Inspection on 04/07/06 for Serenita

This inspection was carried out on 4th July 2006.

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

Other inspections for this house

Serenita 25/11/08

Serenita 19/07/07

Serenita 21/02/06

Serenita 22/08/05

Serenita 05/08/04

Serenita 22/05/04

Serenita 16/04/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

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

CARE HOMES FOR OLDER PEOPLE Russell Haven 15 - 19 Clevedon Road Weston Super Mare North Somerset BS23 1DA Lead Inspector Juanita Glass Unannounced Inspection 4th July 2006 09:30 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 Russell Haven DS0000020380.V302283.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. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Russell Haven Address 15 - 19 Clevedon Road Weston Super Mare North Somerset BS23 1DA 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) 01934 620195 01934 622670 Mr Nunzio Notaro Miss Patricia Elizabeth Waddington Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (2) of places Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. May accommodate up to 38 service users aged 50 years and over requiring nursing care. May accommodate two named people with Physical disabilities. This condition lapses when these people leave the home. Manager must be a RN on parts 1 or 12 of the NMC register Staffing levels detailed in the letter to Nunzio Notaro dated 22nd November 2004 apply. The Registered Manager is subject to three monthly reviews of the management of Russell Haven for the next year. The Registered Manager to receive regular supervision and support from Notaro Care Homes` Operational Manager and Administrator. May accommodate two residents who have a past / present alcohol dependency. This condition applies only to two longstanding, specific residents and lapses when those individuals leave the home May admit one named service user 47 years of age as detailed in application dated 24 March 2006 20th February 2006 Date of last inspection Brief Description of the Service: Russell Haven is registered with the CSCI to provide nursing care to 38 residents aged 50 years and over. The home is located within walking distance of the beach and local amenities and is conveniently placed for access by public transport. All areas are accessible for wheelchair users and access to the upper floor is provided by a lift. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees: £494.58 - £525.00 This key inspection took place over two days the first day with two inspectors resulting in a total of 22 inspection hours. The records for six residents and four members of staff were reviewed as well as maintenance, health and safety checks and a tour of the premises; a visiting pharmacy technician not linked with the CSCI was auditing medication. The inspectors spoke to 11 residents, 2 visitors and 5 members of staff during the inspection, and observed working practices. Comments were largely complementary and residents praised the commitment of staff to providing a good level of care. One resident said that ‘nothing is too much for them.’ Through out the day staff were observed to be very aware of the government Heat Wave guidance and fluids were constantly being offered to residents and visitors. This was commendable practice. Residents were observed to be well groomed and relaxed, several residents were enjoying the warmer weather in the garden. One resident felt that the care was excellent however felt that she had lost some of her independence, she also felt that she would have been more suitably placed in a residential setting. Requirements arising from this inspection were concerned with care planning, health and safety and staff training. However the overall care provided was of a good level. Staff were observed conversing with residents and explaining what they were about to do. Staff showed an awareness of the need for respect, dignity and privacy. Rapport between staff, residents and visitors was friendly but professional. Two members of staff were observed to carry out their work in a task-orientated manner and this was discussed with the nurse in charge. It was necessary to discuss training in Diabetes management for qualified staff, as they did not demonstrate an understanding of the current trends during the inspection. What the service does well: Russell Haven provides a good level of support for their residents in a friendly and caring manner. Staff are encouraged to maintain their understanding of current trends in care through both external and in house training. The home is well maintained and well decorated with residents encouraged to personalise their rooms with pictures and memorabilia. Staff awareness of the government Heat wave Guidance was commendable. Residents also commented on the availability of extra fluids through the day. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 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 the following standard(s): 3 and 5 6 does not apply Quality in this outcome group was good. Admission to the home only takes place if the service is confident that they can meet the assessed needs of the prospective resident. Prospective residents are given the opportunity to visit the home prior to taking up residence. EVIDENCE: Individual care records reviewed showed that preadmission assessments were being carried out prior admission to the home. Residents spoken to said they had been visited by someone who had asked them what needs they had, then the manager let them know whether the home could take them or not. One visitor spoken to said that the preadmission visit had been quite thorough and it helped them identify the needs of their relative. Prospective residents and their representatives are able to visit the home prior to admission; this enables them to make an informed choice on whether they Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 9 choose the home or not. One resident said the visit had been a helpful experience. One relative stated that the home had provided them with all the information they had needed and could not have been more helpful. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome group was poor. Each resident had an individual plan of care. Residents would benefit if these included some specific individual care plans and resident involvement. Residents have access to health care services that meet their assessed needs both within the home and in the local community. However staff were not aware of whom to contact for specific advice. The home has a medication policy, which is accessible to staff. Some areas needing improvement were noted. Staff showed respect towards residents and allowed their privacy and dignity to be maintained at all times. EVIDENCE: All residents records reviewed had some very clear and concise care plans that showed an awareness of person centred care. They were individualised and Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 11 contained adequate guidance for care staff. Some residents records lacked crucial care plans and assessments that should have been identified and drawn up. One resident who suffered seizures had a very poor care plan that just stated they had seizures with no guidelines or indication of possible triggers for staff to observe. Several residents had a diagnosis of dementia but no dementia care plan, and some care records did not contain a nutritional assessment. Needs identified or changes in condition were being recorded in the daily record or on the review sheet for the care plan but not implemented as a separate issue. Although the care plans lacked guidance for staff in some areas residents said that staff were excellent and knew how to meet their needs. They felt that on occasions when bank or agency staff were used the communication was not so good. This can be seen in the lack of documentary evidence to support specific needs. Residents spoken to also said they were not aware of their care plans and had not been consulted in drawing them up. With residents in the home who can contribute to their care the manager needs to identify ways in which they can involve residents in drawing up and agreeing their plans of care. Resident’s records show that they were assisted to attend health care services such as the GP surgery, chiropodist, dentist, optician and outpatient appointments. The home requests district nurse input when necessary, and also have a palliative care link nurse. However on the day of the inspection it was evident that the qualified staff did not know who to contact for advise on diabetes management and had to be guided by the inspectors. The inspectors did not carry out an audit of medication as a company pharmacy technician was carrying out their inspection. Several issues were raised and the home must comply with the recommendations left by the pharmacist. During the day, staff working practices were observed and residents and visitors spoken to. Staff were noted to have a very friendly but professional rapport with both residents and their relatives. Working practices were noted to be person centred with emphasis on talking to residents and explaining what was about to happen. Two members of staff were observed to carry out their duties in a task orientated manner this was raised with the nurse in charge. Residents spoken to said that staff treated them well and worked hard to meet all their needs, they confirmed that staff respected their dignity and privacy. Residents who had chosen to remain in their own rooms said staff respected their right to privacy and always knocked before entering. • • • Care plans must be implemented for specific needs. (I.e. dementia, seizures and diabetes) Care plans must where possible be drawn up with the involvement of the service user The home must comply with recommendations made by the company pharmacy technician. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 12 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, 14 and 15 Quality in this outcome group was good. Residents benefit from a stimulating programme of activities. Residents are encouraged to maintain contact with family and friends. Residents are assisted to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet. EVIDENCE: Records reviewed and residents spoken to confirmed that the home provides a full programme of meaningful activities for all residents. They can exercise personal choice on which ones to attend. Activities are provided by outside sources and include reminiscence, singing and dancing, visiting entertainers and games. Residents go out for outings and staff take residents out for walks along the promenade, or into town. Residents spoken to said they always had the choice of attending an activity; one resident sat in their room said they did not like to join in with the others but they were given the option. Residents and visitors spoken to said that there were no restrictions on visiting times. One visitor said they were always made welcome and commented on the cheerful and respectful approach of staff. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 13 The home has a six-week menu, which is reviewed seasonally. Though the menu does not offer a choice of lunch meal there was evidence from the residents spoken with to show that other choices are provided when requested including vegetarian meals. A choice is offered for the evening meal between a cooked dish and sandwiches. Residents spoken to on the day of the inspection did not know what the meal was, however they were offered a choice if they did not like the main meal, this was an over sight on the day and did not demonstrate common practice. The positioning of the tables in the dining room was discussed with the manager on the second day of the inspection as residents had commented that it was ‘a bit like school,’ sitting in a line, and that it was done in a line to ‘convenience staff.’ However the manager pointed out that following a falls audit it had been noted that the area covered by the tables had been an area where a high number of falls had occurred, they had placed the tables over this area and the falls in the dining room had been reduced. • All residents must have a nutritional assessment. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome group was good. The home has a satisfactory complaints policy and procedure, and clear guidance for the protection of vulnerable adults; all staff spoken to demonstrated a clear awareness of adult protection issues. EVIDENCE: The home has a robust policy and procedure for the handling of complaints, a record is maintained which shows the agreed outcome. One visitor said they knew who to approach if they needed to raise a concern and they felt that they would be listened to and taken seriously. The homes policies and procedures for the protection of vulnerable adults are very clear and concise. They are stored in the office and available for staff at all times; a copy of the North Somerset policies and procedures were also available. Staff spoken to had received adult protection training and showed an awareness of the issues. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 15 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, 25 and 26 Quality in this outcome group was adequate. Residents live in a comfortable, well-maintained environment, however some safety issues were identified. The home is clean, pleasant and hygienic, however use of cotton towels in communal toilets could raise the risk of cross infection. EVIDENCE: Residents spoken to and rooms assessed as part of the inspection process showed that the premises is well maintained. Residents spoken to liked their rooms and many contained personal items including pictures and photographs. Residents have access to safe well-maintained gardens and the community areas are well lit and ventilated. During a tour of the premises it was noted that two wardrobes were not secured to the wall highlighting the potential risk Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 16 of harm to residents, this was dealt with immediately by the maintenance person. Whilst checking water temperatures it was noted that hot water in basins in resident’s room were consistently too hot this was discussed with the area manager. It was pointed out that although you may have to run the tap a long time in one room it then made the water immediately hot in the adjoining room, this puts residents at potential risk of scolds. There were no malodours in the home, all areas showed evidence of a stringent cleaning programme. All rooms were clean and tidy and one visitor spoken to said the home was always clean and tidy. One resident said she was impressed by the cleanliness of the toilet and en suite facilities she had in her room. • • Water temperatures must be checked for all basins and baths and high temperatures rectified. (also NMS 38) Paper, not cotton towels must be provided in communal toilets. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome group was adequate. Residents benefit from adequate numbers of staff, to meet their individual needs. The home does not meet the 50 requirement for NVQ training. The service needs to review its recruitment procedure with regard to obtaining references. The service recognises the importance of training, and delivers where possible a program that meets any statutory requirements. EVIDENCE: Staffing records reviewed and residents, visitors spoken to confirmed that there are adequate numbers of staff on duty to meet the assessed needs of the current resident group. During the inspection staff were observed to carry out their duties in a relaxed and unhurried manner, residents stated that they rarely had to wait long for the call bell to be answered. Out of 12 members of care staff 2 have an NVQ 2 or above this does not meet the 50 required; the manager needs to identify NVQ training for care staff. However residents and visitors spoken to said that staff were competent in meeting their assessed needs. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 18 On the second day of the inspection personnel records for three members of staff were reviewed. All three records contained undated ‘to whom it may concern’ reference letters. Accepting these letters without confirming their origin with the referee is not good practice. Other records required to evidence good recruitment practices were present in the personnel files. The home encourages all levels of staff to maintain ongoing training, a plan of training for the next 12 months was seen and personnel records showed evidence of ongoing training appropriate to the needs of the current resident group. Staff spoken to confirm that they were encouraged to attend training sessions, both within the home and on external courses. However as previously mentioned qualified staff did not demonstrate an up to date awareness of the management of diabetes especially when controlled by insulin. The area manager agreed to access training for the qualified staff. • • • The manager must request references direct from referees, rather than accept ‘to whom it may concern letters.’ Identified members of staff must attend training in the management of insulin-controlled diabetes. The manager needs to enrol staff on NVQ training. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 19 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, 33, 35, 36 and 38 Quality in this outcome group was adequate. Residents benefit from an experienced, knowledgeable manager. Systems are in place for relatives of, visitors and residents to comment on the running of the home. Residents financial interests are safeguarded. Staff are appropriately supervised. Residents are protected by the health and safety checks in place, however the insecure placement of wardrobes and high water temperatures was noted. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager is a qualified nurse with 12 years experience in management. She has completed the Registered Manager Award and is an NVQ assessor; both residents and staff spoken to stated that the manager was always ready to listen to them and spend time with them, an easy and friendly rapport was noted through out both days of the inspection. Systems are in place for residents, visitors and relatives to comment on the running of the home, copies of questionnaires seen showed that residents and relatives are happy with the running of the home, the manager has also re introduced relative meetings where she hopes to encouraged relatives to become more involved in the activities provided for residents. The Notaro group have expressed an interest in piloting the quality assurance process CSCI will be putting in place in 2008, this will enable them to carry out their own quality assurance within the group. The Notaro group maintains a secure system for safeguarding residents finances. All staff carry out an induction within the first week of the start of employment. A supervision agreement is signed and the responsibility for staff supervision is cascaded down from the manager through senior staff. One senior member of staff was not sure about the supervision process at first saying they did not have anyone to supervise then saying that they hadn’t supervised staff due to them being on different shifts. Evidence of regular staff supervision was seen on the day of inspection, however some senior staff need guidance in how to successfully meet this standard. All health and safety checks were in place and up-to-date. The fire risk assessment for the building is available for inspection and the firelog showed that all recommended checks were being carried out. Accident records were maintained whch included a record of the follow-up carried out by staff to identify outcomes. During a tour of the premises as previously stated a wardrobe was identified as needing securing to the wall to prevent it falling on a resident this was discussed with the area manager who immediately contacted the maintenance person the wardrobe was secured before the end of the inspection. Water temperatures were checked through out the home these were found to be consistently too high in all basins in residents rooms as previously stated this puts residents at risk of harm through scalding. Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 21 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 3 X X X X X 2 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 2 Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 2 3 4 5 6 Standard OP7 OP7 OP9 OP9 OP15 OP25 OP38 Regulation 15 (2) 15 (1) 13 (2) 13 (2) 12 (1) (a) 13 (4) (a) (c) 13 (3) 19 (1) (b) (c) Sch 2 Requirement Care plans must be drawn up for specific needs such as (catheter care, dementia, seizures) Care plans must where possible be drawn up with the involvement of the service user An oxygen warning notice must be placed on resident’s door even when temporary residents. The home must comply with the recommendations made by the pharmacy technician All residents must have a nutritional assessment Water temperatures must be checked for all basins and baths and high temperature reading rectified. Paper not cotton towels must be provided in communal toilets The manager must request references direct form referee rather than accept ‘to whom it may concern letters,’ even if received from employment agency Identified members of staff must attend training in the management of insulinDS0000020380.V302283.R01.S.doc Timescale for action 25/09/06 25/09/06 25/09/06 25/09/06 25/09/06 10/09/06 7 8 OP26 OP29 10/09/06 10/09/06 9 OP30 12 (1) (a) (b) 25/09/06 Russell Haven Version 5.2 Page 23 controlled diabetes. 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 OP22 OP28 Good Practice Recommendations Call bell in lounge needs to be clearly accessible. The manager needs to enrol staff in NVQ training Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Russell Haven DS0000020380.V302283.R01.S.doc Version 5.2 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!