspections record that the home does not have a minimum of 50 of care staff trained to NVQ 2 in Care or above. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 18 Induction training based upon the TOPSS programme is in place however training is needed in all safe working practices for all staff including nurses; this must include Basic Food Hygiene and Moving and Handling. Some staff receive supervision routinely, these supervisions include learning, performance, areas of concern and an action plan. One nurse had no supervision records available. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42 The manager of the home has not been registered with the commission, her ability to manage the home has not been fully assessed. In light of this it is deemed that the skills and competencies of the manager are inadequate to fully meet the needs of the residents. EVIDENCE: The home as required at previous inspections does not have a registered manager who is suitable qualified, competent and experienced. The present manager will shortly be leaving the home. The home has some risk assessments for hazards in respect of fire, premises and staff. Further assessments are needed to detail other hazards such as food safety, gas and security at the home. The testing, servicing and maintenance of the homes fire system, utilities such as gas, electric and water and all other health and safety checks are kept upto date. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 20 The recent emergency light service identified seven lights that had failed the test, the manager was left an immediate requirement to have these repaired. The manager since the inspection has telephoned the inspector to confirm the lights have been repaired. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x x 2 Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 x 1 Standard No 31 32 33 34 35 36 Score x x 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Millwater Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score 1 x x x x 2 x E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA1 YA2 Regulation 4(1)(c ) schedule 1 (6) 14(1) Requirement The statement of purpose must be updated to include the provision of nursing care. The life histories of residents must be further developed to include positive experiences, this must be included within a care plan. Previous timescale of 30/6/05 not met, this requirement is carried forward.. Residents contracts must detail that the accommodation is at Millwater Assessments of need must include specific information about what support is needed.. Mental health assessments must include a plan in respect of normal day care needs. Assessments and care plans must have have evidence that required actions have been completed, e.g. referral to a dentist. Concerns / needs raised in assessments must have a written care plan, e.g. regular backache. Timescale for action 30/9/05 30/9/05 3. 4. YA5 YA6 5(1)(b) 14(1)(2) 30/9/05 31/8/05 5. YA6 15(1) 14(1)(2) 31/8/05 Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 23 6. YA6 15(1) 7. YA9 15(1) 13(4) Information gathered from 31/8/05 reviews such as Care Programming Approach meetings must be included within a written care plan and detail how the needs and goals are to be achieved. Risk assessments must be 31/8/05 reviewed at least monthly and more frequently where required. Previous timescale of 31/5/05 not met, this requirement is carried forward. Risk assessments and risk management plans are needed where residents decline to have medical tests such as blood tests. Relevant healthcare professional must be involved in this process, such as GP, Psychiatrist, S/W and Community Mental Health Teams. All residents must be assessed and provided with assistance to maintain and develop their cooking skills. A care plan must be developed and agreed with the residents. The home must have a menu that encourages a healthy eating lifestyle and which also includes the preferences of the residents. All residents must have access to drink making facilities as and when needed and not be reliant on staff to access the main kitchen to make hot drinks. The cyclical menu must include an alternative meal at dinner time. Previous timescale of 30/6/05 8. YA17 14(1) 15(1) 16(2)(h)(i ) 30/9/05 Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 24 9. YA17 13(3) 23(2)(d) not met, this requirement is carried forward.. The home must maintain cleaning and records for cleaning in the kitchen at weekends. Records of probing food temperatures and daily fridge and freezer temperatures must be maintained at the weekends. Samples of food prepared at the home in line with the food hazard analysis must be maintained at weekends. Previous timescale of 31/5/05 not met, this requirement is carried forward. The weights of residents must be recorded monthly in line with management guidance. All medicines received into the home must be accurately recorded on the MAR, this includes medicines prescribed and dispensed by community mental health teams. The home must have in place details of the prescribing wishes of doctors from community mental health teams so they can be checked for accuracy when received into the home. All residents who have “as required” medicines must have a care plan devised that includes why, when, name, dosage, frequency and reasons for administering medicines, outcomes must be recorded. Service users must be involved in the development of the care plan. Previous timescale of 31/5/05 31/8/05 10. 11. YA19 YA20 12(1) 13(2) 31/8/05 31/8/05 Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 25 not met, these requirements are carried forward. A medicine policy that reflects current practice at the home must be available. The home must revise adult protection procedures to ensure full compliance with the guidelines provided in ‘No Secrets’ including Whistle Blowing policy. Previous timescale of 30/6/05 not met, this requirement is carried forward. Staff must receive training to adequately protect vulnerable adults from the risks of abuse. The home must confirm that the insurance on the safe in the office is adequate to fully protect residents money. Staff rosters must include the following details; 1) The full name of staff. 2) Time duty commences and finishes. 3) The name of staff member cooking at the weekend. 4) It must also include details of who is covering for the member of staff cooking at the weekend. The home must employ permanent domestic/cleaning staff to maintain acceptable standards of hygiene, rather than delegating these duties to care staff. Previous timescale of 31/5/05 not met, this requirement is carried forward. All staff must have an enhanced CRB disclosure check in place 31/8/05 30/9/05 12. YA23 13(6) 13. YA23 13(6) 31/8/05 14. YA33 18(1)(a) 17(2) schedule 4,(7) 31/8/05 15. Millwater YA34 19(1)(b) schedule 30/9/05 Page 26 E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 2(7) completed by the home prior to appointing new staff. Staff with CRBs on file from previous employers must have a CRB check completed by the home. The care manager must ensure that a minimum of 50 of the employed care staff achieve NVQ 2 in Care by 2005. Currently only 3 staff have NVQ 2 or above. All staff including qualifed nurses must receive and have maintained training in all safe working practices based upon the TOPSS programme, this must include Basic Food Hygiene and Moving and Handling. All staff including qualified nurses must receive supervision at regular intervals and in line with National Minimum Standards. 16. YA35 18(1)(a) 18(1)c)(i) 31/12/05 17. YA36 18(2) 12(1) 30/9/05 18. YA37 CSA 2000 Sec 24. 19. YA42 23(4) 20. YA42 23(4)(b) Qualified nurses must receive clinical supervision and be assisted with development needs in respect of their clinical practice. The home must have in post a 30/11/05 qualified, competent and appropriately experienced manager that has been registered with the commission. The home must further develop 30/9/05 risk assessments at the home to include food safety, gas and appliances and security at the home. The emergency lights identified 11/7/05 at the June 2005 service must be repaired and maintained in operation. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 27 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 YA23 Good Practice Recommendations The balance of money for one resident should be discussed with the resident and social worker to ensure it is fully secure. Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection Birmingham and Solihull Local Office 1st Floor, Ladywood House 45/46 Stephenson Street Birmingham, B2 4UZ 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 Millwater E54 S63161 Millwater V230966 080705 - Stage 4.doc Version 1.30 Page 29 - 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!