Inspection on 01/07/05 for Northlands

This inspection was carried out on 1st 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 but made no statutory requirements on the home.

Other inspections for this house

Northlands 30/01/09

Northlands 25/01/07

Northlands 25/01/06

Northlands 24/01/05

Northlands 05/08/04

Northlands 19/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Northlands 21 Kings Avenue Morpeth Northumberland NE61 1HX Lead Inspector Irene Bowater Unannounced 1 July 2005 9:15am st 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 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. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Northlands Address 21 Kings Avenue Morpeth Northumberland NE61 1HX 01670 512485 01670 512317 N/A Autumn Care Group 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) Mrs Margaret Aird CRH 35 Category(ies) of OP Old age [35] registration, with number of places Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One named resident under pensionable age Category PD is known to be in the home. Date of last inspection 24th January 2005 Brief Description of the Service: Northlands Nursing Home is a large,three storey building,compromising of a converted house and a purpose built extension. The home is located within a residential area near the centre of Morpeth and is within walking distance of the town centre facilities. The home has 35 bedrooms which all have ensuite facilities.There are specialist bathrooms,toilets and shower rooms on each floor. The ground floor has a large lounge with access to a pleasant garden and patio area. The middle and top floors have lounges,dining rooms and a conservatory. Smoking is permitted in the conservatory. The home has separate kitchen and laundry facilities. A passenger lift accesses the middle and top floor. There is limited car parking at the rear and front of the building and on street parking is also available on Kings Avenue. A sloping pathway gives access from the main parking area to the front of the building. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 and a half hours. The home manager was available and assisted throughout the inspection. Eleven staff, fifteen residents and eight relatives were spoken to throughout the day. Part of the day was spent examining records and the majority of the time was spent touring the premises and talking to residents, their relatives and staff. What the service does well: The home ensures that all residents who are admitted have detailed care records and they encourage visits to the home before residents decide to stay. The staff have formed good relationships with the residents’ and residents’ confirmed that the “staff are good”, “they always look after me”, “they know how I like things done and “they help me get out and about”. Relatives were also very complimentary about the home and the staff saying, “the home is clean, friendly and the staff are excellent”. The home benefits from a designated activities organiser who arranges events outside and inside the home. Residents said how much they enjoyed the trips out and the regular in house scrabble mornings. The menus are regularly reviewed and offer choice and variety. Specialist diets are catered for. The residents said the meals were good and they had no complaints. Residents and relatives said they knew how to complain and said the staff tried to resolve any issue they had. Staff have suitable training to ensure residents are protected from harm and residents said they felt safe and well cared for by “lovely staff”. The home is clean, bright and comfortable for the residents. All of the residents said they liked living in the home and had nice rooms and a lovely garden to sit in. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 6 The home has a stable staff team who are trained and keen to develop the care for residents. The home has regular meetings with residents and their relatives to identify any issue they have. What has improved since the last inspection? What they could do better: The care planning must improve to ensure that all staff are able to know how to care for each resident. Advice must be sought from other health care specialists to ensure all health care needs are met and recorded. The qualified nurses must ensure they follow procedures for the safe administration of medicines. To ensure the home remains clean, comfortable and safe the repairs and redecoration must continue. All emergency call cords must reach skirting level. All bins must have suitable lids. All wardrobes must have a risk assessment and be made safe to prevent toppling accidents. The accident-recording book should follow Health and Safety Guidance. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,5 The admission procedures are comprehensive and ensure that residents assessed needs will be met. Procedures are in place to enable potential residents and their representatives to visit the home prior to admission to ensure it is suitable for their needs. EVIDENCE: The care plans showed evidence of comprehensive assessments being completed by Care Managers and the senior staff before residents are admitted to the home. The assessment tool used by the home follows a recognised nursing model and covers all aspects of health, social and personal care needs. The completed assessments then form the basis of the care planning process for individual residents. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 10 The residents and their representatives are encouraged to visit the home before admission. There is a trial period of six weeks followed by a multidisciplinary review before residents make a decision to move into the home on a permanent basis. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 There is no clear or consistent care planning system in place to adequately provide staff with the information they need to meet residents’ current and changing health care needs. These shortfalls have a potential to place residents at risk. The systems for the administration of medicines are not satisfactory and potentially place residents at risk. The staff have a good understanding of the residents’ support needs. This is evident from the positive relationships, which have been formed between the staff and residents. EVIDENCE: The care plans still lack the detail needed for all staff to follow to ensure all aspects of residents personal, health and social care needs are met. The daily progress sheets were completed, however any changing need was not recorded in the care plan. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 12 The plans are not up dated on a monthly basis; risk assessments were incomplete and not dated or signed by the author. The care plans were generally disorganised with various additional sheets added which made them difficult to follow or understand. The care plans showed that residents have access to all NHS facilities and services. The staff are able to access other specialist nurses for continence care, wound care, nutrition and fall prevention. Advice from the wound care specialist is sought, however the care plans for wound care were not detailed regarding assessments, nursing interventions and evaluations. There was no evidence to confirm that the residents were being nursed on the correct pressure relieving mattresses and that it was set at the correct pressure according to residents weight. The nutritional assessments were not up to date, residents were not regularly weighed and there was no evidence that random blood sugars were checked and the results recorded. Details regarding moving and handling residents including which hoist and sling to use were not available. Monthly blood pressure. pulse, temperatures and weights were not up to date or recorded either on charts or in care plans. Resident’s families said they thought “the care is good”, one resident said the staff “has brought her back from the brink” and another said, “ “I get good care”. The home has policies and procedures for staff to follow to ensure the safe administration of medicines. A random audit of the Controlled Drugs was found to be satisfactory . The Medicine Administration Records showed some gaps in signing. One plastic pot containing tablets was found in the medicine cupboard. A check of the Medicine Administration Record found that the dose had been signed for and not given. The qualified nurse discarded the tablets appropriately and amended the Medicine Administration Record. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 13 The recording of medicines coming into the home and disposed of was satisfactory. There was an overstock of lotions and creams and these have not been used in rotation resulting in out of date supplies. The home does not maintain a register of qualified nurses signatures and initials who are authorised to administer medication. A fridge is available for medicines, which require cold storage, and the temperatures are recorded daily. The staff continue to record the room temperature to ensure it does not exceed 25 C. Throughout the inspection the staff carried out personal care in the privacy of residents room, bathroom and toilets. The relationships between the staff and residents were friendly, professional and respectful. All of the residents spoken to said that the staff were good, caring and always were there for them. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 The social care needs are well organised and provide stimulation and interests for residents living in the home. Links with the community and residents representatives are good and support residents’ daily lives. The meals in this home are good offering choice and variety and catering for special dietary needs. EVIDENCE: The home benefits from a designated activities organiser who arranges leisure and social events for residents inside and outside of the home. Records showed that there have been trips to Morpeth, Carlisle Park, Orchard tearooms and the Arts and Crafts Museum. Various activities take place in the home. Residents said they enjoyed Scrabble, completing crosswords and looked forward to the regular church services. Residents confirmed that there is plenty to do and that they are supported o go out if they wish. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 15 Several of the residents and their families spent most of the warm summer day in the garden. There were many visitors to the home on the day of inspection. All of the visitors spoken with said they are always made welcome; they can stay for as long as they wish and can be involved in all aspects of their relative’s care and events in the home. The home has separate dining rooms on two floors of the home. The rooms were pleasantly decorated and appropriately set for both the breakfast and lunchtime meal. Staff confirmed that all meals are flexible and residents can choose to have meals in the dining rooms or in their own room if they wish. The inspector joined the residents for lunch. Choices were available, however the residents all complained about the batter on the fish being hard and they found it difficult to eat. The manager said that an alternative supplier was being found. The residents said that they were happy with the meals and are given choices. The meal was relaxed and unhurried and staff assisted resident who needed help in a sensitive discreet manner The kitchen was clean with all foods appropriately stored. Menus are regularly reviewed and the home maintains a record of residents special dietary needs. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The complaints process is satisfactory with evidence that residents feel that their views are listened to and acted upon. The staff have knowledge of Adult Protection procedures, which protects residents from risk or abuse. EVIDENCE: The home has policies and procedures available for residents and their representatives to follow should they wish to raise a complaint. The procedures are readily displayed on notice boards in the home. All of the residents and their visitors said they were aware of the procedures and would be able to use it. The home has policies and procedures in place for staff to follow should there be any allegation or suspicion of abuse. The staff were able to discuss the steps they would take and said they had received training in Abuse and Aggression. The records confirmed that 19 staff have completed the Protection of Vulnerable Adults Training and the manager has completed a 2-day investigation-training course. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24,26 The standard of the environment is good providing residents with a comfortable, homely, clean place to live. There are some premise issues that have the potential to place residents at risk. EVIDENCE: The location and layout of the home is suitable for the residents who live there. The home continues to refurbish the building ,furniture and fittings as part of an ongoing programme. The gardens are easily accessible from the ground floor and are pleasant and well kept. Several of the residents and their visitors said how much they enjoyed sitting in the gardens in the warm weather. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 18 There are large lounges on three floors and dining rooms on two floors. There is a small conservatory, which is used as a smoking area. Generally the communal areas were nicely decorated and well presented. There is some wear and tear to furniture in the conservatory and both dining room carpets have food stains and black marks from wheelchairs and trolleys. All of the bedrooms have en suite facilities and there is a good range of specialist bathing, shower and toilet facilities throughout the home. One shower room has had the flooring replaced and another shower room was being decorated on the day of inspection. There is some wear and tear to the vinyl floorings in theses areas and there is some damage to the enamel on the rim of the bath next to room 7. Several of the emergency call cords in bathrooms and toilets did not reach floor level or were tied out of reach and many of the lids were missing of the waste bins. An inspection of several rooms on each floor found that they were clean bright and airy. The residents have been encouraged to bright small items of furniture and other items with them resulting in highly personalised rooms which reflect residents previous lifestyles and preferences. Many of the wardrobes were not fixed to the wall and had large items stored on top which could cause a toppling accident. On the day of inspection the home was clean, bright with no odours. There are domestic and laundry staff on duty seven days a week. The laundry is small, however the home contracts out for all laundry services apart from personal items. There are sluice facilities in the home and a working disinfector is on the first floor. All staff were able to discuss infection control policies and were observed to follow procedures on the day of inspection. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The staffing levels in the home are adequate to meet residents assessed needs. Staff are enthusiastic and are keen to work with residents to improve their quality of life. The procedures for the recruitment of staff are robust and provide protection for residents living in the home. Training continues to develop to ensure staff are able to meet residents needs at all times EVIDENCE: A recent recruitment drive has been successful and the home is currently fully staffed with qualified nurses and care staff. The staffing levels are: 2 qualified nurses and 5 care staff during the day 1qualified nurse and 3 care staff overnight. There are sufficient ancillary staff employed An activities organiser is employed for 15 hours a week The manager is supernumerary and she is supported by a deputy There is no administration support in the home, this is carried out from the companies head office. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 20 A random inspection of personal files showed that the home follows procedures for the recruitment and selection of staff. Evidence was available regarding 2 references, Criminal Record Bureau checks and proof of identity. Qualified nurses have their registration and Personal Identification Number confirmed as required by the Nursing and Midwifery Council. The training records show that the staff have received training in all safe working practices, infection control, challenging behaviour and safe administration of medicines. The manager confirmed that staff are receiving further training in care planning. The home has undergone audit by the university and is able to have student nurses on placement. The student nurse is supernumery and was positive about all aspects of the placement. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36,38 The systems for resident consultation is good with a variety of evidence that their views are both sought and acted upon. The home reviews aspects of its performance through self-review and consultation, which include seeking the views of residents, staff and relatives. The staff are suitably supervised to ensure residents receive care according to their individual needs. The staff follow the health and safety procedures to protect residents, other staff and visitors from harm as far as reasonably practicable. EVIDENCE: All of the residents and relatives spoken with throughout the inspection said that the manager is always available to discuss any concerns and issues. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 22 The manager sends out invitations to both residents and relatives to ensure they know when meetings are to be held. The minutes from the meetings are available and include any action taken to resolve concerns. Staff meetings are held on a regular basis with minutes recorded. The staff said that the manager is very approachable and they can discuss any issue with her. The home has carried out a quality assurance audit for 2005 with the results available in the home. The feedback from the audit has been complimentary regarding the welcome to the home, the environment, activities and meals. One concern regarding access to the home has been resolved to everyone’s satisfaction. All of the residents and relatives were complimentary about the home and the staff. Comments ranged from “everything is fine”, “the staff are excellent”, “we have no problems, the staff ensure everything is good” to “the home is friendly, clean, and we get on well with all the staff.” Records are now available to show that staff receive supervision at least six times a year. The staff confirmed that supervision covers all aspects of their practice and any development needs. The home has policies and procedures for staff to follow to ensure the health and safety of residents, staff and all visitors. The broken glass in the conservatory has been replaced. The certificates for utilities and contract services were available and up to date. Fire training is carried out with records kept. The fire risk assessment is available and up to date. A fire inspection carried out in June 2005 was satisfactory. Accidents were being recorded to a satisfactory standard, with good monthly analysis documented. The accident book does comply with the Heath and Safety Guidance. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 2 2 x x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 x x 3 x 3 Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 24 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 OP 7 Regulation 15 Requirement The care plans must set out the detail the action needed to be taken to ensure all aspects of health,personal and social care needs are met. The care plans must be evaluated at least once a month according to changing needs and be dated and signed by the the author. OUTSTANDING SINCE 24/1/05 The wound care documentation must be comprehensive regarding the assessment,interventions and evaluation of all action taken by the qualified nurse. Nutritional screening must be regularly recorded and care plans formulated for those assessed at risk. All risk assessments including dependency levels,pressure sore and nutrition require up dating monthly. OUTSTANDING SINCE 24/1/05 The home must ensure that medicines are not secondary dispensed for someone else to administer at a later time. The Medicine Administration B53-B03 S509 Northlands V226706 010705 Stage 4.doc Timescale for action 1ST October 2005. 2. OP 8 17 1ST October 2005 3. OP 9 13 1st July 2005 Northlands Version 1.30 Page 25 4. OP 20 23 5. OP 21 23 6. OP 24 23 Record must accurately record when medicines given,refused or not administered. All medication must be used in rotation and excess stock returned to pharmacy. The home must retain an up to date register of staff authorised to administer medication. The home must ensure the dining room carpets are deep cleaned or replaced.The conservatory furniture requires repair or replacing. The home must ensure that the enamel on the bath is repaired. The emergency call cords in bathrooms and toilets must reach floor level and all bins must have suitable lids.l The home must ensure that all wardrobes have risk assessments and wardrobes fixed to the wall.Large items must not be stored on top of wardrobes. 1st October 2005 1st October 2005 1st October 2005 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. 2. 3. Refer to Standard OP 19 OP 29 OP 38 Good Practice Recommendations It is recommended that the bathroom,toilet and ensuite floorings are replaced as part of the refurbishment programme. It is recommended that progress continues with NVQ level 2. It is recommended that the HMSO Accident Recording Book be implemented. Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Northlands B53-B03 S509 Northlands V226706 010705 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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