Inspection on 13/07/05 for Shila House

This inspection was carried out on 13th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Shila House 13/10/08

Shila House 17/09/07

Shila House 22/06/06

Shila House 16/02/06

Shila House 08/11/04

Shila House 28/04/04

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

CARE HOME ADULTS 18-65 SHILA HOUSE 49-53 Main Avenue & 1 Poynter Road Enfield Middlesex EN1 1DS Lead Inspector Teferi Degeneh Unannounced 13 July 2005 @ 9.25 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Shila House Address 49-53 Main Avenue & 1 Poynter Road, Enfield, Middlesex, EN1 1DS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8367 8774 Mrs Kalpna Patel of Simiks Care Ltd Mr Delroy Watson PC - Care Home 14 beds Category(ies) of MD - Mental Disorder registration, with number of places SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 11 people with mental health needs of either gender at 49-53 Main Avenue and 3 people at 1 Poynter Road. Date of last inspection 08 November 2004 Brief Description of the Service: Shila House is a home registered to provide care to fourteen people with a mental disorder, excluding learning disability or dementia. The home is located at Main Avenue in Enfield and the annexe is over the road at Poynter Road. There are eleven places at Main Avenue and three at Poynter Road. Both homes are managed by Simiks Care Limited. Many of the service users have enduring mental health issues and have periods of time in hospital. The home was first registered in 1994.The main house was built partly above and behind a parade of shops. Poynter Road is a small end of terrace house. Next to the homes are a range of local shops and public transport. There are other leisure amenities in the local area. The annexe at Poynter Road is a semi-independent service where service users do their own cooking and other domestic chores. All the service users have their own bedrooms and at Shila House there is a wash basin and shower in each room. Shila House has two communal lounge and dining room areas. There are also two kitchens, one of which is for the service users to cook their own food if they wish. The home does not have a garden but does have a yard at the back of the home where service users can sit.The home has staff available 24 hours a day. Most of the service users spend their time doing domestic activities in the home or going out in the local area. Some attend a local day service one or two days a week.All the service users have access to a GP, psychiatrist and care manager. Some have input from a community psychiatric nurse. Currently there are two vacancies. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 13th of July 2005 starting at 9:25 am. The manager and a team leader were present during this inspection. Six people who live at the home, two members of care staff and a professional who was visiting the home were spoken to regarding their experiences of the home and the services provided there. The service users’ files were seen and other documents and records such as the home’s policies, procedures, various certificates in relation to the business and the buildings, the visitors’ book and the diary were examined. The inspector had a guided tour of the premises at Main Avenue and Poynter Road. What the service does well: What has improved since the last inspection? What they could do better: Some of the people who live at the home are bored having little or no social or leisure activities outside the home. The registered person needs to review the staffing levels in order to provide appropriate number of staff to meet the needs of service users. The sofas in Poynter Road and some carpets in Main Avenue and Poynter Road need replacing. The registered person must ensure SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 6 that the boilers meet the standards. It is also required that the registered person asks the people who live at the home and relevant visitors how they feel about the quality of the services and facilities provided at the home. The owner needs to carry out unannounced visits to the home on a monthly basis and check how the home is running by assessing the premises and the facilities and by talking to the people who live at the home and the staff. It is required that the staffing levels are reviewed to ensure that the number of staff on shift is appropriate to meet the health and welfare of service users. Recommendations are made for the registered person to introduce a policy, which ensures that there is a limited amount of cash kept at the home for each service user. Finally, the registered person is advised to consider ensuring that at least 50 of the care staff achieve a care qualification equivalent to NVQ level 2 by 2005. 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. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, and 5 The procedures for admission to the home are satisfactory and new service users are confident that their admission is based on the outcome of their assessment and on the availability of services and facilities to meet their assessed needs. Service users are reassured by the written contracts issued to them by the registered person. This has enabled them to know their rights and responsibilities. EVIDENCE: The home’s records and discussions with the registered person showed that new service users are referred to the home by their social workers. Information is then requested and obtained in respect of each prospective service user. Reports from health professionals and assessments of social workers have been received for service users before admission. The registered person confirmed that new service users are visited and assessed by the manager before they are offered a place at the home. A new service user is currently referred to the home and full information about them is received. The registered person said he would visit this service user and complete their assessment before making a decision whether or not the home is suitable and their needs can be met. The files and diaries showed that new service users visited and spent time at the home before admission. Seven service users, who were spoken to confirmed that they had visited the home prior to their admission. A signed contract was available in each of the assessed service user’s file. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, and 9 The registered person has done a good job in ensuring that care plans and risk assessments are reviewed. Service users know that they are encouraged and supported to take responsible risks and to do more for themselves. EVIDENCE: Six service users spoken to confirmed that they attended their care plan meetings. The files of service users have evidence that care plans have been reviewed and service users, professionals and relatives have been involved. One service user said they goal is to move on to a place of their own and they are supported by the home and their social worker to achieve this. A number of people at the home are able to travel independently to places of interest. Those service users who needed support in travelling or carrying out tasks such as self-care or shopping are provided with appropriate support. The service users spoken to confirmed that they know their support needs and they have keys for their bedrooms. They said that there are no time restrictions for going to bed and getting up. The registered person and the staff explained their roles as being to assess each service user’s needs and enable and encourage them to do more for themselves. The service users at the building in Poynter Road do their own shopping, cooking, cleaning and laundry. A small kitchen is provided at the Main Avenue for service users to prepare light meals. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 10 One service user at Main Avenue explained that they go out to shops to buy their lunch. All the service users spoken to said they are happy with the staff. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 17 The social and leisure activities provided at this home are not satisfactory with the evidence that most service users spend their time at the home watching television. There are satisfactory arrangements for service users to go on holidays away from the home. The services and facilities of the home are conducive for service users to see visitors in private. The food provided at the home is good and service users’ needs are met. EVIDENCE: Some of the service users spoken to confirmed that they are able to travel independently to access community based facilities. It was evident from discussions with the staff and service users that some service users go to a day centre and a local library. But a number of service users at the home do not have a structured day or educational activity and most of them stay at the home watching television programmes. On the day of the inspection two service users were observed going out with the staff at different times and another service user was seen going out and returning to the home independently. As mentioned under the Staffing Section below, there are two care staff on shift at Main Avenue where eleven people live and given the tasks SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 12 (cooking, medication administration, laundry and escorting to appointments) the staff are required to undertake, it would be practically difficult for them to meet the social, leisure or educational needs of the service users. However, it was noted in discussions with the registered person that service users go to public houses, shops and cafés. Records at the home indicated that service users have been on a holiday. The minutes of service users’ meetings showed that discussions were held regarding day outs and the menus. The people spoken to said the meals provided at the home are good. Three service users who live in the annex at 1 Poynter Road said they do their own shopping and cooking. A health visitor was spoken to and said they are satisfied with the care provided at the home. They confirmed that they can see service users privately in a sitting room or in a bedroom. The service users spoken to also confirmed that they are able to have visitors. It was evident in the visitors’ book that families and relatives visited service users. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, and 20 The procedures and practices of providing personal care, ensuring health needs, and storing and administering medication are satisfactory. These have ensured that service users’ personal, health and medical needs are met. EVIDENCE: The diaries, appointment letters and service users files showed that service users had appropriate medical care. On the day of the inspection a community psychiatric nurse, who was visiting two service users, confirmed that they regularly came to the home and had also made referrals to specialists on behalf of service users. One service user was escorted to a dentist while the inspection was in progress. A service user explained that they see different health professionals and they are happy with the support they are given. The registered person confirmed that all service users are registered with their own general practitioners. The service users spoken to said they have bedroom keys. Discussions with the registered person and service users revealed that there are no time restrictions for going to bed and getting up. Medication is administered by the staff and it was evident from records and discussions with the staff that staff who administer medication have undergone relevant training. Following an error in medication administration, the registered person has amended the medication procedures. Currently medication is administered by a trained member of staff and is witnessed and signed by a second member of staff. Medicines are kept in a locked cabinet in a room. The temperature in the area where medication is kept is monitored and records showed that it is SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 14 maintained at 25 or below degree Celsius. The medicines and the medication administration record sheets were checked and found to be in order. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, and 23 Adequate facilities are in place to ensure that service users’ concerns are listened to and acted upon and service users are protected from abuse. These have given a feeling of reassurance, confidence and protection to service users. EVIDENCE: The home’s complaints procedure has been included in the service users’ guide and this has been given to each service user. The registered person has implemented two complaints books, one for external complaints and another one for resident’s complaints. A complaint recorded in the external book has been satisfactorily resolved. No complaints have been recorded in the residents’ complaints book. The Commission for Social Care Inspection has received a complaint regarding staff training, supervision, safe working practice and medication administration. These have been investigated and it was found out that some of the complaints were partially upheld and the registered person had already taken action to address them. A policy and procedure on the protection of vulnerable adults from abuse has been developed by the home. The registered person has also received a relevant policy and procedure from the Enfield Council. The staff spoken to were able to give examples of abuse and how they can protect service users from abuse by following the home’s procedures and by reporting incidents of abuse. Discussions with the staff and the records seen indicated that abuse was one of the items of agenda discussed at a staff meeting. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, and 30 The location of this home is good and service users have access to transport and shopping facilities. The standard of the furniture and the carpets in the home are below the expectation of service users. EVIDENCE: The home is located within a close proximity to the Cambridge Road in North London and service users have easy access to a range of shops, leisure and transport facilities. Shila House comprises two buildings, one at Main Avenue and the other across the Road at Poynter Road. All service users in both buildings have their own bedrooms and those who are able to use have been given bedroom and front door keys. The communal areas in both buildings include sitting rooms, toilets, kitchens, dining areas and gardens. The sofas at the Poynter Road have been worn out and are in need of replacement. The carpets in the lounge and bedrooms at the Poynter Road were stained and loose. Also, the carpets in the stairs by the office in Main Avenue have been worn out and are in need of replacement. The laundry facilities have washing machines with appropriate programmes. The home was clean and there were no offensive odours on the day of the inspection. A cleaner has been employed to clean the premises at Main Avenue. The environmental officer who recently visited the home said the SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 17 kitchen and toilet areas she assessed were satisfactory. The registered person has amended the policy on service users’ finances explaining the arrangements for when the Company acts as an appointee. Records and receipts have been kept for monies spent and received. However, a large some of cash was kept at the home and the registered person is looking ways of ensuring that this does not happen and a maximum limit is set for the amount to be kept at the home for each service user. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 Even though the recruitment procedures are adequate and the current staff have undertaken various training programmes, service users are at risk due to the low staff ratio at the home. EVIDENCE: Only one member of care staff has achieved a care qualification equivalent to NVQ level 2. The registered person said five staff have embarked on NVQ or nursing training to achieve a care qualification equivalent to NVQ level 2. The two care staff spoken to demonstrated good understanding of supporting adults with mental health needs. The home has fourteen care staff, a cleaner and the manager. The manager is on shift during the days from Monday to Friday. The rota shows that there are two care staff at Main Avenue and one care staff at Poynter Road during the days and at nights. The tasks of the staff include cooking, medication administration, and providing personal and social care. It has been noted above that the home has implemented a procedure whereby two care staff are present when medication. The registered person said additional staff are called in when needed. Currently there are two care vacancies. It was noted from discussions with the staff and staff files that the staff have attended various training programmes such as basic food hygiene, health and safety, challenging behaviour, fire safety and mental health awareness. The SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 19 registered person said one of his identified objectives for the year is to develop a training programme for the service. At the previous inspection requirements were made for the registered person to ensure that two written references and satisfactory CRB certificates are obtained before staff start work at the home. It was evident from the staff files and discussions with the registered person that these have been complied with. It was also clear from discussions with the staff and the files that the care staff had regular supervision. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, and 42 The home’s health and safety precautions are poor and put service users’ health at risk. The systems for monitoring the quality of the services and facilities are not adequate. Service users’ views are not systematically sought and an action plan to address possible shortfalls not developed. EVIDENCE: Discussions with the registered person and the documents revealed that the manager undertakes auditing of staffing, service users related issues, health and safety and the finance of the home. The registered person said professionals and relatives are asked to give feedback after each of the service user’s review. Questionnaires have been developed to be given out to service users, relatives and professionals so that their views can be gathered as part of the quality assurance system. Evidence was not available to confirm that the registered provider undertakes unannounced visits to the home on a monthly basis in line with Regulation 26 of Care Homes Regulations 2001. The registered person has reviewed the procedures for the administration of medication. Five incidents and accidents have been recorded since the last SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 21 inspection. The home was clean, tidy and there were no offensive odours on the day of the inspection. Requirements are made under Standard National Minimum Standard 24 regarding the sofas and the carpets in the home. An environmental health officer, who visited the home, was happy with the standard of cleanliness in the kitchen and toilet areas. The staff have attended training in health and safety and fire safety. An engineer visited the home on 3rd June 2005 to inspect the gas boilers at Main Avenue and Poynter Road. The report of the engineer states: “part of the installation and/or appliances did not fully confirm with the current standards”. A number of care staff have attended first aid training and more care staff are due to undertake same training. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 SHILA HOUSE Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 12 Regulation 16(2)(m) Requirement The registered person must consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. The registered person must replace the carpets in the bedrooms and the lounge of the building at Poynter Road. It is required that the carpets of the stairs by the office in Main Avenue are replaced. The registered person must ensure that the sofas at Poynter Road are replaced and are of good quality. The registered person must, having regard to the size of the home, the statement of purpose and the number and needs of service users, ensure that at all times suitably qualified and competent persons are working at the home in such numbers as are appropriate for the health and welfare of service users. The registered person must consult service users and visitors about the quality of services and facilities provided at the home. Timescale for action 30/9/05 2. 24 16(2); 23(2) 30/9/05 3. 24 16(2); 23(2) 18(1)(a) 30/9/05 4. 33 31/8/05 5. 39 24(1)(2) 30/9/05 SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 24 6. 39 26 7. 42 23(2)(4) The feedback obtained through the quality assurance must be summarised with action plans and made available to all stakeholders including the CSCI. The registered person must carry 31/8/05 out unannounced visits to the home on a monthly basis in line with Regulation 26 of the Care Homes Regulations. A copy of the written report must be sent to the CSCI and a copy must be held in the home. The registered person must 31/8/05 ensure that the installation of the boilers comply with the current standards. A copy of a certificate showing compliance must be sent to the CSCI Inspector. 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 23 32 Good Practice Recommendations The registered person should introduce a policy which ensures that there is a limited amount of cash kept at the home for each service user. The registered person should ensure that at least 50 of care staff achieve a care qualification equivalent to NVQ Level 2 by 2005. SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 SHILA HOUSE G59 S10620 Shila House V235680 13.07.05 Stage 4.doc Version 1.40 Page 26 - 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. 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