Inspection on 29/01/08 for Preston Towers

This inspection was carried out on 29th January 2008.

CSCI found this care home to be providing an Adequate service.

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 22/01/07

Preston Towers 15/06/06

Preston Towers 05/01/06

Preston Towers 16/09/05

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 Key Unannounced Inspection 09:30 29th January 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000065402.V354512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Preston Towers Address Preston Road North Shields Tyne & Wear NE29 9JU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 259 1828 F/P 0191 259 1828 no email Moorlands Care Homes (N.E.) Limited Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (2) of places Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. At any time, three service users can be aged 55 years to 64 years category physical disability (PD) added condition s requested. 22nd January 2007 Date of last inspection Brief Description of the Service: Preston Towers is a converted detached building set in its own grounds set back from a 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 car 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. The home charges fees of £361 per week. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 22nd January 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals, including surveys. The Visit: An unannounced visit was made on 29th January 2008 and further visits were made on 15the and 22nd February 2008. During the visits we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. • Spoke to the registered proprietor of the home. We told the manager what we found. What the service does well: Preston Towers offers a homely environment, which is spacious and well lit. The lounge and dining areas are well decorated and offer the residents a pleasant area to spend their time should they wish to do so. There are a variety of bedrooms sizes and layouts and when residents move into the home they are encouraged to bring in items to make them more homely and personalised. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 6 Residents are assisted in a courteous and friendly manner throughout the day. The staff also take into account the residents choices and wishes. The food being served is tasty and well presented and a number of the residents were complementary about the meals. The dining room, which is a light pleasant area, has recently been supplied with new dining furniture. What has improved since the last inspection? What they could do better: The manager must make an application to the Commission for Social Care Inspection to become the Registered Manager for the home. The service user plans must be improved to make sure it clearly identify how their needs in respect of their health and welfare are to be met in an individualised way. The cook must be given training to ensure that she has the skills and competencies to offer the residents the nutritional support they need particularly those who have specialist needs. The home must continue the refurbishment programme, by providing suitable bedroom furniture and carpets, and decoration to the bedrooms. Although improvements have been made to the treatment room additional work is needed to make it fully fit for purpose. Staff must be given adequate statutory and clinical training, and the supervision programme must continue. This will ensure that staff receive the support and supervision to make sure that they are all working in line with best practice advice. There must be a comprehensive quality assurance programmes to ensure that the home is run in the best interest of the residents, taking account of their views. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. (the home does not provide intermediate care.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a comprehensive assessment of need prior to admission which means they be confident that their needs will be met. EVIDENCE: The care plans contain pre admission assessments. They show that the home liaise with the residents and family prior to admission. The admission information identified the resident’s needs and ensure that the home can meet them. They contain information about equipment required or need to contact specialist advisors to assist them. However improvements are planned to more clearly identify how the needs are to be met and this is planned as part of the general improvements to be made with the care planning documentation. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 10 The Manager is involved in the decision as to if they can meet the needs of the resident. Residents are invited to visit the home prior to agreeing to move in, however a number rely upon their representatives to view the home on their behalf and advice them on the decision. Two resident spoken to during the visit said that their families had chosen the home. Both said that they were happy with the home as it was as they had expected it to be from the information they had been given. During one of the visits a relatives of a perspective resident visited the home without an appointment. They were made welcome and were shown around the home. As the resident was not taking admissions at the time they were given information and placed on the waiting list to be contacted at a later date. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although individual health and personal care needs are well supported in a way that promotes privacy and dignity, documentation lacks the necessary detail to ensure that people’s all aspects of their needs are met. EVIDENCE: The care plans contain a large amount of information, however they are not “person centred”. This means that they are not specific enough about the resident they describe and contain some assessments that do not lead to a care plan in a detailed enough way. There are assessment tools such as pressure care, nutrition, moving and handling, mental health and dependency, which are not completed consistently. The manager is currently looking at the care plans and is working toward changing them in line with current best practice advice. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 12 Contact with social and health professionals is good and staff were observed liaising with a number of professional visitors during the visits. Residents have access to GP, Physiotherapist, Speech Therapist, Dieticians and Chiropodists. A survey completed by a professional who visits the home said that the “staff have knowledge of the patients.” and that the individual health care needs are always met by the home. The home has a general practitioner who visits the home to carry out an “in home” surgery. The nursing staff identifies those residents who would benefit from his advice and then they are seen by the GP who is usually the same one week after week. Not all of the residents in the home are registered with this practice so some still need to have the general practitioner called in the usual way. Relatives interviewed were very complementary of the home and the care, one said that they had confidence in the manager and her deputy. Another described how the home had remobilised their relative after they were in hospital for five weeks and when it was suggested that she could not walk. The home had referred her to physiotheraly and had taken their advice. They said that they were “really happy she is here” and that they had “got her back on her feet”. Residents are supported to make choices in their day-to-day lives through simple but important ways. Examples of this is when they go to bed or get up, how they spend their days and what they eat and drink. During the inspection residents were asked about the way staff treated them. They said that they felt that they were treated well and this was confirmed in the questionnaires to residents and relatives during the last inspection. During these site visits staff were assisting the residents in an appropriate way and there were pleasant conversations between residents and staff throughout the day. There are policies and procedures available for safe receipt, recording, storage, handling, disposal and administration of medicines. These were being followed. Medications receipt administration and disposal are recorded effectively. Improvements have been made to the treatment room, however more are necessary to make the room fit for the purpose it is being used for. I needs to be easily cleaned and have work space for the staff to use. These improvements are planned when the new system of administration are introduced. See standard 19. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines are flexible and people living in the home are helped to take part in activities and maintain contact with family and friends taking into account their individual wishes, abilities and interests. EVIDENCE: The home has an activities organiser who organises activities both on an individual and group basis. She is employed for fifteen hours per week and is flexible around hours she works depending upon what is being organised. There are now more activities being offered and the she is getting to know the resident’s likes and dislikes. Two residents were asked about the provision of social activities and they said, “more is going on now”. However the Manager is looking at how this is recorded in the care plans. During the inspection visit some of the residents were watching the television or reading newspapers, some were entertaining themselves in their own bedrooms or the lounge areas. The residents do not currently receive up to date information about Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 14 leisure or social events planned in the home. This is something that the new manager and activities co-ordinator or working on introducing. Commission for Social Care Inspection survey responses suggested that there are activities being offered one relative when asked if there were sufficient said ”yes, and as a visitor I have also taken part in the activities. The staff also cheer patients up in the general routine of the day”. The manager is planning to further develop this and is going to focus on resident choices when planning activities. Relatives said that they were encouraged to visit and felt welcomed by the staff. The home still does not have the menu displayed very visibly although one was hanging at the entrance and a copy was provided on request. Residents are asked for their choice for lunch and tea daily, which is recorded and given to the kitchen staff. The food being served on the day was enjoyed by the residents who were complementary about it one said, “the food is nice” and the staff “make sure that you can have what you want to eat”. The cook provides good wholesome food. However, she does not have sufficient knowledge of the needs of residents who need a specialist diet or how to support a resident who is at risk of weight loss. Hot drinks were offered at midmorning, and the residents are given a biscuit, cake 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. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are effective and people using the service know how to access them to raise concerns. Safeguarding procedures are in place to reduce the risk of harm to residents. EVIDENCE: The service has a complaints procedure, which is available within the home. Residents and their relatives understand how to make a complaint. The records of the complaint investigations undertaken and the outcomes are now in sufficient detail to show that the manager is investigating any complaints and make any improvements necessary as a result. The policies and procedures regarding protection of residents are satisfactory and are reviewed and updated in line with regulations and other external guidance. Within the policy it is clear when incidents need external input and who to refer the incident to. Links with external agencies are good and include CSCI, police and adult protection teams. All staff are aware of the policies around complaints and safeguarding and know what immediate action to take and when and who to refer any incident Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 16 on to. The additional training planned will further support staff in this. (see requirement around training, standard 30) Residents are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. The home is aware of the need to facilitate advocacy services and makes efforts to access advocacy services on the resident’s behalf. The home facilitates the right for all residents to vote in elections when ever possible. There have been referrals made to the adult protection team of the local authority regarding Preston Towers residents. The Manager has worked with the appropriate organisations as part of the safeguarding procedures. The Commission for Social Care Inspection is to be kept informed of the outcome of these. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although improvements to the decoration and maintenance of the building have been made there remains a significant amount of outstanding work to be carried out. The home is generally clean and odour free and control of infection practices are now good. 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 although this is very hot in the summer and is not used. All communal areas were generally clean and tidy, and the Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 18 improvement in the decoration in the main lounge and other communal areas has made a significant improvement. The corridor carpets have now been replaced and now needs to be decorated in places. Bedrooms are personalised and are kept clean. There remaining seventeen bedrooms that need new carpets as they are worn, badly stained or damaged. Some of these bedrooms need to be re-decorated, as do others that have already had the carpets replaced. A number of bedrooms need replacement furniture as they are worn and damaged with some drawers not being able to be closed properly. The manager supplied a recent maintenance audit and she is monitoring the work being done. There are three sluice rooms in the home two of which now has a disinfector. The staff were seen to be following good prevention of infection practices during the site visit. The care and domestic staff were knowledgeable about the practices when asked. The toilet and bathrooms are in need of redecoration and the flooring to many of these are loose from the wall. This makes it impossible to avoid water seepage onto the floor below when cleaning is carried out. A number of the facilities in the rooms are poorly sited or lack appropriate disability aids. The redecoration and repair to the flooring would give the opportunity to reevaluate the way they are set up to make them more appropriate for the residents living in the home so that they can live more independent lives. Improvements were noted at the last inspection to the treatment room but these have not yet been completed. Changes are needed to make it fit for purpose, as it cannot be adequately cleaned and presents a control of infection risk in its current condition. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user’s needs are well supported by adequate numbers of competent staff who have undergone robust recruitment. However, training records lack the detail to show that staff receive regular updates to ensure their skills are maintained. EVIDENCE: Staffing rotas and observation during the day indicated that the home is appropriately staffed. During the visit the Manager was on duty and there was a Registered Nurse and five carers on duty (one of which was a senior carer). The home also had on duty a bed maker so that care staff could spend more time with residents. There is good ancillary support. There is domestic and laundry staff on duty to cover appropriate times of the day. A bed maker is employed to allow care staff to spend more time in caring duties, which works well. There is dedicated laundry staff and although the laundry area is small it was tidy and well organised on the day of the site visit. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 20 Staff recruitment files examined, were satisfactory including application forms, references and CRB checks. There is a system in place to ensure that the qualified nurses are maintaining their NMC registration. The new manager has introduced an induction programme, which was being used on the day of the visit. Training files do not clearly detail what training staff had completed for induction, foundation, mandatory and NVQ training. However examination of the records showed that initial staff training has been completed for the key areas of practice for example moving and handling and protection of vulnerable adults and fire training. Annual updates of training are due now and there are plans to ensure that they are provided as necessary. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of the people using the service but quality assurance systems are still developing. This means that the service responds to shortfalls rather than taking a proactive approach. EVIDENCE: The manager Mrs Stuart has been working in the home as both the deputy and now the manager. She is an experienced Registered Nurse and has completed her Registered Managers Award. She has completed a number of post registration training programmes. She is working hard to improve the training Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 22 opportunities for the staff in the home. She is yet to be registered with the Commission for Social Care Inspection. Improvements have been made since the last inspection regarding the internal mechanisms for auditing the quality of the service being provided. There are now structures in place to undertake audits such as the residents and relative’s views, the environment, care practices, care plans and control of infection. The manager has carried out an internal home self assessment and overview audit using a comprehensive manual. She has used relative questionnaires to assist her in planning improvements. The action plan following the audit has been developed but it is not clear how this will be progressed. Although there are elements of the quality assurance process in place there is currently no overall mechanism for identifying the improvements necessary for the service. This needs to be developed by the proprietor to ensure that the home is run in the best interest of the residents. Residents personal allowance records were examined and were being completed appropriately. Signatures are recorded for purchases made and there is good recording of their balances with personal accounts in place as necessary. The Manager is not fully up to date with staff supervision although there is now a procedure in place and an annual programme. Senior staff have been allocated the staff they will responsible for supervising. New staff are now given a mentor and have a one then three month review of their performance to ensure they are suitable for the post they are employed in. Staff meetings are occurring monthly, for which notes are available. They contain relevant information for the staff and give opportunities for them to comment upon issues in the home they are concerned about. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Timescale for action The care plans must be improved 01/08/08 to show detailed assessments, care planning, evaluation, and the records of daily care being provided. The cook must be given training 01/01/09 to ensure that she has the skills and competencies to offer the residents the nutritional support they need. The home must undertake a 01/09/08 refurbishment programme Including: • The treatment room must be made fit for purpose. • Bedroom furniture • Bedroom carpets Outstanding from 15.06.06. The toilets and bathrooms must 01/09/08 have remedial work undertaken and then redecorated. This must be carried out taking into account the needs and dependencies of the people living in the home and maximising their opportunities to living an independent lifestyle. All staff must receive adequate 01/07/08 statutory and clinical training sot DS0000065402.V354512.R01.S.doc Version 5.2 Page 25 Requirement 2. OP15 19 3. OP19 16, 23 4. OP21 23 5. OP30 18 Preston Towers 6. OP31 9 7. OP33 23 & 24 8. OP36 18 that they can meet the needs of the residents. The manager must compete her application to become registered with the Commission for Social Care Inspection. There must be a comprehensive quality assurance programmes to ensure that the home is run in the best interest of the residents, taking account of their views. Outstanding from 15.06.06. Staff must receive adequate supervision at the necessary frequency. Outstanding from 15.06.06. 01/07/08 01/08/08 01/07/08 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. Refer to Standard OP19 Good Practice Recommendations It is recommended that the Proprietor look at putting in shading to make the glass roofed lounge on the first floor usable in warm weather. Preston Towers DS0000065402.V354512.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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