Inspection on 16/09/05 for Preston Towers

This inspection was carried out on 16th September 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

Preston Towers 19/11/08

Preston Towers 29/01/08

Preston Towers 22/01/07

Preston Towers 15/06/06

Preston Towers 05/01/06

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

CARE HOMES FOR OLDER PEOPLE Preston Towers Preston Road North Shields Tyne & Wear NE29 9JU Lead Inspector Suzanne McKean Unannounced 16 September 2005 09:30 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. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Preston Towers Address Preston Road North Shields Tyne & Wear NE29 9JU 0191 259 1828 0191 259 1828 N/A Moorlands Care Homes (N.E.) Ltd 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 M Eeles CRH 53 Category(ies) of OP Old Age (51) registration, with number PD Physical Disability (2) of places Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 25 residents receiving nursing care 2. 28 residents receive personal care 3. CSCI must be notified when either of the service users in the PD category no longer reside in the home Date of last inspection 25.01.05 Brief Description of the Service: Preston Towers is a converted for use detached building set back from the main road in North Shields. The home is located within walking distance of local amenities.To the front of the building there are extensive lawns and garden areas and ample care parking is provided.The home has retained many original features such as mosaic-tiled floors in the hallway and high ceilings with original covings.Preston Towers is registered to provide personal and nursing care for up to fifty-three older persons. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 5 hours on one day by the lead inspector Suzanne McKean she was assisted by Irene Bowater who has visited the home on a number of previous occasions. The manager was on duty during the visit and assisted the inspectors in the process. The inspectors spoke to eleven residents six relatives six of the staff. The records examined included, five care plans and medication records, some training and complaints records, accident records and the residents personal finance documentation. This inspection identified ten requirements, four of which were outstanding from the last inspection and two recommendations. What the service does well: What has improved since the last inspection? The home has made significant improvements to the care plans which only need minor further work to bring them up to the necessary standard this helps the staff give the right care to the residents. Remedial work to the shower area identified in the last report has been completed and it is now safe and clean for the residents to use. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 7 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 Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 8 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, 6 There is a detailed assessment undertaken by the staff prior to admission, which forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Five care plans were examined and each has pre-admission assessments, which were undertaken by the Manager or the senior staff in the home. The residents also have a care management assessment, which is provided, to the home on admission. From these documents an individual care plan is produced. The home is not registered for, and therefore does not provide, intermediate care. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 9 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 Individual care planning is undertaken and the care is being delivered in line with these plans. The administration and recording of medicines is not being maintained to the required standard. Residents are confident that the staff treat them with respect and maintain their privacy so far as possible when delivering care and throughout their daily life. However some of the practices do not promote individual residents right to privacy and dignity. EVIDENCE: Individual plans of care are available for all residents, which are based on the care managers and the home’s admission assessments. The care plans follow a recognised nursing model and included risk assessments for nutrition, falls prevention and pressure sore care. The recording of the care being delivered to ensure all aspects of health care for one resident was comprehensive. Since the last inspection there has been an improvement in the care planning process, however not all of the plans are being reviewed monthly and updated when residents needs change. Regular reviews are held with residents, Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 10 representatives and care managers make sure the residents’ needs can be met. It will take very little to ensure that the care plans achieve the satisfactory standard by the next inspection. All residents have access to all NHS services and facilities. The home seeks advice from a range of specialists including dieticians, speech and language specialists, wound care specialists and consultants. The home has a range of specialist equipment for the prevention and treatment of pressure sores. Residents are regularly weighed and care plans record weight loss or gain. There are policies and procedures available for safe receipt, recording, storage, handling, disposal and administration of medicines. These were not being followed. The treatment room and medicine store cupboards were untidy, disorganised and needed a cleaning. There was an overstock of all medication and medicines were not being used in date rotation. A random check of the Controlled Drugs found two bottles of Temazepam open for the same resident which made an audit impossible and not all Controlled Drugs had the required two signatures. A random review of the Medicine Administration Records found several gaps in recording, handwritten transcriptions did not have two signatures and changes in dosage had been crossed out instead of being rewritten in full. Medications received are recorded on the Medication Administration Records, however medicines for disposal are not recorded and the home does not have a nominated waste management supplier. There was evidence of Epiderm cream being used on more than the individual resident and the cream was out of date. This was given to the registered manager for immediate disposal. All personal care was carried out in private and staff were seen to knock on bedroom and toilet doors before entering. The residents can have a telephone in their own room and there is a payphone available where residents can make calls in private. The staff and residents have formed good relationships and the interaction was based on mutual regard. All of the residents spoken to said the “girls are good”. “I have everything I need” and “I am happy here”. The common practice of using communal tights, stockings’, toiletries, creams and “netlast knickers” does not promote individual residents right to privacy and dignity. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 11 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 Residents are supported to take part in a variety of social activities and this is offered one to one or group basis. However as they are not made aware of the social activities being offered it is difficult for them to make informed choices regarding participation. Residents are encouraged to maintain contact with family and friends and are supported to attend outside activities if they wish to. The home was not able to demonstrate that it offers the residents a balanced diet and there is sufficient quantity of both food and fluids to meet their needs. The resident are able to choose on a daily basis from the choices, the menus are not available for either resident or staff to view. EVIDENCE: The home has benefited from an activities organiser who takes responsibility for arranging activities to meet individual residents needs who has now left her employment. Most activities take place on a one to one basis or as a group within the home. During the inspection there was little activity going on apart from residents sitting watching television or entertaining themselves in their own bedrooms. Currently residents do not receive up to date information about leisure or social events happening in the home. Relatives spoken to during the visit confirmed that they were encouraged to visit and felt welcomed by the staff. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 12 The home does not have the menu displayed as it is written in a kitchen diary, which is not accessible to residents or care staff. Residents are asked for their choice for lunch and tea daily which is recorded and given to the kitchen staff. The lunchtime meal was fish chips and peas followed by jelly and evaporated milk. The alternative was fried egg, chips and peas. The meal was poorly presented in small portions and a number of residents said the fish batter and the chips were hard. Several of the residents require their food cut into small pieces but were offered little or no assistance. Their portion size was small and presented in a desert bowl. Residents requiring a soft or pureed diet were given poached fish mashed potato and Tartar sauce. This was liquidised into a pulp, served in a dessert bowl. All residents were offered orange juice in coloured plastic beakers. The tables were appropriately set, however tablemats were sticky and there was food debris on the tables from the previous meal. The mealtime was disorganised with residents coming into the dining room and having meals at different times and residents sitting in the dining room before and after the meal for some considerable time. Some of the staff assisted residents to eat their meal in an unhurried manner, however other staff stood over residents spooning food into their mouths which did nothing to promote their dignity or enable the meal to be an unhurried social occasion. The residents spoken with criticized the content and presentation of the meal. Hot drinks were offered at midmorning, however the residents are not given a biscuit or fruit at this time. The staff confirmed that they do have biscuits mid afternoon and sometimes-fresh fruit is available. There was an ample supply of fresh frozen dried and tinned food. Trays of eggs were stored both in the fridge and on a shelf in a warm storeroom. Freezer 1 was rusty at the bottom and had not been defrosted for some time. Several items of food were stored incorrectly and the bottom of the fridge was covered with food spillage. The cooker top was covered in burnt food spillage and the floor was slippy. All recording of core food, fridge and freezer temperatures are recorded in a kitchen diary, which was difficult to follow. The staff had limited knowledge regarding offering fortified foods for residents who have little appetite or have lost weight. The only negative comments received from residents during the visit related to the food presented at lunch time examples being “the chips are hard” “the batter hard and fish dry”, “my egg was hard” and “there was not a lot to eat”. Also three residents commented that “I don’t know what is for tea” and the dessert on the day of inspection was not known to anyone prior to it being served. Residents also said that there was not always a choice for meals and he was sick of being given soup. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 13 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 home ensures that residents and relatives are made aware of the complaints policy and it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The residents are protected by ensuring that the staff are given Protection of Vulnerable Adults training and whistle-blowing as well as reporting concerns to the Manager. EVIDENCE: The complaints procedure is available and a copy is displayed at the front entrance as well as being in the home. The records of the complaints were examined, there has been one complaint recorded and the records of this was detailed including the response to the complainants and the action taken in response to the issues raised. Two of the residents spoken to were asked about how they would have any problems dealt with, both were able to identify how this would be done. A relative who was visiting the home was aware of the complaints procedure but had not needed to use it. The training records show that the staff are receiving ongoing training in Protection of Vulnerable Adults.10 staff have been nominated to attend the next training with the Tyne and Wear Care Alliance. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 14 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, 22, 23, 24, 26 The home is generally clean, tidy and free from unpleasant odours. The décor is in keeping with the style of the building and the communal rooms are spacious with good natural light. The outdoor areas are pleasant and accessible. There are sufficient toilet and bathing areas for the number of residents in the home. The bedrooms are personalised and comfortable and although a planned refurbishment programme should be put in place the home is generally being maintained to a satisfactory standard. Moving and handling equipment is available as well as other aids and adaptations to meet the need of the residents. However control of infection practices are not satisfactory and an audit and action plan must be undertaken to ensure that improvement is made. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 15 EVIDENCE: The home was generally clean, tidy and free from offensive odours. There are two lounges and one dining room on the ground floor. One lounge is a designated smoking area. Upstairs is a lounge with glass roof and residents can choose to have their meals there. All communal areas were generally clean and tidy, although some areas are now looking tired and worn and would benefit from a planned refurbishment programme. The décor is in keeping with the style of the building and the communal rooms are spacious with good natural light. There are three sluice rooms in the home only one of which has a disinfector. The sluice on the ground floor has had water damage and the floor is lifting making effective cleaning impossible. There were no paper towels or liquid soap to enable staff was their hands after dealing with soiled contaminated linen or body fluids. The floor mops were stored with the mop head on the floor and the heads had not been washed for some time. There was no suitable storage for commode pots and no bin for used hand towels or other disposable equipment including clinical waste. The sluice on the top floor was not locked, contained only a sluice hopper and no hand washing facilities. On the floor were two commode pots with cloths soaking in with unidentified liquid all of which are poor control of infection practices. All of the bathing facilities in use had used linen and towels left on the floor, there was general communal use of all toiletries, tights, stockings and “netty knickers”. None of these areas including toilets had appropriate storage for used or soiled lined and clothing and the bins did not have lids nor were they foot operated. The laundry area is small and there was dirty linen being stored on the ironing board, staff were aware of the need to separate dirty from clean linen but as there were no suitable linen baskets to carry dirty linen from the areas of the home to the laundry this proved to be difficult to achieve. There were no red dissolvable bags available for contaminated laundry. Staff were not using gloves and aprons effectively. The staff are unable to wash their hands effectively as the bedrooms do not have liquid soap and paper towels and it is recommended that this be put into place. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 16 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 are being maintained only by staff working excessive numbers of hours residents and short falls are leading to the residents needs not always being met effectively. Staff are receiving a variety of training opportunities ensuring their competency and skills are maintained. The home must achieve the standard of having 50 of the care staff trained to NVQ level 2. The home is recruiting and selecting according to safe practice principles and the records were satisfactory. EVIDENCE: The home has experienced a number of difficulties for some time Agency staff could be used, however the staff tend to cover shortfalls themselves that results in some staff working excessive hours. On the day of inspection one member of staff had phoned in sick and the registered manager was unable to cover this shift. The absence of one person had the effect of staff being under pressure to attend to residents assessed needs at all times. The peak times of the morning and lunchtime was extremely busy which resulted in residents’ personal care being compromised and residents’ lunchtime meal being rushed. A random sample of training files showed that each member of staff has an individual file, which contains a record of all training undertaken. The home uses Tyne and Wear Care Alliance and Monument Safety Services to assist in the staff-training programme. The staff also attend training sessions Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 17 held at the Primary Care Trust, which enables the qualified nurses to keep up to date with their training. Staff spoken to during the visit were able to describe in detail the care needs of the resident and showed a good understanding of the principles of delivering good care. A sample of four staff records were examined and the recruitment and selection documentation checked. There were references in place and competed documentation relevant to the position of the applicant. Application forms were complete and each had a Criminal Records Bureau (CRB) check in place. Although the home usually has an up to date photograph for each staff member there were not all in place and it necessary that the home remedy this, also a record of interviews should be kept. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 18 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) 35, 38 The management of the personal allowances undertaken by the home on behalf of the residents is being maintained in a detailed and logical way. Staff are trained in health and safety practices and the home was tidy and free from hazards. EVIDENCE: The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the resident were in place. The home has in place arrangements to ensure that persons working at the care home receive suitable training in fire prevention and by means of fire drills and training in the procedures to be followed in the case of fire. The records of these were up to date. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 19 Staff have also received up to date training in safe working practices and specialist training includes, Health and Safety, Medications in Care Homes, wound care, nutrition, and Protection of Vulnerable Adults. Generally the home tidy and the communal areas are free from hazards fire escape areas were unobstructed and the staff were aware of the need to keep areas free from items which would present a risk for safe passage around the home. The accident records were satisfactory. The water temperature monitoring and recording is not being carried out since the change to new ownership. Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 20 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 1 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 x 1 STAFFING Standard No Score 27 2 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 x x x 3 x x 2 Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 21 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 7 Regulation 15 Requirement The care plans must be reviwed regularly and updated when residents needs change. Outstanding The administration and recording of medicines must be undertaken to the required standard. R.G.N.s must be remided of responsibilities in relation to administration of medications. This must be addressed through supervision and disciplinary. Outstanding Staff must not use practices which compromise individual residents right to privacy and dignity including shared communal tights, stockings’, toiletries, creams and “netty knickers”. Residents must be given the information regarding the social activities being offered in the home. The home must provide the residents with a balanced diet in sufficient quantity and quality in both food and fluids to meet their needs. The menus must be made available for both residents and staff to view. Timescale for action 01.11.05 2. 9 13 (2) 01.11.05 3. 10 12 (4) 01.11.05 4. 14 16 (2) n 01.12.05 5. 15 16 01.11.05 Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 22 6. 19 16, 23 7. 26 13 (3) 8. 38 13 (6) 9. 29 Schedule 2 10. 28 18 The home must provide the CSCI with a refurbishment programme idenitifying priorities and time scales. This must include the replacement, repair re-varnish of damaged lounge chairs and the provision of some dining chairs with arms and skids. Outstanding The home must undertake an extensive control of infection audit and develop an action plan to address the issues identiifed including:- Provision of laundy equipment, provision of a second steriliser, handwashing facilities as necessary, effective cleaning of equipment and the environment and staff training. The home must have in place a system for water temperatures to be monitored and recorded and a strategy to take appropriate action when they require adjustment. All staff records must contain an up to date photo and it is recommended that a record is kept of staff interviews for all posts. The home must have 50 of the care staff trained to NVQ level 2. Outstanding 01.12.05 01.11.05 01.12.05 01.12.05 01.04.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 26 12 Good Practice Recommendations It is recommeded that liquid soap, disposable hand towels and waste bins (with flip top lids) are put into all bedrooms to allow staff to wash hands before leaving the room. It is recommended that the home that the home recruit an activities co-ordninator. B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 23 Preston Towers Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 24 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 Preston Towers B53-B03 S65402 Preston Towers V246068 160905 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!