Inspection on 31/08/05 for Silverdale

This inspection was carried out on 31st August 2005.

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 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

Silverdale 18/04/07

Silverdale 26/01/06

Silverdale 24/02/05

Silverdale 18/08/04

Silverdale 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Silverdale 20 Bents Avenue Bredbury Stockport SK6 2LF Lead Inspector Kathleen Mcall unannounced 31 August 2005: 09:30 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 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. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Silverdale Address 20 Bents Avenue, Bredbury, Stockport, Chehsire SK6 2LF 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) 0161 430 5010 0161 430 5019 Borough Care Limited Mrs Maureen Hayes Care Home 47 Category(ies) of OP- Old Age - 47 registration, with number DE(E) - Dementia - over 65 - 28 of places MD(E) - Mental Disorder- over 65 - 4 Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The ratios of care staf to service users must be determined according to the assessed needs of residents and in accordance with guidance issued by the Deparment of Health. 2. The home is registered for a maximum of 47 service users to include: *up to 28 service users in the category of DE(E) (Dementia over 65 years of age) *up to 47 service users in the category of OP (old age not falling into any other category). *up to 4 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). 3. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 24 February 2005 Brief Description of the Service: Silverdale is a purpose built residential care home that is registered to provide care for up to 47 older people over the age of 65 years, including 28 residents who have a diagnosis of dementia and 4 residents with a diagnosis of mental disorder. Silverdale provides permanent residential care services, respite and short-stay services and day care services The home is one of 12 homes owned by Borough Care Limited. The registered manager is a Mrs Maureen Hayes who has been in post since the 1st April 2005. Accomodation comprises of 47 single bedrooms, 19 of which have en suite facilities. The home is divided into four units each has its own lounge, dining room and kitchen area. Several smaller seating areas are situated around the home and provide quiet private areas for service users and visitors use. Day care facilities are available for up to five services users each day, Monday to Sunday. Day care service users have their own lounge and dining room, on the first floor of the home. The building is suitable for wheelchair service users and has a passenger lift to assist service users to the first floor. There is a good-sized garden area with a pond and patio areas for service users use. Silverdale is situated in the Bredbury area of Stockport. It is close to the motorway network and public transport is easily accessible. There are a number of shops, post office, chemist and churches all within walking distance. Silverdale F54-F04 s8572 Silverdale v245404 310805 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, which took place over the course of a day. The registered manager was not available at the time of the inspection. The deputy manager and a care supervisor assisted the inspector throughout the inspection process. Care plans, assessment documentation, medication and their storage were examined. The inspector spoke with a number of residents in the home and had a discussion with three relatives who were visiting at the time of the inspection, and spoke with a large number of care and housekeeping staff. The inspector had a discussion with a member of staff responsible for organising activities in the home and met an advocate from Age Concern who was visiting a resident at the home. Day care facilities are available for up to five services users each day, Monday to Sunday. Day care service users have their own lounge and dining room, on the first floor of the home. A member of staff is employed to undertake specific duties to organise activities within the home for day care service users and service users resident at the home. What the service does well: What has improved since the last inspection? Since the last inspection the home has been fully refurbished. As part of the refurbishment programme the number of bedrooms at Silverdale increased from 38 to 47 beds, 19 of these bedrooms provide en suite facilities. Mrs Maureen Hayes was appointed as the manager of Silverdale on the 1st April 2005 and Mrs Sue Harrop was appointed as deputy manager on the 6th June Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 6 2005. Both Mrs Hayes and Mrs Harrop are experienced workers in the field of residential care services. 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. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 standard(s) 2, 3, 4 and 5.. Service users had a written contract, their care needs were fully assessed before admission and arrangements were in place for them to visit the home prior to their admission. EVIDENCE: Service users admitted to the home had a written contract which detailed the terms and conditions of their stay. Service users were assessed prior to their admission to the home; no service users were admitted to the home without their care needs having been assessed. Assessments were obtained from social workers and health professionals if they had been involved in the admission. Borough Care had its own assessment documentation called the “key-working together document”; this was completed for all new service users irrespective of their funding arrangements. Service users told the inspector that they were quite satisfied with the way in which the home met their care needs. The needs and preferences of service users were recognised and met by care staff. Care staff demonstrated a good understanding of service users care needs. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 9 Arrangements were in place for service users to visit the home prior to their admission. Service users could stay for lunch or longer. Some service users were already known to the home through their use of day care and respite care facilities. One service users told the inspector that he had visited three homes as part of his decision making process and finally settled on Silverdale as this was the one which he believed would best suit his needs, he told the inspector that the facilities and the positive attitude of the staff had helped him make his decision. Another service user who was admitted to the home at the time of the inspection told the inspector that he had been made ‘ to feel most welcome and that if this was an indication of how he would be treated then he would have no complaints’. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 9 and 10. Care plans need to be developed to accurately reflect how a service users cares needs were met. Service users were treated with respect and dignity at all times. EVIDENCE: Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 11 All service users had a care plan. However care plans did not include all aspects of a service users care needs and how care staff were meeting these needs for example in respect of those service users with dementia there was nothing on the care plan to indicate how their dementia affected their daily presentation and functioning and how staff were responding to aspects of challenging behaviours. Similarly care plans did not indicate whether a service user was managing their medication or required assistance from staff. Care plans were stored in one accessible folder along with risk assessments, moving and handling assessments, weight charts, daily records and a review sheet. Care plans were reviewed on a monthly basis and any changes needed were made. Care plans were drawn up with a service users relative or a professional who may have been involved in their admission to the home. Silverdale had specialist equipment in place to meet the needs of service users living there. GP’s and district nurses were regular visitors to the home. Medication was provided in the monitored dose system, this was stored appropriately and medication records were accurately maintained. The home had a secure dedicated refrigerator for the storage of medication requiring refrigeration; the temperature of this refrigerator was monitored and recorded on a daily basis. Medication was stored in two storage areas in the home, one on the ground floor and one on the first floor. The temperature of the ground floor storage area felt extremely hot. At present the registered manager does not monitor the temperatures in these areas. There was one service user who managed their medication, whilst a risk assessment had been completed that identified potential risks and means of addressing these risks, there was no overall assessment of a service users understanding and ability to manage their medication. Those serivce users who have a diagnosis of dementia were accommodated on the ground floor and in seven bedrooms on the first floor area. All other service users were accommodated on the first floor areas. There were approximately twenty service users with a diagnosis of dementia in the home at the time of the inspection. The majority of these service users were unable to comment in detail on the quality of care they received due to their levels of dementia. Consequently the inspector spent time observing the practices of staff and the daily routine of the home and observed that staffs approach towards service users was respectful, sensitive and caring at all times. Other service users who were able to comment on the care they received told the inspector that staff treated them well and they were very satisfied with the care they received. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. The routines of daily living at the home did not meet all service users expectations and preferences. Mealtime arrangements were well managed and satisfied service users expectations. EVIDENCE: Generally the routines of daily living at the home were varied and flexible and met the majority of service users expectations and preferences. However at the time of the inspection the weather was very hot and a number of service users and day care service users on the first floor of the home, told the inspector that they would like to sit in the garden and complained that they were unable to do so. One service user told the inspector that staff told her that she could not go in the garden but was not given an explanation for this. Another service user told the inspector that she could go in the garden but had to wait for staff to take her and that there wasn’t always staff available to do this. Care staff and the deputy manager confirmed that service users could use the garden at anytime, however staff would have to take them and would need to ensure that another member of staff was covering the unit and that staff were available to supervise those service users using the garden areas. At the time of the inspection no service users were brought down into the garden by staff, however two service users using the garden had been brought down by their visiting relatives. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 13 Service users could get up and go to bed at times that suited them. Staff encouraged service users to make choices about how they spent their time, whether they wished to join in activities or not and what they ate. Several service users liked to spend time in their bedrooms, with many being quite comfortably self-contained. One service user told the inspector that she believed that staff preferred service users to sit in the lounge areas and not in their bedrooms, she believed this was because it was easier for staff to look after service users if they were all in one area. Day care facilities were available for up to five services users each day, Monday to Sunday. A member of staff was employed to undertake specific duties to organise activities within the home for day care service users and service users resident at the home. A structured activities programme was in place. Visitors were made welcome at the home and service users kept in touch with family and friends. Meals were served at regular intervals and were usually taken in the dining room areas. A hot meal option was offered at both lunchtime and teatime meals with the exception of Sunday teatime when a cold buffet tea was offered. Staff were on hand to help service users with meals. A number of service users told the inspector that they had enjoyed their lunch, one service user told the inspector that the variety and quality of meals offered was very good and another service user said that that choice and standard of meals provided had greatly improved and she was extremely satisfied. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. Service users and their relatives felt confident that their complaints would be taken seriously and acted upon. Staff had undertaken appropriate training in adult protection, which ensured the protection of service users. EVIDENCE: The home had a detailed complaints policy and procedure; there had been no complaints since the last inspection. However at the time of the inspection two relatives complained to the inspector about the standard of cleanliness in their mother’s bedroom and the way in which their mother was dressed. The housekeeper with responsibility for the bedroom was on leave and it was reported that another member of housekeeping staff had cleaned kitchen, bathroom and toilet areas of the unit but no one had cleaned service users bedrooms. An agency member of staff had helped the service user dress that morning, however other care staff reported that they knew the service users preferences regarding clothes and would have ensured that she was dressed more suitably. Despite their complaint the relatives said that they knew whom to complaint to and were generally satisfied with the way in which staff responded to complaints, however they were concerned that the standard of housekeeping in their mother’s bedroom was variable. Several service users with whom the inspector spoke said that they knew who to complain to if they had a problem and all felt confident that the problem would be resolved in a satisfactory manner. All added that they had never needed to complain and were very satisfied with the care that they received. The home had a procedure for responding to allegations of abuse. All staff on duty at the time of the inspection had completed training in adult protection. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 15 Staff had a clear understanding of their responsibilities with regard to reporting abuse and poor practice. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26. The home was well maintained and provided comfortable living accommodation for service users. EVIDENCE: The home was well maintained throughout and provided comfortable accommodation. A programme of refurbishment at the home was completed in January 2005. Several service users who had lived at the home before the refurbishment programme was undertaken told the inspector that they were very pleased with the new and improved standards within the home and many enjoyed having their own ensuite facilities. The grounds of the home were well kept and attractive with a garden pond feature and garden furniture provided for service users use. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the occupants, with many of the service users being quite self contained in their own rooms. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 17 Despite a complaint made at the time of the inspection regarding housekeeping standards in one service users bedroom, the home was clean, tidy, bright and airy throughout and was free from any unpleasant odours. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. The home was insufficiently staffed and did not meet the full needs of the service users resident there. Thorough recruitment procedures were not followed in respect of all employees. The staff group were appropriately trained to undertake their duties. EVIDENCE: Service users, relatives and care staff made a number of complaints regarding the staffing levels in the home to the inspector at the time of the inspection. Care staff felt that the home had got busier since the numbers of service users had increased to forty-five and that service users care needs were greater. Staff identified the 1st floor area of the home as being a difficult one with twenty-five service users, four of which required hoisting and three of who required assistance with feeding. In addition to this three-day care service users were also in the home and day care facilities were sited on the first floor. Care staff described difficulties with caring for those service users on the ground floor, saying that several had high care needs, they required increased levels of supervision and exhibited challenging and aggressive behaviours. Care staff complained that they were no longer able to spend ‘quality time’ with service users. One member of staff felt she was always saying ‘in a minute’ in response to service users requests. Another said that she used to be able to sit and talk to service users and do manicures but is no longer able to do this. Staff morale was low and staff feared that colleagues would leave. One member of staff said that there was no laundry staff available at the weekends and that laundry duties were the responsibility of weekend care staff, which took them away from caring tasks. A relative complained that it was difficult Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 19 to find staff at the weekends. A housekeeping member of staff was on leave at the time of the inspection and no one had picked up her duties, which led to a complaint being made to the inspector. The inspector observed care staff rushing around and looking flustered. A number of care staff said that they had raised their concerns in supervision sessions but nothing had changed, one member of staff said that ‘she did not feel listened to’. Others said that they had not had a staff meeting for sometime and had no means of feeding their views back to the senior management team. The deputy manager had a long discussion with the inspector regarding staffing levels and she felt that the admission of four new service users this week might have contributed to staffs’ feelings of being overwhelmed, as had the fact that four members of staff were on long-term sick leave. Relatives told the inspector that they were very happy with the efforts of the care staff at the home who they described a very caring. A number of new care staff had been recruited to the home. The inspector looked at the recruitment files for these staff members and found that files did not contain all of the required documentation for example staff photographs, one file had one reference instead of the required two, another reference had not been fully completed and in one instance a third reference should have been obtained. Staff appeared to have a positive relationship with the service users. Care staff on duty at the time of the inspection confirmed that they had undertaken further training to assist them in their role as carers and new staff had completed a period of induction at the commencement of their employment. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38. Not all care staff were supported and supervised in their work. Health and safety issues at the home were addressed. EVIDENCE: Staff confirmed that they received regular supervision and written evidence to support this was made available at the time of the inspection. However casual staff employed at the home did not receive formal supervision. Casual staff can be employed at a number of Borough Care homes without receiving formal supervision. All persons working at the home should be appropriately supervised. Staff had updated their training in safe handling and moving procedures, fire safety, food hygiene and health and safety. The home maintained records in respect of fire safety at the home. Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 2 x 3 Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 22 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 OP 9 Regulation 13(2)(4)( c) Requirement The registered manager must ensure that service users who wish to manage their own medication are assessed as to their ability to do so, before medication is provided to them. Assessments must then be repeated on a regular basis. (Timescale of 10.03.05 not met). The registered manager must ensue that medicines in the custody home are stored at a temperature that does not exceed 25c. The registered manager must consult with service users regarding their preferred choices and assist service users to access garden areas provided at the home. The registered manager must continue to monitor and review the ratios of care staff to service users according to their assessed needs and in acordance with guidance issued by the Department of Health. (Timescale of ongoing not met) The registered manager must ensure that domestic and laundry staff are employed in Timescale for action 1st September 2005. 2. OP 9 13(2) 1st September 2005. 1st September 2005. 3. OP 12 16(2)(m)( n 18(1)(b)) 4. OP 27. 18(1)(a) Residentia l Forum Guidance. 1st September 2005. 5. OP 27 18(1)(a) 1st September 2005. Page 23 Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 6. OP 29 Schedule 2. 7. OP 36 18(2) 8. OP7 15(1) sufficient numbers to meet the needs of service users. The registered manager must ensure that all the required documents listed in Schedule 2 of the Care Homes Regulations 2001 are in place at the commencement of employment of a member of staff.. The registered manager must ensure that all persons working at the care home are appropriately supervised. The registered person must ensure that care plans cover all aspects of health, personal and social care needs of service users. 1st September 2005. 1st September 2005. 1st October 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 0QD 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 Silverdale F54-F04 s8572 Silverdale v245404 310805 Stage 4.doc Version 1.40 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!