Inspection on 19/09/06 for Newton Lodge

This inspection was carried out on 19th September 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newton Lodge 29/11/07

Newton Lodge 01/02/06

Newton Lodge 01/09/05

Newton Lodge 09/03/05

Newton Lodge 11/11/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Newton Lodge 50 Olive Road New Costessey Norwich Norfolk NR5 0AS Lead Inspector Mrs Dorothy Binns Unannounced Inspection 19th September 2006 10:00 Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 Newton Lodge DS0000027627.V312989.R02.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 Adults 18-65. 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. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton Lodge Address 50 Olive Road New Costessey Norwich Norfolk NR5 0AS 01603 740282 NO FAX # 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) www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Position Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Newton Lodge is a care home providing personal care and accommodation for up to 3 younger adults with a learning disability. The service users may also have a physical disability. Care Management Group Limited whose registered office is located in London owns Newton Lodge which is located in a residential area of New Costessey and a bus ride to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow. All bedrooms offer single occupation and one is below 10 square metres. None of the bedrooms have en-suite facilities. There is ample communal space. There are access issues regarding the garden. On-road parking is available. The home is staffed at all times including a waking staff at night. The level of fees for the service are dependent on the care needs of the service users but range from £3683 - £11694 per month. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection lasting four and a half hours in all and consisting of two visits. During the first day discussions were held with the new manager about the progress of the home and whether requirements from the last inspection had been attended to. Records and policies were examined and a tour was made of the premises. Plans of a proposed extension were also viewed. As none of the service users were at home during that visit, an arranged second visit was made two days later in order to see the service users and staff. In addition the Commission sent out surveys to the service users to see what they thought of the service. One reply was received. Information on the Commission’s files and contact with the home between visits has also been taken into account in the writing of this report. Only the key national minimum standards were covered in this inspection. This is a small home for three service users and overall the care offered is very good and staff are committed to the service users. At a hands on level the service users have a good quality of life. Where the home still has work to do is largely where they are dependent on the work of the head office of the organisation in such areas as recruitment processes, training and in maintenance of the building. What the service does well: The service offers a good quality of life to the service users. They have multiple needs and require a lot of attention from staff but staff have come to know them well and work hard to see that their individual needs and preferences are properly attended to. Staff spend most of their time seeing that service users are comfortable and stimulated and they take them out a lot into the community. Overall staff convey a commitment to the service users and their rights to have a good life. The care records are very detailed and provide a good framework of information to help staff assist service users in the right way. These records give good protection to the service users as they show how well they are being cared for and monitored. Other records are also generally well maintained including how the staff deal with medication and the service users’ money. There is good liaison with medical professionals in the community ensuring service users keep healthy. Contact with their family is encouraged and facilitated. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 2 The quality of this outcome area is good. The home ensures that the individual needs and aspirations of the service users are assessed prior to admission to enable the home to look after them appropriately. EVIDENCE: Two service users’ care files were seen to contain full details about the service users including their needs, routines, abilities and skills. There was information about their background and family contacts, and what their health needs were. Where appropriate, social workers and medical professionals had provided information to ensure the home was properly briefed about the needs of the service users. Service users continue to be monitored carefully following admission to see that the care offered is satisfactory. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 6,7 and 9 The quality of this outcome area is good. The individual needs and choices of the service users are understood and recorded in the care plan with procedures in place to enable staff to assist the service users in a safe manner without restricting their activities. EVIDENCE: Two care plans were examined and both were generated from the assessment information. The plans set out what assistance is required and where staff need to encourage and accompany. Individualised procedures are laid down where there are dangers of harm or challenging behaviour. The service user is consulted as much as possible with the staff using signs when speech is limited. Each service user is appointed a key worker who appreciates their individual characteristics and needs. The plans were regularly reviewed to ensure they were still up to date. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 10 The care records show the individual activities and routines of the service users and the evidence was that they are assisted to make as many decisions as they can about their lives. In talking to staff it was clear they understood the different personalities of the service users and what they liked and did not like. There was evidence in the record of service users being taken to town to choose their own clothes and staff reported that service users chose their own routines. In terms of their own finances, all the service users need help in looking after their day to day personal money but families or outside agents attended to their benefits and fees. The personal money looked after by the home was properly recorded and safely held. Records were checked against cash held and against the bank books and found to be satisfactory. They showed that money was freely available to the service users and they were able to enjoy outside activities with it. As the service users are vulnerable, the records showed that many activities had been assessed for risk and there was a plan in place to ensure safety. Examples found on the files included whether they could bathe safely, travel in the minibus, whether they self harmed or might choke. Detailed actions were laid down for staff to follow to ensure the activity could be carried out safely. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 12,13,15,16 and 17 The quality of this outcome area is good. The overall quality of life of the service users is good. Service users need assistance to join in community and leisure activities but staff are committed to ensuring that they are given opportunities for fun and outings. Service users are also offered a varied diet at home and have opportunities to see their families. Overall there is an emphasis on promoting service users rights to choice and fulfilment. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 12 EVIDENCE: Service users are not able to work because of their disabilities, but one service user attends a day centre four days and week and the other two attend a skills centre twice a week. Service users are also not able to go out unaccompanied and rely on staff assistance. The Home does share a minibus with another home however and staff reported that they take service users out every weekday even if just to go shopping. They do use the local facilities including the pub and shops and the records were full of references to service users being taken on outings to local beauty spots (Broads) and facilities (Gressingham Museum, Inspire centre, Dinosaur Park) as well as parks, the seaside and picnics. In talking to staff they clearly saw their role as including social visits and stimulation to the service users and the day was organised in a way that allowed them to take them out. All three service users have some contact with their family. One service user had a holiday with his sister recently, one service user has weekends with his family and another has visits from her relatives who staff said are welcome to visit when they want. Service users have friends from the skills centre who live in other homes belonging to the same organisation and staff take them to visit or invite them to the home. The menus have been changed since the last inspection and are now more varied. More fresh produce is used and fresh vegetables and fruit were seen in the kitchen. All staff have to take a turn with the cooking and some may be more skilled than others though the team manager thought there was always someone on duty who was experienced. Staff thought the quality of the food was good and service users enjoyed their food. On the menu on the day of the inspection, was beef stew and vegetables which were seen cooking and smelled delicious. Trifle was to follow. There are no special diets. Service users were seen to go to their rooms as they wanted and staff said they acknowledged that service users needed to be by themselves at times and relax in their room or listen to their own music. They do not have keys to their rooms because of their disabilities and staff have to help them with any mail. However the attitudes of the staff conveyed an understanding of the rights of the service users and a commitment to ensuring a good quality of life. Staff spend most of their time interacting with the service users and staffing is not reduced at the weekends. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 18,19 and 20 The quality of this outcome area is good. Service users are supported in their personal care in an individual way and their health care needs are met with good liaison with medical professionals. Service users are not able to administer their own medication but are protected by the home’s policies and training of staff. EVIDENCE: Service users have varying amounts of assistance depending on their needs and staff were able to talk about the differences. Service users are helped in private in their own rooms and are encouraged to be as independent as possible. All need some support in the bath and there is an electric hoist used by one service user. There are staff of both sexes allowing a service user to be assisted by someone of the same gender though the timetabling of such choice is sometimes difficult, the manager said. One service user is blind and another has limited vision so both need specific help. Other agencies have been used for additional support and advice, like the Blind Institute. From talking to staff the evidence was that personal preferences are acknowledged and that service users are supported in an individual and personal way. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 14 The records showed that service users have full access to medical assistance and the records showed appointments with doctors, opticians, dentists and chiropodists. One service user has recently had an eye operation and appointments with consultants were in evidence. The daily record also showed that staff monitor how service users sleep and eat and keep an eye on their general demeanour. Service users also have contact with the learning disability community team who review their care and general well being. The medication records were examined and found to be completed satisfactorily. One service user has no medication and two have to have staff assistance. The record was checked against the medication in the cupboard and everything was correct. One controlled drug is used but was correctly signed for. Staff reported that they had been on a medication training course and undergo a medication competency assessment before giving out medication. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 22 and 23 The quality of this outcome area is good. Although service users may be limited in their ability to speak up, the home has good procedures and a commitment to ensuring that they are listened to by staff and protected. EVIDENCE: A complaints procedure is available in the service users guide and provided in a widget format for easier understanding by the service users. The complaints procedure is in all the rooms of the service users. The complaints procedure was also seen in the visitors book ensuring they had a voice if they needed it. The manager felt that staff were attuned to the service users and picked any concerns from them at an early stage. Service users also have access to their families and staff at the skills centre should they not wish to speak to staff in the home. The information provided by the manager showed that no formal complaints have been received and none have been received by the Commission. Full procedures on abuse and whistle blowing were seen ensuring that staff understood the standards expected of them and what to do if they suspected abuse. The procedure locks into local multi agency procedures. The protection of adults is included in the induction course for new staff, but the team manager has also attended an outside course on adult abuse. It is recommended that all staff attend these courses. The home also has a gifts policy and keeps good records, as already mentioned, regarding service users finances. This shows a good commitment by the home to the protection of their service users. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 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 the following standard(s): 24 and 30 The quality of this outcome area is adequate. The premises do need renovation and the back garden is not accessible for all the service users. The home is cosy however and service users are kept comfortable. EVIDENCE: A tour was made of the premises. The home is on one level and offers single accommodation to service users though two rooms have a poor outlook and small windows. One room is below 10 square metres. The sitting room is comfortable and homely and the bathroom is small. The home is looking dowdy and is in need of decoration. The manager confirmed that this is being delayed because of a proposed extension which has not yet passed through the planning stage. The garden at the back remains inaccessible to service users because of the different levels and a requirement made in the last two inspection reports for improvements to the grounds has still not been complied with. The Commission is sympathetic to the fact that building work is planned but would want to see the alterations carried out quickly so as not to disadvantage the service users longer than necessary. This summer for instance service users have not been able to use the garden in all the good weather despite a previous recommendation by the Commission to provide some temporary solution. Overall the premises do need improvement. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 17 The laundry is housed separately in a lobby and there is a domestic washing and drying machine. The washing machine can cater for high temperature washes when there is foul laundry and staff have procedures regarding infection control. There are no offensive odours in the home and it is kept clean and hygienic. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 The quality of this outcome area is adequate. Although in practice staff are committed and skilled through experience, and because the number of service users is only three they are able to give good and appropriate attention to the service users. However the organisation is not maintaining a thorough enough system of recruitment, is slow in offering training of a national standard and is not yet ensuring that staff are adequately supervised. EVIDENCE: There have been recruitment problems in the past and the staff list shows that six staff were recruited this year. The rota showed that newer staff are usually on duty with an experienced member of staff. All staff receive induction training and shadow a member of staff as part of that. Having only three service users helps staff to focus in on their special needs. In their discussions with the inspector, staff showed a knowledge of each service user and their needs and specific behaviours. A team manager on site is in charge of staff ensuring that new staff are properly briefed. Only one staff is currently qualified to NVQ3 level though the manager said they are actively seeking places for more staff enrolment on the national course. An NVQ assessor arrived during the inspection to assess one staff. The standard is that 50 of staff should be trained to NVQ2 level so currently this is not being met. A requirement has been made. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 19 The recruitment procedures of the home were examined by checking the files of two recently appointed staff. Both files showed that references were requested and identity checks made. Interviews were recorded. However there were flaws in the system. One file showed that two references were obtained but both were from the same referee though three months apart. The other file showed that two references were received though the second reference was poor and should have been questioned. A further referee was provided by the applicant but there was no evidence that they had been approached. POVA and criminal records checks had been made. A recommendation was made at the last inspection for tighter procedures regarding recruitment but this has not been carried out. It is accepted that recruitment is carried out at the head office of this organisation and that this home was under a different manager at the time of this recommendation. It is accepted that the current manager is working hard to ensure that procedures are adhered to. However these examples shows flaws in the system which are not being picked up. A requirement has been made to sort this out. The two staff files examined showed that staff did undergo an induction training and the organisation provided all basic health and safety training. Several training courses were provided this year for staff. Certificates were seen in staff files and there was a training profile for each staff member. The organisation has recently delegated training issues to a nominated person and the manager said they will be tackling the gaps in staff training. Further training in learning disability should be provided. Because of the small size of the home, staff have regular contact with the manager who also oversees two other homes. Handover meetings take place each day to ensure staff are up to date with what has been happening to the service users. Formal one to one meetings with the manager have lapsed due to a change in management with some staff files showing they have not had such sessions for 6 months or more. It is accepted that the new manager will need to settle in but one to one supervision will need to be provided in future in order to ensure that service users benefit from well supported staff. A requirement has been made. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 43 The overall quality of this outcome area is good. Although the manager is not yet registered, he is experienced and competent and is aware of the procedures which need to be improved in order to ensure a good service to the service users. The organisation is developing a better quality assurance programme and health and safety systems are appropriately in place making sure service users are protected. EVIDENCE: The current manager is only recently in post and is not yet registered. However he has been registered before in another home and is currently studying for his NVQ4 in management. In discussion about his work and what he is implementing in the home, he appears competent and experienced. He is also well supported by a Norfolk regional manager. The Commission is expecting an application for registration in the near future. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 21 The home is part of a large national organisation which has some commitment to quality assurance in their literature. Policies are generated from head office and reviewed regularly and there are questionnaires for service users to survey their views about the home. Care plans are reviewed regularly. However in practical terms a system where an annual development plan is generated from a review of the systems in the home was not in evidence in the home. A requirement has been made. Health and safety policies were seen outlining the organisation’s responsibilities and what they had in place to ensure a safe environment and safe working practices. Staff files also revealed that staff receive health and safety training as part of their induction and are made aware of policies and procedures to keep the service users safe. A risk assessment for the building was seen. The records showed that fire systems were appropriately checked with fire drills for both staff and service users carried out every three months. Gas and electrics were checked for safety and water temperatures were checked regularly to prevent scalding. Overall there was good evidence that the health and safety of both service users and staff was taken seriously. Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 23 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. Standard YA24 Regulation 23(2)(o) Requirement The external grounds of the Home must be made suitable and safe for use by the service users and properly maintained. Previous timescale was 31/10/05. In view of the possibility of a new extension imposing on the garden, a temporary solution is required in the meantime. Previous timescale 30/04/06 The registered person must ensure that staff receive training appropriate to their work. In this instance, more training should be offered in learning disability and staff should be given the opportunity to study for the NVQ2. Timescale for action 30/04/07 2. YA35 YA32 18(1) 31/12/06 3. YA34 19 The registered person must not 01/10/06 employ a person to work in the care home unless he has obtained the information and documents specified in paragraphs 1 –7 of Schedule 2 of the Care Homes Regulations. In this instance two references should be sought and more DS0000027627.V312989.R02.S.doc Version 5.2 Page 24 Newton Lodge 4 5 YA36 YA39 18(2) 24 scrutiny made of the application. This requirement has been made despite a recommendation at the last inspection for tighter procedures. The registered person must ensure that staff are appropriately supervised. The registered person must establish and maintain a system for reviewing the quality of care. 31/10/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Newton Lodge DS0000027627.V312989.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!