Inspection on 02/05/07 for Shirebrook Manor Nursing Home

This inspection was carried out on 2nd May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shirebrook Manor Nursing Home 01/05/08

Shirebrook Manor Nursing Home 23/05/06

Shirebrook Manor Nursing Home 24/02/06

Shirebrook Manor Nursing Home 31/08/05

Shirebrook Manor Nursing Home 31/01/05

Shirebrook Manor Nursing Home 06/10/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Shirebrook Manor Nursing Home Central Drive Shirebrook Nottinghamshire NG20 8BA Lead Inspector Nancy Bradley Key Unannounced Inspection 2nd May 2007 09:15 Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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 Shirebrook Manor Nursing Home DS0000002074.V335591.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 Adults 18-65. 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. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shirebrook Manor Nursing Home Address Central Drive Shirebrook Nottinghamshire NG20 8BA 01623 744414 01623 748882 shirebrookmanor@tesco.net 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) Shirebrook Nursing Home Limited Naomi Reynolds Care Home 33 Category(ies) of Learning disability (33) registration, with number of places Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Shirebrook Manor Nursing Home is registered to provide personal care with nursing, to male and female service users who fall within the following categoriesLearning Disability (LD) 33. To accommodate the service user named in variation application V33834 who is over the age of 65 and has a learning disability LD (E) The maximum number of persons to be accommodated at Shirebrook Manor Nursing Home at any one time is 33. 23rd May 2006 2. 3. Date of last inspection Brief Description of the Service: The Care home is situated in the village of Shirebrook, which lies on the Derbyshire and Mansfield boundaries. The home is purpose built for the provision of nursing care to a maximum of 33 service users with a learning disability. The home comprises of two floors with each floor being divided into smaller units, one of which provides care to service users with a challenging nature. The home also provides a small day care facility, for the residing service users. The current scale of charges is a basic £900.00 per week. The information on additional charges was not available. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection and took place over six hours. The inspector spoke with the Registered Manager, care staff and made a tour of the building. Records were examined relating to the three service users and the general operation of the home. Additionally, time was spent in preparation for the visit, looking at the pre inspection questionnaire. Currently the home is caring for thirty-one service users No family or relatives were present during this visit. At the time of the inspection none of the service users are able to manage their own financial affairs and one-service users’ financial affairs are subject to a Guardianship order. Although service user questionnaires were sent out to the home, none were completed or returned to the Commission for Social Care Inspection. The homes Statement Of Purpose and Service user Guide/Charter are displayed in the main entrance and on the notice boards around the home. The last inspection report from the Commission for Social Care Inspection is also available in the main entrance. A number of the service users had difficulties in expressing themselves in words and were unable to contribute directly to the inspection. During the tour of the home the inspector observed several staff interacting in a positive and caring manner with service users. What the service does well: What has improved since the last inspection? The majority of the requirements from the previous inspection have been fully complied with by the time of this inspection. Requirements not met are identified in the report Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 6 Several of service users bedrooms have been decorated and personalised and new flooring has been laid 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. The summary of this inspection report can be made available in other formats on request. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that service users needs are fully assessed and met prior to admission this ensures that all potential service users holistic needs are appropriately met. EVIDENCE: The records of three service users were checked. The majority of the service users who are admitted to the home have their needs assessed through the care management system, which highlights their additional needs, and the need for additional staffing hours. The home also undertakes its own individual comprehensive needs assessment and which is in accordance with Shirebrook Care Ltd assessment process and the National Minimum Standard 2.3. The assessment then forms part of the service user plan compiled by the home. The majority of the care needs assessments examined were of long-term service users and the initial assessment provided very little information. The home is developing a system for recording significant events in the service users life, however this is proving difficult, as many of the service users do not have any significant family or friends. There was evidence on file to show that the care needs assessments are now being reviewed by the referring agency. There have been no new admissions since the previous inspection. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Inconsistencies in the care planning system and recording may compromise service delivery and leave service users vulnerable EVIDENCE: During the visit care plans of three service users were examined. The care plans have been compiled by the care staff on each service users and evidence was seen of care plans being reviewed on a regular basis. At the previous inspection the Registered Manager was seeking to phase in new care planning, risk assessments and individual profiles on all service users. However on examination of service users’ records several of the staff have not moved to the new style care plans and risk assessments. This has lead to inconsistencies in care planning, the level of recording and evaluation of care plans. This was discussed with the Registered Manager and Representatives from the Shirebrook Care Ltd. The service user records which are on the new style care planning showed service users’ individual lifestyle preferences, choices, and the interventions prescribed by outside healthcare professionals. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 10 The service user involvement in drawing up the plan should be through family, friends and/or advocates, and other relevant agencies. The home has a system for reviewing service user care plans and these were fully recorded During the tour of the home care staff were observed encouraging service users to make decisions, which affect their daily lives. All service users have access to the Derbyshire Advocacy Service should they require and the home is setting up service user meetings with the Advocacy Service. Detailed risk assessments were in place and these included actions to be taken by staff. The Registered Manager recognised the need for these to be updated and reviewed in line with care plans. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were arrangements in place to enable service user to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. EVIDENCE: The care records of three service users provided details of care planning and risk assessments on their social, recreational, educational and occupational activities both within the home and outside in the community. The Registered Manager stated the home is looking to enrol service users at the local college on a computer course. The home has two computers available for service users. On the day of the visit service users were involved in reflexology, and aromatherapy. The daily routines are flexible with the service users being able to make their own decisions about how they spend the day. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 12 The relationships observed between care staff and service users were open and good-humoured. The service users are encouraged to take pride in their appearance and their preferred style of dress is respected. Information on service users’ records indicated that contact with family and friends were appropriate. Any restrictions on contact are recorded in care plans. The home operates a three weekly menu with service users being given a choice if they do not like the options on the menu. From examination of the menus the home is providing a healthy well-balanced and nutritious diet with some service users on special diets. Service user’s weekly weights are recorded. The menu is displayed on service users’ notice board Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 20 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and beliefs. EVIDENCE: Many of the service users were not able to express themselves verbally and to directly contribute to the site visit. During the tour of the home several service user spoke with the Inspector and said “that the staff cared for them and that they liked it at the home.” Also that “they get the help when they need it, are able go out to the shops and on trips.” Those service users who were less able to express themselves looked relaxed, and were involved in the day’s activities. Service users were all dressed in clothes appropriate to their age and personal preference. From records examined and from discussions with staff, service users’ health and personal needs were being met Service users were generally healthy and records showed that staff promptly contacted the appropriate medical services. All service users attended services within the community including doctor’s optician, podiatry, dentist, and audiologist. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 14 The home operates and monitors service users’ medication. None of the service users are able to administer their own medication. All staff have received training on medication training procedures. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to satisfactory. However the home needs to review its policy and procedures on homely remedies. Currently they are blanket prescribing none prescribed medication. Also there was no clear audit trail of the medication held. Service users’ health care records need to show that non-prescribed medication. Although the staff stated this had been agreed by the local practice, the agreement was only a verbal one. The home has their medication supplied from the local pharmacy who carries out regular inspections. On one-service user’s records the Placing Authority had an “ Ending of Life Plan” in place. The Registered Manager stated this is going to be extended and all service users will have a plan. The plan covered how they wanted to be cared for and funeral arrangements. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard service users’ welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: Service users are made aware of the home’s complaints procedure through the service user guide and via their key worker. A copy is displayed on the service users’ notice board. The Registered Manager has developed a user-friendly complaint form for service users. Any concerns and complaints made by service users are investigated within the agreed time scales. The Registered Manager maintains a record of all complaints made by service users, details of the investigation action and outcome. The procedure contains the current contact details of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaints process if they wish to do so. Records seen indicated that no complaints had been received from service users or their representatives about their care since the last inspection. From discussions with the Registered Manager and from records examined there has been two reported incidents or allegations under the safeguarding of adults procedure since the last inspection. The home has a vulnerable adult protection policy and procedures however this does not make reference to local procedures, or reflecting the change of policy to the Safeguarding of Adults. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 16 Staff training records confirmed they had received training on safeguarding of adults. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The implementation of an improvement,plan would ensure the service users live in a safe, comfortable and homely environment. EVIDENCE: The Inspector carried out a full tour of the home, accompanied by the Registered Manager. All communal areas were inspected together with staff facilities. Service users’ bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and were being personalised. The issues relating to the environment and the general condition of the building have been identified in the two previous reports. The refurbishment of the building is urgently required. This was discussed at the inspection with representatives from Shirebrook Care Ltd, and an assurance were given that this is being given priority. Some alterations have been made to the home and following the tour of the home several of the windows need replacing. This includes windows in service users and communal rooms. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 18 The environment in Phoenix unit still continues to be one of control and containment with the service user being offered very little comfort in their surroundings. Plastic seating, some curtains to windows, tables and chairs secured to the floor. The Registered Manager has been able to re decorate several of the service user bedrooms and is actively looking to soften the environment for the service users. The home was free of any unpleasant odours or smells. The home has satisfactory hygiene procedures in place. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,33,34,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust recruitment and selection procedures in place to ensure that the appropriate staff are employed to care for vulnerable people. EVIDENCE: The home has a high percentage of staff who hold a NVQ level 2/3 or the equivalent, with several staff being approved trainers for adult protection and physical intervention. The staff working on the “ Phoenix unit” are registered nurses in mental health or learning disability and the care staff work along side them. As discussed with the Registered Manager and Director of Shirebrook Care Ltd, newly appointed staff need to reflect the changing needs of the home, and that of the service users. The staff numbers and skills mix of the teams needs to be integrated to benefit the effective operation of the home. The home has a robust recruitment procedure in place, which ensures that their staff are suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a 3 months probationary period. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 20 The records contained all required information has detailed in Schedule 2 of the National Minimum Standard, Care Homes for Adults 2001. The staff personnel records were well presented and organised. All staff receive induction training and commence comprehensive foundation training with 3 months of appointment. From discussions with the Registered Manager and from examination of records the home is providing good training and development opportunities. Details of staff training together with training planned were provided by way of the pre inspection questionnaire. The training programme covered eating and drinking difficulties for people with a disability, dementia, dealing with difficult situations and physical interventions. As discussed with the Registered Manager the care staff need to be aware of the Mental Capacity Act, which became law in April 2007. Although staff supervision is taking place and records were seen confirming this, the Registered Manager did state that several staff are not receiving regular supervision as required under National Minimum Standard 36.4. Staff appraisals have been arranged. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that service users have a voice and their views are listened to. EVIDENCE: The Registered Manager has a number of years experience in the care sector, and has gained a Recognised Manager’s Award. Examination of her personnel records confirmed she had a contract and relevant job description detailing her role and responsibilities. The Registered Manager has yet to apply to be registered with the General Social Care Council. The Registered Manager has undertaken an audit of the home following on from the last inspection and would like to implement several changes. The managing director and group care manger were present for part of the inspection and are looking to support the Registered Manager in her endeavours. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 22 The Registered Manager attends service users’ meetings and liaises with care managers about the quality of care service users receive at their reviews. No other formal system for assessing the quality of care is carried out at present. However in discussions with the managing director Shirebrook Care Ltd are looking to address this. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to the Commission for Social Care Inspection. Systems were in place for the monitoring and maintaining the hot water temperatures. These were examined and found to be within a safe range. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 3 X Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement To prevent inconsistency in recording staff must comply with Shirebrook Care Ltd policy and procedures on care planning, risk assessment and daily recording. Service users must be included in the planning process. This is a previous requirement. The home must have in place a policy and procedure on none prescribed medication. The home must obtain written consent to administer none prescribed medication. All none prescribed medication must be recorded and there must be a clear audit trail. The homes policy on adult protection must be revised and updated to reflect current practice. The homes policy on Safeguarding Adults must make reference to local procedures. The home must be suitable for the needs of the service users and be maintained both internally and externally. This is a previous requirement DS0000002074.V335591.R01.S.doc Timescale for action 30/06/07 2. 3. 4. 5. 6. YA26 YA19 YA19 YA19 YA23 15 13 13 13 15 11/05/07 30/06/07 30/06/07 30/06/07 30/06/07 7. 8. YA23 YA24 15 23 30/06/07 11/05/07 Shirebrook Manor Nursing Home Version 5.2 Page 25 9. YA34 23 10. YA36 18 Shirebrook Care Ltd must proceed with the planned refurbishment and extension to the home and dates must be provided as to when this can commence. All staff must have regularly supervision in line with the National Minimum Standard 6.4. An effective quality assurances system based on the service users’ views must be developed This is an outstanding requirement As part of assessing the quality of care provided by the home consultation with stakeholders and service user representatives must be undertaken. 30/06/07 30/06/07 11. YA39 39 11/05/07 12. YA39 39 30/06/07 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 YA6 YA33 Good Practice Recommendations The service user or their representative should sign all care plans The home should ensure that there is a good skills mix, of staff on duty at all times. Shirebrook Manor Nursing Home DS0000002074.V335591.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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