CARE HOMES FOR OLDER PEOPLE
Rosewood Court Shakespeare Close Butler Street East Bradford BD3 9AR Lead Inspector
Nadia Jejna Unannounced Inspection 18 November 2005 10:30 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 Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Rosewood Court Address Shakespeare Close Butler Street East Bradford BD3 9AR 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) 01274 308308 01274 308307 Southern Cross Healthcare (Kent) Ltd Care Home 80 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (40), Old age, not falling within any other of places category (40), Physical disability (1) Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. That the category of PD be used for the service user named in the application signed on 5 October 2004 The place for DE is for the named service user only. Date of last inspection 27th April 2005 Brief Description of the Service: Rosewood Court provides care to older people diagnosed as needing residential and nursing care including older people diagnosed with dementia. The home was purpose built as a care home. The size and layout meets current minimum standards. All rooms are single and provided with an en-suite toilet and washbasin. The home is situated close to Bradford city centre and is well served with public transport from both Leeds and Bradford. There is level access into the home and two passenger lifts to the first floor. The building is split into four units, each catering for up to twenty people providing a total of eighty. Each unit has a designated speciality as follows, residential (Aspen Unit), residential dementia care (Rowan Unit), general nursing (Willow Unit) and dementia nursing (Cedar Unit). There are two enclosed garden areas. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections; these may be announced or unannounced. The last inspection was in April 2005. This showed that the home had not made progress towards meeting requirements and recommendations made at previous inspections, 18 requirements and 4 recommendations were made as a result. The purpose of this inspection was to monitor the home’s progress since the last unannounced inspection. Time was spent looking at whether the requirements made at the last visit had been addressed. The inspectors also looked at care plans and other records as well as speaking to the management team, staff and residents. Comment cards/questionnaires were left for residents and visitors so that they can share their views of the home with the CSCI. Four had been received from relatives at the time of writing this report. This inspection was unannounced and was carried out by two inspectors. The visit started at 10:30 and ended at 17:15. A second visit was made by one inspector to collect copies of documents that had been requested and provide feedback to the manager. The people who live in the home prefer the term residents, and this is the term that will be used throughout this report. What the service does well:
The atmosphere in the home was warm and welcoming. Visitors said that they could visit the home at any time. They said that they and the resident could choose to see them in the privacy of their own rooms or in one of the communal lounges. Survey cards received from relatives said that they were satisfied with the care given to their relatives and that they were kept informed about changes affecting their relatives. Information about the home and the services provided were displayed in the reception area and people could take copies if they wished. Relatives said that they had been to look round before making decisions about moving in. Relatives and residents can speak to the manager whenever she is on duty but she has also introduced a weekly surgery when she is available between the hours of 09:00 and 05:00. Residents said that the staff were kind, caring and respected their privacy. They said they could choose when to get up, go to bed, where to spend their time and whether or not they join in with activities, when they were taking place. Residents said they enjoyed their meals and said that the food was good. They said that they felt safe in the home. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 6 Staff said that they enjoyed working at the home because they worked as teams on each unit making sure that the residents received a good standard of care. They said that the management team were approachable and supportive. What has improved since the last inspection? What they could do better:
The work that has already taken place to improve the care plans and move them towards being person centred must continue and be reinforced with appropriate training for staff. The plans must include details about all actions taken and advice sought from healthcare professionals when needed, for example from the falls prevention team for a resident at risk of falling.
Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 7 Residents’ leisure and social activity preferences must be identified, encouraged and supported. This must be evidenced in the care plans. The home’s programme of activities must be geared towards residents’ needs and abilities. The increase in training provision must be continued and extended to make sure that all staff receive training appropriate to the role they are fulfilling in the home. This must include abuse and adult protection, health and safety, infection control and other topics around maintaining the health, safety and wellbeing of residents and staff. It must also include specialist needs of residents, for example dementia, dealing with challenging behaviours and communicating effectively with residents. The formal supervision process must be continued and steps taken to make sure that staff providing it have received appropriate training. The staffing levels on each unit must be reviewed and take into account the needs and dependencies of the residents on these units. Appropriate action must be taken. This requirement was made at the last inspection and the timescale of 31st October 2005 was not met. The redecoration and refurbishment of the home must continue. This must include improving the outdoor areas for residents, weather permitting. The laundry facilities must be improved in order to provide more room and clear separation of soiled and clean laundry. The registered person must contact the infection control nurse for advice on maintaining best practice until this work has been completed. 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. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 the following standard(s): 1, 3 and 4. Resident’s needs are assessed and identified before arrangements are made for them to move into the home. If a residents needs change whilst in the home they are reviewed in order to make sure that they can still be met. EVIDENCE: The Statement of Purpose and Service User Guide have been revised and copies were on display in the reception area. Information packs with details of the provider company and the Service User Guide were also available to give out when people come to look round the home. A copy of the most recent inspection report was displayed on the reception desk. The pre admission assessment record has been revised and allows for all relevant information about prospective resident’s needs to be identified and the home can assess if it will be able to meet their needs. The manager said that if a resident’s needs could no longer be met in the home a review by the care management team would be requested. This was taking place for a resident with mental health needs but the process being followed was not clearly evidenced in the care plan. The manager was advised that if staff
Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 10 received appropriate training and it was felt that their needs could be met in the home an application for a variation in registration could be made. Residents said that they or their relatives had looked round the home before decisions were made to move in. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10. Residents care needs are met but this is not fully evidenced in the care plans. This could provide the opportunity for needs to be overlooked. EVIDENCE: The manager said a new format for the care plans has been introduced. It has been used for all new admissions and most care plans have now been transferred to the new format. In house training and support has been given to staff. The manager said that they intend to move towards person centred care planning. Three care plans were seen. These showed that: • The pre admission assessment was being used to provide information for the care plan. • The resident, where possible, and their relatives were involved and aware of the care plans. • The care plans were evaluated monthly and reviewed in full annually or more often if residents’ needs change. • Appropriate healthcare assessments are carried out, including pressure area care, dependency levels, moving and handling, nutritional risks along with monthly weight records and risk of falling. But the information in records kept was not consistent in each unit. • A record of visits by the GP and other healthcare professionals is kept.
Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 12 • • • Care plans were in place for most identified needs. In one case they were not seen for social care and specialist medical needs of epilepsy and diabetes. These were put in place immediately. The care plans for residents with specific religious and cultural needs did not provide clear information on how they were to be met. Examples included skin and hair care for an Afro Caribbean resident. Plans for residents with continence care needs did not show clearly how they were being managed or if advice had been sought from the district or continence care nurses. There has been a high number of reported falls in the home. The manager said that risk assessments are carried out and appropriate action taken to prevent further falls. This was not evidenced in care plans seen on the residential units. As a result of problems with the monitored dosage systems (MDS) that were being used the home now has another pharmacy supplying the medications in an MDS blister packs system. Staff said that this system is easier to use and is much safer. Senior staff on each unit are responsible for ordering the repeat prescriptions and records are kept. Staff said they were aware of the changes around disposing of medications from the nursing units and appropriate steps were taken. The policies and procedures should be revised to reflect this. The medication administration records on one of the units showed that there were gaps in signing to state that medication had been given. Residents said that the staff were kind, caring and respected their privacy. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 and 14. Activities provided meet resident’s expectations, but there is a risk that the needs of people with dementia will be overlooked. EVIDENCE: Weekly planned activities were displayed in the reception area and on each unit. The posters used pictures, which could be easily understood. The manager said that an activities organiser had been employed but they were not on duty. There were no activities taking place on the units visited other than the televisions being on and music being played. The activities programme should be extended to take into account the needs and preferences of all residents. All care staff should be involved with providing social stimulation. The care files seen showed that a social care profile was completed for each resident. These documents gave an outline of the resident’s preferences and had space to include a detailed life history; those seen had not been completed in full. The proper use of these documents will lead towards person centred care. Social care plans were not seen in the plans reviewed but there were charts that briefly recorded which type of activity a resident had joined in with on a graph format.
Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 14 One of the residents had been out for the day with a relative and said that this was a weekly occurrence. They said they could choose when to get up, go to bed, where to spend their time and whether or not they join in with activities. Relatives said that they could visit at any time and were welcomed by staff. In one unit lunch was served in a room, which was also used as the smoking room. Some of the residents on the unit have breathing problems and the presence of smoke in the dining room could affect their comfort as well as being unpleasant for those who do not smoke. Residents said they enjoyed their meals and said that the food was good. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 the following standard(s): 18 Residents feel safe living in the home. EVIDENCE: Adult protection policies and procedures were in place. The manager said that these refer to the local authority adult protection procedures. Staff said that they were aware of the homes policies and procedures files and where to find them. Some have attended training sessions around abuse awareness. The manager said there are plans to make sure that all staff receive this training. Staff said that they would not hesitate to report suspected or actual abuse to the person in charge or to senior company personnel. But those spoken to were not aware of the local authority adult protection procedures. Residents said that they felt safe living in the home. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 Some work on the environment has taken place, but further refurbishment is required. The system of laundering soiled linen creates the opportunity for cross infection. EVIDENCE: The manager said that a new maintenance person has been employed who will also look after the gardens. The gardens have not been altered yet but there are plans to improve them and provide interesting focal points and seating areas for residents. A programme of redecoration has started in Rowan unit. The manager said that advice has been sought about making sure that the decoration is suitable for people with dementia. The home was clean and tidy. But the bedrooms of residents with continence problems smelled of urine. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 17 A requirement was made at the last inspection that plans be put in place to improve the laundry facilities by 31st March 2006. The area is small for the size of the home and the amount of laundry generated, it does not allow for the adequate separation of clean and dirty linen and there is inadequate storage space for laundered items. The infection control nurse should be contacted for advice on how to reduce the risk of cross infection. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staffing levels on individual units do not always guarantee that the needs of residents can be met. EVIDENCE: Following the last inspection in April 2005, a requirement was made that the staffing levels must be reviewed taking into account the needs and dependency levels of the residents. This information was to have been forwarded to the CSCI along with information on what changes were to be made. This has not been done. The manager and staff said that staffing levels had remained the same. It was clear that the needs of residents vary on each unit and that the standard staff allocation was not always appropriate. Three staff files were reviewed in detail. These showed that: • Steps had been taken to make sure that gaps in information of existing staff files when the manager started in March 2005 have been remedied. • Files for recently recruited employees showed that all required pre employment checks were in place before offering jobs. • Application forms are now being used that ask for a full employment history. • Staff were issued with copies of their individual job descriptions. • Staff were issued with copies of the General Social Care Council Code of Conduct. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 19 The manager said that interview checklists and questionnaires are being used. It was pointed out that these do not prompt the interviewer to ask about gaps in employment. The organisation has produced a new staff induction and training record. Upon reviewing this booklet it was clear that it does not fully cover the induction and foundation training standards as set out by Sector Skills Council or the mandatory training requirements for staff employed in care homes. Staff said that they had attended training courses and that over the last 6 months training provision had increased. The training records showed that: • 14 staff have achieved NVQ level 2 and a further 5 were part way through this qualification. The home is well on the way to having 50 of care staff qualified to this standard. • A training and development plan is in place. This states that all staff will do the induction training and the senior carers and team leaders will attend leadership training courses. Also an in house training programme around privacy, dignity, care practices, communication and customer care will be provided. • The moving and handling, fire safety, health and safety, food hygiene, infection control and first aid training and updates have not been provided to all staff as required. • The deputy manager said that staff working on the dementia units have received training around dementia and dealing with challenging behaviours. The manager said that plans are in place to make sure that staff are given all required training. This must include specialist needs of residents, such as dementia, diabetes and how to care for people from different ethnic backgrounds. A number of staff were from overseas and spoke English as a second language. The manager must make sure that they are able to communicate clearly with and be understood by the residents. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 36. Steps are being taken to involve residents, their relatives and staff in the running of the home. EVIDENCE: The manager has applied to undergo the registration process with the CSCI. The manager said that relatives and residents meetings are now being held. The minutes of the most recent one were still being typed. A notice was displayed in the reception area that the manager was available to residents, relatives and visitors every Thursday from 09:00am to 5:00pm; this is good practice. Staff meetings are held regularly, the most recent was two weeks ago. Staff said that these meeting are not usually well attended but that unit meetings are also held and they talk about issues relating to the unit they are allocated
Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 21 to. They said that they could speak to the unit team leaders and the manager at any time and that they were approachable and supportive. A system of formal staff supervision has been introduced. All staff in the home have attended their first session and arrangements are being made for the next one. The manager and unit team leaders are providing supervision to staff but they have not all received training in order to enable them to do so effectively. Staff said that they had found the first supervision session to be of value and discussions were had about how these can be used to identify training needs as well as being of benefit to individuals and to the general management and running of the home. Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 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. 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 3 x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X X 2 X X Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 23 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 OP4 Regulation 14 Requirement Timescale for action 31/01/06 2 OP7 15 3 OP8 14, 15 4 OP12 16 The registered person must make sure that clear records are kept when a residents needs are being reviewed if it is felt that their needs can no longer be met. The registered person must 30/04/06 make sure that the care plans clearly show how all assessed health, personal and social care needs will be met. These must evidence all actions taken and provide an accurate picture of the service users medical, physical and social well-being. Staff must be trained in writing care plans and appropriate systems put in place to ensure this. (The timescale of 30.11.05 was almost met and it was agreed to extend it.) The registered person must 31/03/06 make sure that where residents are identified as at risk of falling, appropriate advice and actions are taken. Records must be kept. A regular programme of 30/04/06 activities must be put in place which takes into account the
DS0000034033.V253436.R01.S.doc Version 5.0 Rosewood Court Page 24 5 OP18 18 6 OP19 23 7 OP19 23 8 OP26 13, 16 9 OP26 23 10 OP27 18 needs, preferences and abilities of residents. The registered person must make sure that all staff receive training around abuse and adult protection. They must be aware of all available systems for reporting abuse. The registered person must having regard to the number and needs of service users make sure that the external grounds are suitable for, and safe for use by, service users and that they are appropriately maintained. The gardens must be landscaped and furniture provided. (The timescale has not been altered.) The communal rooms situated on the ground floor must be upgraded in respect of furniture and decoration. (The timescale has not been altered.) The laundry facilities must be improved in order to provide more room and clear separation of soiled and clean laundry. (The timescale has not been altered.) The registered person must contact the infection control nurse for advice on maintaining best practice until this work has been completed. Appropriate action must be taken to make sure that the source of bad odours in the home are controlled and reduced. The registered person must make sure that at all times there are enough suitably qualified, competent and experienced people are working at the care home to meet the needs of the service users. A full review must be undertaken of the staffing levels provided on each Unit. The service users
DS0000034033.V253436.R01.S.doc 30/06/06 31/03/06 31/03/06 31/03/06 31/01/06 31/01/06 Rosewood Court Version 5.0 Page 25 11 OP29 19 12 OP30 18 13 OP31 9 14 OP36 18 dependency level and needs must underpin this assessment. The CSCI must be informed of the outcome and action taken. (The first timescale of 31.10.05 was not met.) The registered person must make sure that gaps in employment are explored and records are kept. The registered person must make sure that people working in the home receive training appropriate to the work they do and suitable assistance, including time off, for obtaining further appropriate qualifications. This must include the Sector Skills Council training targets with regard to induction and foundation training and suitable updates on pressure area and wound care and administration of medicines for nurses. The specialist needs of service users must also be taken into account especially with regard to dementia care and dealing with challenging behaviour. The registered person must make sure that all staff can communicate effectively with residents. (The timescale has not been altered.) The manager must complete the registration process with the CSCI and achieve a management qualification equivalent to NVQ level 4. The registered person must make sure that the programme of providing formal supervision staff is continued and that it is given to staff at least six times per a year. (The timescale has not been altered.) Staff providing supervision
DS0000034033.V253436.R01.S.doc 31/01/06 31/03/06 31/03/06 30/04/06 Rosewood Court Version 5.0 Page 26 should receive appropriate training to enable them to do so. 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 OP9 Good Practice Recommendations The registered person should make sure that the homes policies around dealing with medication are revised to reflect the changes in disposing of medicines for the nursing units. Policies should be in place to make sure that MAR’s are completed. The registered person should review the dining arrangements in the residential units in order to make sure that meal times are a pleasant experience for all. The registered person should make sure that at least 50 of the care staff are qualified to NVQ level 2 by 31.12.05. December 2005. 2 3 OP15 OP28 Rosewood Court DS0000034033.V253436.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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