CARE HOMES FOR OLDER PEOPLE
Peel Gardens Nursing Home Off Vivary Way Colne Lancs BB8 9PR Lead Inspector
Marie Matthews Announced 24 May 2005 9.30 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. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Peel Gardens Nursing Home Address Off Vivary Way Colne Lancs BB8 9PR 01282 871243 01282 871344 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) European Care (UK) Ltd Mrs Patricia Joan Cairns Care Home 48 48 4 24 Category(ies) of PD(E) registration, with number TI of places OP Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Under Annex 2 a maximum of 48 Service Users who fall into the category of PD(E) 2. A maximum of 24 service users who fall into the category of OP 3. A maximum of 4 service users who fall into the category of TI 4. Staffing for service users requiring nursing care will be in accordance with the previous communication dated 29 November 2000 5. Within the overall registration of 48 places, no more that 4 TI or 24 OP should be accommodated 6. The registered provider must at all times, employ a suitably qualified manager who is registered with the Commission for Social Care Inspection Date of last inspection 8th November 2004 Brief Description of the Service: Peel Gardens is a purpose built two storey facility that provides accommodation for up to forty eight people who require nursing care or personal care. Within the maximum number of forty-eight the home is also registered to provide terminal care for four people. The home is situated in a quiet residential area and there is adequate parking. Attractive lawned areas surround the home and there is a patio area that is accessible from the main lounge. There are 44 single bedrooms and 2 double bedrooms; all bedrooms offer en suite toilets and hand basins. The double rooms were in use as single accommodation at the time of inspection. There is a passenger lift to access the first floor. There are a variety of communal areas in the home including two adjoining lounges and a separate dining room on the ground floor. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The announced inspection was conducted at Peel Gardens on 23rd May 2005. The inspection involved looking at records, talking to management, two staff, eight residents and one visitor, a tour of the home and generally looking at what was happening in the home. Information was also taken from comment cards filled in by four residents and four visitors. This inspection looked at things that should have been done since the last visit and a number of areas that affect resident’s lives. Concerns were raised about a number of unresolved issues from previous inspections despite the Commission having been advised, in writing, that these would be attended to within agreed timescales. As a result of failing to respond the home was beginning to look ‘neglected’. A meeting will be arranged with senior management to discuss these concerns as a number of these decisions were thought to be out of the registered manager’s control. There were thirty-seven people living in the home on the day of the visit. Residents and visitors were generally content with the care given and the friendliness of staff although a number of concerns about the environment had been raised. What the service does well:
The home always obtained detailed information about prospective residents before they were admitted to make sure the home would be able to meet their needs. Staff treated residents and their visitors with respect; one resident thought staff ‘were more like friends’ another said the staff ‘were very friendly and if they can be of help they do’. Visitors said they were always made to feel welcome. Residents said they enjoyed the food and commented that the cook was ‘a grand cook’ and the food was ‘lovely and always looks nice’. There was a
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 6 choice of meals and residents had been involved in suggesting changes to the menu. The home had a good complaints system in place and responded correctly and quickly to any concerns and complaints raised. Residents and visitors felt their concerns would be listened to and responded to. What has improved since the last inspection? What they could do better: Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 7 The care plans contained a lot of detail but the home needed to make sure residents needs and how their needs would be met were clearly identified in the plan. The care plan needed to be developed from the initial assessment information and the home needed to confirm that they were able to meet the needs of new residents before they were admitted to the home. Residents and their visitors had commented about the standard of the environment and said ‘the public rooms and exterior are neglected’. During a tour of the home it was noted that furnishings and carpets in communal areas and residents bedrooms were in need of cleaning, repair or replacement. The exterior of the home needed painting and the flagstones at the entrance were unsteady and made access difficult for some. Visitors and residents also commented about the standards of cleanliness of the home. One person said ‘the public areas of the home are not as clean as they could be’. These concerns were discussed with the registered manager. The company needed to develop systems to make sure the home could respond promptly to any work needing to be done to make the home accessible, pleasant, safe and comfortable for service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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 Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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) 1, 3 and 4. (Standard 6 was not applicable to this home). The home provided enough detail for existing and future residents to be clear about the services the home provides. The home consistently obtained detailed information about prospective residents to ensure the home was able to fully meet their needs. EVIDENCE: The statement of purpose and service user guide had been reviewed. The service user guide was available in resident’s rooms and was given, with a brochure, to prospective residents or their relatives before admission. Some of the residents said they had read the information. Three resident’s care plans were looked at and all had had their care needs assessed before admission to the home to assess whether their needs could be met. The assessments were detailed. The home needed to confirm, in writing, that they were able to meet prospective resident’s needs.
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 10 One recently admitted resident’s care plan did not contain all of their needs identified in the assessment. (See standard 7 & 8). From looking at training records and talking to staff and residents it was clear that staff had the skills and experience to meet the needs of the people who lived at the home. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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 and 10. The care plans had not consistently been developed from the initial assessment information and did not fully detail how resident’s needs would be met. Residents were confident they would be treated with respect and would be well cared for. EVIDENCE: All residents had care plans. Three residents care plans were looked at and these generally included a lot of detailed information to help staff to care for them. New care plans were being introduced for all residents. From looking at assessment information and talking to people it was found that one of the care plans did not fully detail the care and support needed to be given by staff to make sure the resident’s needs were met. Detailed risk assessments had been completed but when risks had been indicated there was not always clear information about what action would be taken by staff. One resident did not have a falls risk assessment despite having bed rails in place.
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 12 Reviews and updates of the care plans had been done regularly and residents said they had been involved in discussions about their care. Two visitors said they had been consulted about their relatives care and two felt they were not consulted enough. There was signed information to support that residents and their relatives had been asked if they wished to be involved in their care planning. Staff were seen to knock on doors and treat residents and visitors in a respectful and friendly manner. Residents commented they were treated well and that privacy was respected. One resident discussed aspects of his care that he was unhappy with and arrangements were made for him to talk to the manager. All visitors said they were made to feel welcome and able to visit their relative in private. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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 and 15. The home provided activities that were flexible and suited the needs and capabilities of the residents who lived in the home. The home had improved the menu to offer a varied selection of meals that met the tastes and choices of the residents. EVIDENCE: Residents said they were able to make choices about their care, how they spent their day and whom they chose to spend it with. Residents were seen relaxing in various lounges and in their own rooms. All care plans contained detailed information about resident’s likes and dislikes and any hobbies or interests they had. A list of planned activities was displayed on the notice board. Staff and residents were enjoying a game of bingo on the day of the visit. Other activities included chair exercises and ball games. Residents said they were able to choose whether to join in or not. Staff were seen chatting to residents who did not wish or were unable to be involved in the group activity. At the last visit concerns had been raised about the lack of activities for residents. A residents meeting had been held to discuss this and the majority
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 14 of residents said they were happy with the activities provided by staff. The manager said ‘trips out’ were due to begin; some residents said they were looking forward to this. Activities that had taken place were recorded in an ‘activities diary’ and had been discussed with residents at a recent meeting. Staff and residents had been asked to become involved in producing a newsletter. All visitors said they were welcomed into the home and could visit anytime. One resident said his visitors from the church were always welcomed. The menus were displayed and a choice of meal was available. The main meal, including a starter, was served at lunchtime and a lighter meal at teatime. Drinks and snacks were served throughout the day. Residents said they enjoyed the food and commented that the cook was ‘a grand cook’ and the food was ‘lovely and always looks nice’. Residents had been involved in suggesting changes to the menu and mealtimes were discussed with the cook at resident meetings. Staff were seen giving discreet assistance to those who needed help. Residents were pleased with the new dining tables and chairs and the tables were nicely presented. The dining room floor was still waiting for further work to be completed despite reassurances that this would be completed after the last visit. Residents commented that the ‘floor looked shabby’. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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 and 18. The home had a good complaints system and residents were confident they would be taken seriously. Staff were trained to recognise abuse and how to respond to ensure residents were protected. EVIDENCE: From looking at records and talking to people it was clear that residents and visitors knew who to talk to if they were unhappy with their care. Three residents said they would feel confident that their concerns would be listened to and responded to. Clear records had been kept and complaints had been dealt with appropriately. Information about who to complain to was available for residents. The adult abuse procedure had been reviewed to clearly indicate who staff should contact if abuse was suspected. Staff were given training about this issue and knew how to respond. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 16 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, 21, 22, 24, 25 and 26. The standard of the environment in this home was poor; areas of the home looked neglected and the home did not provide a safe, comfortable and pleasing environment for the resident’s to live in. EVIDENCE: The home employed a handyman who completed weekly audits that detailed any repairs, maintenance and replacements needed. There was evidence that minor repairs and redecoration had been completed. The registered manager said that empty rooms were being decorated. However it was clear that some areas of concern raised at the last two inspection visits had not been responded to, despite written reassurances from European Care. A meeting with senior management will be arranged to discuss these issues as it was felt that a number of these areas were out of the control of the registered manager. Issues outstanding from the last visits included:Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 17 A large number of failed double-glazing units were noted. This had increased from the last visit. All three windows in one resident’s room had failed and the resulting condensation made this very difficult for her to see out of. The registered manager had provided a number of quotes to head office but work had not been authorised. The dining room floor had been cleaned but work was incomplete. Residents commented that the ‘floor looked shabby’. Quotes had been obtained but work not authorised. The grill in the kitchen had still not been replaced. Adjustable beds had not yet been provided for those residents who would benefit from them. Quotes had been obtained but not authorised. During a tour of the home it was noted that some areas of the home were in need of attention. Some of the furnishings in resident’s communal areas and bedrooms needed cleaning, repair or replacement. A number of carpets in resident’s rooms were stained and walls were badly scuffed. The exterior of the home was in need of re-painting and the flagstones at the entrance were unsafe and made access into and out of the home difficult for some people. One visitor said the ‘public rooms and exterior are neglected’. Visitors and residents had commented about the standards of cleanliness around the home. Visitors said the cleaning of wheelchairs, furnishings and tables could be improved. Residents said that windows and mirrors around the home were ‘streaky’. One said ‘public areas of the home are not as clean as they could be’; one resident showed the inspector an example of this. These issues were discussed with the registered manager. Two new sluice machines had been provided and the dining room had benefited from new tables and chairs. One of the two washing machines had been out of order since January and whilst this had not caused any problems for the residents it had increased the workload for staff. The registered manager had contacted head office and was waiting for approval to be given to replace the machine. All rooms had been provided with an alarm facility but not all rooms had wander leads; the reasons for this were not documented in the care plan. Residents had personalised their rooms and the standard of décor in each room varied. Minimum furnishing had been provided and four residents said they were pleased with their rooms. Residents were given keys to their rooms if they had requested them but this was not included in the risk assessments. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 18 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, 28, 29 and 30. The standard of recruitment of new staff had improved and residents were protected by the recruitment practices. The arrangements for training of staff had improved, this had a positive impact on the standards of care that residents received. EVIDENCE: The staffing numbers were in line with agreed staffing levels. Most residents and visitors generally felt there were enough staff on duty; one visitor said there were not enough staff and that staff should ‘spend more time talking to residents’. The rota showed that domestic staff were employed but a number of comments had been made about the standards of cleanliness around the home. Three staff recruitment files were checked and were complete. It was recommended that staff photographs be used for identification purposes. Eleven of the twenty-nine care staff had an appropriate NVQ qualification and others were due to complete this year. There was evidence to show that staff had undertaken appropriate induction and foundation training. Staff training and development files were maintained and showed that staff had attended training appropriate to their work. A large number of staff had achieved a first aid qualification since the last inspection. Staff turn over was low and morale
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 19 seemed to be good this had a positive effect on the consistency of care offered within the home. A visitor said the staff ‘were very friendly and if they can be of help they do’ and another was ‘very satisfied with the dedicated care and attention’. One resident said that staff ‘were more like friends’. Four of the five visitors were satisfied with the overall care. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 20 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, 34 and 37. EVIDENCE: Mrs Pat Cairns, a registered nurse with many years experience, is the registered manager for this home. She is due to complete the Registered Managers Award this year. She works closely with the staff and is able to communicate a clear sense of direction and leadership. Residents were aware they could discuss any problems with her. Regular meetings were held for residents and their visitors. Residents said they felt they were able to ‘have a say in what goes on’. Residents had commented that they would like to ‘be more involved in decision making within the home’. Minutes from the staff meetings included concerns raised during inspection visits.
Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 21 Resident and relative surveys had been completed and the results had been displayed on the notice board. The registered manager had developed an annual development plan for the home. A business plan and financial information would be available on request. As detailed previously some requirements remain outstanding from the previous two inspections. These concerns would be discussed with senior management. The registered manager said residents could have access to any information held by them. Two residents confirmed they had been involved in their care planning and had seen their records. Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 1 x 3 2 x 2 1 1 STAFFING Standard No Score 27 3 28 2 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 2 3 2 3 x x 3 x Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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 4 Regulation 14 Requirement The registered person must confirm in writing to the resident that the home is able to meet their needs prior to admission to the home. The residents plans must be generated from a comprehensive assessment and detail the action to be taken by care staff to ensure all needs of the resident are met. Timescale 19/12/04 not met. The registered person must ensure the service users plan includes a risk assessment in relation to the prevention of falls. Timescale 19/12/04 not met. The registered person must ensure that the use of bed rails is risk assessed and the service user and/or representative are involved in this process. Timescale 19/12/04 not met. The registered person must ensure that once a risk has been identified, appropriate interventions are recorded in the care plan. Timescale 19/12/04 not met. The registered person must
F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Timescale for action By 18/07/05 2. 7 15 By 18/07/05 3. 7 13 By 18/07/05 4. 8 13 By 18/07/05 5. 8 14 By 18/07/05 6. 19 23 By
Page 24 Peel Gardens Nursing Home Version 1.20 7. 19 23 8. 19 & 25 23 9. 22 13 10. 24 13 11. 24 16 12. 13. 26 33 23 10 ensure that the home is accessible, safe and well maintained. Timescale of 19/12/04 not met. The paving slabs at the front entrance must be repaired to ensure safe access for residents and visitors to the home. The failed double-glazing units in communal areas and residents rooms must be repaired or replaced, in particular the windows which restrict residents views. Was previously a recommendation. The registered person must ensure all residents have access to the nurse call system. The reasons for not providing residents with a call lead must be risk assessed. Timescale 30/11/04 not met. The registered person must ensure residents are provided with keys to their bedroom doors unless their risk assessment suggests otherwise. Timescale of 19/12/04 not met. The registered person must ensure that residents receiving nursing care are provided with adjustable beds. Timescale of 10/01/04 not met. All areas and furnishings of the home must be kept clean. The registered person must ensure that action in response to requirements identified in CSCI inspections is progressed within agreed timescales. Timescales not met-further dates set under individual requirements. 18/07/05 By 20/06/05 By 8/08/05 By 18/07/05 By 18/07/05 By 8/08/05 By 20/06/05 As Detailed Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 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. Refer to Standard 8 9 Good Practice Recommendations The registered person should ensure that the type of health care/medical equipment in use should be documented in the residents care plan. The registered person should ensure that documented evidence of agreements with district nurses are kept where nursing procedures are undertaken for non nursing residents. Work to the dining room floor should be arranged to ensure residents dine in well maintained surroundings. The registered person should ensure that 50 of staff are qualified to NVQ level 2 or equivalent. The registered manager should have a relevant management qualification by 2005 3. 4. 5. 15 28 31 Peel Gardens Nursing Home F57 F57 S22494 Peel Gardens V221852 240505 Stage4.doc Version 1.20 Page 26 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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