Inspection on 19/07/05 for Palmersdene

This inspection was carried out on 19th July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Palmersdene 03/05/07

Palmersdene 25/05/06

Palmersdene 06/01/06

Palmersdene 22/02/05

Palmersdene 13/09/04

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 Palmersdene Grange Road West Jarrow Tyne and Wear NE32 3JE Lead Inspector Sam Doku Unannounced 19 July 2005 06:55 am 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. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Palmersdene Address Grange Road West Jarrow Tyne and Wear NE32 3JE 0191 428 0660 0191 483 7726 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) Anchor Trust Robert William Lyall Care Home Only 40 Category(ies) of OP Old age - 40 registration, with number DE(E) Dementia - over 65 - 5 of places Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 February 2005 Brief Description of the Service: Palmersdene is a purpose built home, which was built in 1990 in a location that could be described as the centre of the local community. It is a 2-storey construction and is close to local shops, bus and metro services. There is also a range of community services such as G.P and religious places of worship. The home has its own driveway and private entrance to the front, in which there are some garden areas with bench seating and a goldfish pond. The home is registered to provide personal care for 40 older people over the age of 65 years. At present the home is only registered for older persons and does not have registration for any of the different categories such as dementia or mental health.The home has 40 single person rooms which are referred to as flats all with their own en-suite toilet facility. A range of communal lounges, dining facilities and bathing facilities are evenly distributed over the two floors. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection involved one inspector and was carried out at 06:55 in the morning to observe the early morning practices in the home, and the arrangements for getting service users up and out of bed. The views of service users and relatives/representatives were sought. Observations of staff practices and procedures, examination of documents and records and discussions with staff and management, also contributed to the inspection findings. The atmosphere and environment within the Home was friendly, relaxed and comfortable throughout the time of the inspection. A number of service users a relative and a visiting district nurse were spoken with. All were very complimentary about the Home and the staff. Service users appeared cared for and comfortable with the staff. Staff were professional in their manner and care practices they were involved in. What the service does well: What has improved since the last inspection? Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 6 Since the last inspection, the home’s pre-admission assessment process has improved and evidence of this was available for inspection. Care plans are now regularly reviewed and changes made to take account of changing needs. The service user guide has been re-written pointing out to prospective service users that they can bring their own furniture into the home if they wish but if not then the organisation would provide them with the necessary furniture for their flats. A copy of the Department of Health “No Secret” document has now been obtained and the manger confirmed that this is discussed at staff meetings to ensure that all staff are properly informed about issues relating to the protection of vulnerable adults. What they could do better: A number of issues have been identified in the body of the report which the manager and the provider should take appropriate action to resolve. At the last inspection a recommendation was made for the manager to compile a central record of the training that has been provided for the staff. This has not been completed and the manager has again been advised to so as it is difficult to assess the competence of the staff with such record. A requirement was made on the manager to organise a suitable training on the administration of medicines to all staff who are responsible for administering medicines in the home. This remains outstanding but the manager stated that there are plans to provide this training in due course. The kitchenettes on the ground floor and the first floor require re-decoration as walls and skirting boards were found to be dirty. The ceiling paint is flaking and looks unsightly and unhygienic. The inside of the cooker in one of the kitchenettes was dirty with food particles and needed to be cleaned. The storage of bottles of juice on the floor beside the waste bin is inappropriate and the practice must cease. There were two incidents, which affected the wellbeing of service users but these had not been report to the Commission as required under the law. The manager also failed to alert the protection of vulnerable adults (POVA) team about an incident involving a service user. Instead he instigated an internal investigation into the incident. The manager was advised to follow the South Tyneside POVA procedures to ensure that service users are protected from all forms of abuse. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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 Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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, 4, 5. The home has a policy of carrying out assessments prior to admission, ensuring that the needs of potential service users can be met by the home within the available resources and skills. EVIDENCE: The home’s policy is that all service users admitted to the home are first assessed by a social worker and also by the staff from the home. This allows health and social care needs to be properly assessed and to ensure that the identified needs can adequately be met within the available resources and skills. The process provides reassurance to the service users and their relatives that their needs can be met. Four service user case files were examined and they showed evidence that the policy on pre-admission assessments had been rigidly adhered to by the manager and the senior staff team. Available in all the case files were copies of the social workers’ assessments and the assessments carried out by the home before admissions were arranged. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 10 It is also the policy of the home that prospective service users are offered the opportunity to visit the home before admission is arranged. This is also included in the Service User Guide, copies of which are available to the service users. One service user indicated that she had the opportunity to visit the home and view her flat before coming to live in the home. Another service user stated that her daughter and son-in law viewed the home before it was decided that she came to live there. This ensures that service users and their relatives are confident about the facilities available to promote good quality care. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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, 10. The Health and personal care needs of service users based on their assessment and care plans are met in a way, which treats them with respect and promotes their rights and privacy. EVIDENCE: A number of service user files were examined and these provided evidence of health care needs being met. The records contained evidence of visits by GPs, District Nurses, Chiropodists, Opticians, and also visits by or to other specialist healthcare personnel such as hospital consultants. The records also contained evidence of regular checks on service users’ weights and nutritional assessments being carried out to ensure that all the service users receive adequate and nutritious diet. The service users who were spoken with confirmed that they regularly receive medical attention from their GPs. Three service users spoke about their recent outpatient appointment at the local community hospital. Three other service users were spoken with regarding privacy and dignity. They all confirmed that the staff respect their privacy, and treat them with Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 12 respect and dignity. They also confirmed that consultation with GPs and other health professionals take place in the privacy of their flats. Staff interaction with service users was friendly but professional and staff were observed to treat service users with respect and dignity. For example, staff were observed to knock on bedroom doors before making entry. Staff were also noted to speak discreetly to service users when offering assistance with personal tasks thus ensuring that their dignity is preserved. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Service users are offered the opportunity of participating in a wide range of leisure and social activities enabling them to lead active and fulfilled lives. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This contributes to their general health and wellbeing. EVIDENCE: The service users files contained details of their social interests. The service users who were spoken with indicated that they had often been spoken with by the staff about the kind of social activities they would like to be organised. This ensures that the service users are consulted about activities thus providing them with the opportunity to influence and make independent decisions about what social activities they would like. Two service users spoke about the computer literacy lessons they have been receiving in the home, which they seem to value and enjoy. One relative who was spoken with stated that he is able to visit at anytime convenient to him and commented positively on this level of flexibility. There was a general agreement between relatives and service users that the daily routines are organised flexibly to take account of individual likes and dislikes. They sited meal times and bed times as examples of such flexibility. The Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 14 service users stated that although there are set times for meals, they can have their meals at separate times or in their flat if they wish. There was evidence of this on the day of the inspection when breakfast was organised in a way that provided the opportunity to have their break when they got out of bed. Some service users indicated that this level of flexibility allows them to exercise choices about their lives. Staff stated that they often take service users out for walk to the nearby Jarrow shopping centre and that the service users enjoy such outside activities. A number of the service users who were spoken with were complimentary of the staff and their effort to keep them in touch with the local community. Two service users spoke about recent newspaper article about a forthcoming public meeting at the local community centre to advice older people on falls prevention. Both service users declared their interests in attending the meeting, and this has been supported by the staff. The four-week rotational menu remains in operation in the home. The service users who were spoken with commented positively on the quality and quantity of the meals provided. Examination of past menus indicated that the home provides wholesome and nutritious meals for the service users thus promoting good health. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18. Robust procedures are also in place, which ensure that service users are protected from abuse. However, the process of referring possible abuse situations to the POVA team has not been effective in some cases. EVIDENCE: The manager has arranged for the home’s complaints procedure to be displayed in the home, thus making it accessible to both service users and visitors. The procedure is also included in the service user guide and statement of purpose. Service users who were spoken with stated that they are aware of the complaints procedure. Suitable training on the protection of vulnerable adults (POVA) has been provided for the majority of the staff working in the home. However, the lack of centralised training record for the staff made it difficult to confirm this. The staff who were spoken with showed good understanding of the POVA procedures and an awareness of the need to protection service users from all forms of abuse. During the inspection, it was noticed that one incident which should have been referred to the local POVA strategy team had not taken place, instead the manager decided to treat this as internal investigation. This is in contravention of the local POVA policy and could potentially work against safeguarding the welfare of the service users. Those service users who were spoken with indicated that if they have any concerns they felt confident to raise it with the manager or any staff without Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 16 fear of intimidation. Some service users also confirmed that they feel their rights are respected by the staff. Service users who were spoken with about voting rights confirmed that they do receive postal votes during local and national elections. The manager confirmed that all service users have been registered to receive postal votes. This ensures that the service users’ civic rights are maintained. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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, 22, 25, 26. Lapses in health and safety measure compromise the safety and wellbeing of the service users. EVIDENCE: The carpet along the corridors, are badly stained and detract from otherwise pleasant surrounding for the service users. The corridor carpets have become bumpy and split in places, posing potential tripping hazards to the service users. There are two kitchenettes attached to the two sitting areas. Both these require cleaning and redecoration. Although there are sufficient storage spaces in these kitchens large bottles of juice were stored on the floor next to the waste bin. It was also observed on arrival that bread and milk which, had been delivered had not been put away in the kitchen but left in front of the kitchen door, posing potential tripping hazard to service users. The seal on the small fridge in one of the kitchenettes was broken and need to be replaced. The inside of the cooker on the ground floor kitchenette was dirty Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 18 with food particles and need to be cleaned. Such lapses in health and safety measure compromise the safety and wellbeing of the service users. As part of the organisation’s quality assurance system, a Health and Safety sheet was to be completed by the home on a monthly basis. This had not been completed since December 2003, although the manager indicated such checks are done regularly but the form had not been completed as required. The safety records that were examined showed that measures relating to fire and environmental health matters were generally being observed. The fire-log book contained details of regular fire alarm tests and maintenance of fire detection and fire fighting equipments. Other servicing certificates included mobile and fixed hoists, gas servicing, electrical installation, water chlorination and treatment, water mixer valves and lift servicing. These arrangements have been maintained to ensure the safety wellbeing of the service users. A number of the service users who were spoken with stated that they found their flats very comfortable and homely. Most of the residents have furnished their flats with personal items thus ensuring a homely and familiar environment for them. A number of service users confirmed this. There are sufficient communal spaces in the home to meet the needs of the service users. This allows choice for those service users who would wish to use other communal areas other than the ones commonly used by everyone. At the time of the inspection the home was noted to be generally clean and free from offensive odour. It was noted that all toilets had liquid soap dispensers. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. These arrangements had been put in place to avoid the spread of infection and to promote the safety and wellbeing of the service users. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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. Staffing levels are insufficient to effectively meet the needs of service users living in the home. The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. EVIDENCE: Details of staff rotas were examined during the inspection. It was noted that the home consistently maintains adequate staffing levels to meet the needs of the service users. Service users confirmed that they feel there is always sufficient staff on duty to meet their immediate personal care needs. The manager listed the training provided for the staff, included moving and handling, first aid, protection of vulnerable adults, health and safety, food hygiene and nutrition. However, there was no central record of training provided to verify this. However, staff who were interviewed confirmed the training they had received as described by the manager and felt that these had equipped them to do their jobs better. Two staff records were examined with the view to determine whether or not the company adheres to proper employment policies in recruiting staff. It was evident from one of the files that the organisation’s recruitment procedures have not been followed. For one recently appointed carer, there was no second reference obtained. Recruitment procedures have been put in place to ensure further protection of residents from possible abuse from applicants who Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 20 would otherwise be deemed as unsuitable to work with vulnerable people. In this case the manager had not followed the procedures, and therefore exposing service users to possible risk of abuse by not making the necessary checks as required. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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) 31, 32, 33, 38. The resident’s health and safety is promoted by a well managed home. However, there are some areas of potential risk to resident’s safety which need to be addressed. Staff are appropriately supervised which assists in promoting and safeguarding the best interests of the resident’s. EVIDENCE: The manager has a social work qualification with long experience of working in care homes, and has had good management experience in care settings. He also has management qualification. Such training and experience has enhanced his skills for the benefit of the service and the service users. However, there were three incidents in the home where the manager failed to discharge his duties under the Care Homes Regulation 2001 by not advising the registration authority appropriately. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 22 A programme of induction is in place for all new staff, and completed copies were available on the staff files. As a result, a number of service users felt that they are safe in the home and that staff provide them with good care. The staff who were spoken with acknowledged that the manager is new in post but has effectively established himself as a credible manager and indicated that he runs the service for the benefit of the service users and has positive relations with the staff. Staff confirmed that they are able to approach the management to discuss any issues relating to both personal and professional matters. A number of service users who were also spoken with about the general management of the home confirmed that the management staff are approachable and always available to offer support and advice The company has produced detailed Health and Safety policies and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The manager stated that staff have had training in food hygiene, fire precaution and first aid. This ensures that health and welfare of staff and service users are promoted and protected. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 x 3 x x 3 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 2 x x x x 2 Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 24 NO 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 9 Regulation 13(2) Requirement Suitable arrangments must be made to provide training to staf on safe handling of medication for the staf who are responsible for administering medicines. Incidents involving possible abuse to service users must be referred to POVA team for action. The kitchenettes require redecoration Deliveries must be immediately stored in the appropriate places and not left in the corridors which pose trip hazards to service users. Carpets along the corridors must be cleaned and made safe. Storage of bottles of jiuce on ktichen floor and beside waste bins must cease. The cookers in the kitchenettes must be cleaned and kept in hygienic condition at al times. Timescale for action 1 November 2005 19 July 2005 15 January 2006 19 July 2005 2. 18 13(6) 3. 4. 19 19 23(d) 13(40(a ) 5. 6. 7. 19 26 29 13(4)(a ) 16(j) 16(j) 1 November 2005 19 July 2005 19 July 2005 Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 25 26 27 Good Practice Recommendations The organisations QA system shoiuld be carried out as directed and records maintained. The seal to one of frigdes in kitchenette is broken and should be repaired. The manager should compile a list of the training provided to staff and retain this in the home and made available for inspection. Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 Palmersdene B52 B02 S248 Palmersdene V219479 19 Jul 2005 Stage 4.doc Version 1.40 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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