Inspection on 09/05/05 for Silverdale Nursing Home

This inspection was carried out on 9th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Silverdale Nursing Home 20/05/08

Silverdale Nursing Home 29/05/07

Silverdale Nursing Home 15/12/06

Silverdale Nursing Home 15/05/06

Silverdale Nursing Home 25/01/06

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

CARE HOMES FOR OLDER PEOPLE Silverdale Nursing Home Newcastle Street Silverdale Newcastle Staffordshire ST5 6PQ Lead Inspector Yvonne Allen Unannounced 09 May 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 Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Silverdale Nursing Home Address Newcastle Street Silverdale Newcastle Staffordshire ST5 6PQ 01782 717204 01782 717204 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) Silverdale Care Homes Ltd Mr Anandutt Rucktooa Care Home 27 Category(ies) of 27 DE(E) registration, with number 27 MD(E) of places Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4/10/04 Brief Description of the Service: Silverdale Mental Nursing Home provides nursing care for up to twenty-seven older people, both male and female, requiring long stay, short stay and respite care with severe mental health or dementia care needs. The home is situated in the residential area of Silverdale and is approximately two miles from Newcastle town centre.The home provides single storey accommodation and comprises of single and shared rooms. The majority of rooms are single rooms and some of them have en-suite facilities. Bedrooms can be personalised by the individual service user. The home has assisted bathing and toilet facilities, two communal rooms, a dining room and a quiet area. There are catering and laundry facilities on site. There are small car parking areas to the front and rear of the home. The grounds are not extensive and are easily accessible to the service user. There is a small patio area to the rear of the home equipped with garden furniture for service users to use during the summer months. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this unannounced inspection over four hours. The inspection focussed mainly on discussions with staff, visitors and some of the residents in the home. A tour of the home was conducted where all the communal areas and most of the bedrooms were inspected. Relevant documentation was examined. The home has recently been taken over by a new provider. However the previous provider/manager remained in post as manager of the home. At the end of the inspection the inspectors gave verbal feedback to the registered manager and provider. It was disappointing to note there were a number of requirements made previously which have not been actioned. If the home fail to complete these by the new deadline the Commission for Social Care Inspection may be mindful to issue Statutory Enforcement Notices. What the service does well: What has improved since the last inspection? The menus have been revised since the last inspection and now offer more variety. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 6 Some redecoration has taken place including new carpeting in the lounge. 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 Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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 Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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) 3 and 4 Service users are only admitted to the home following a full assessment of needs. The registered person was able to demonstrate that he had the knowledge required to meet the assessed needs of individuals admitted. However, further staff training is required in dementia care along with the development of therapeutic activities and a review of the dining process, in order to ensure that needs are fully met by the home. EVIDENCE: Pre-admission assessments were contained within individual care plans. These were found to be comprehensive and often included the assessments of other healthcare professionals including social workers and psychogeriatricain reports. Reviews of care were held and reports of these were contained within care plans. The manager was skilled and competent to oversee the psychological and mental health care needs of individual residents. However, there was little evidence of other staff having received training in this area. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 9 A visitor stated that she was very happy with the care her husband was receiving in the home and that the home provided the specific care, which other homes had failed to do. Another visitor who was just leaving, following a visit to his relative, stated that he was very happy with the care and attention his relative was given in the home. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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 and 10 The standard of care planning was good with evidence of regular meaningful reviews. Individual healthcare, including psychological healthcare needs were monitored with access to specialist advice and treatment as required. Residents were afforded privacy and dignity and staff were attentive to the needs of individuals. EVIDENCE: A sample of care plans was examined. These were found to be comprehensive and had been well maintained. Evaluations of care had taken place on a monthly basis and comments documented from staff on reviews were meaningful. The manager stated that there was good support from the GP surgery and there was evidence of visits by GPs. There was documentation of monthly healthcare checks including weights. In one instance where a resident had lost weight, the manager explained that this Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 11 had been a gradual weight loss over a significant period of time and that this resident had been seen by the GP on a regular basis. There was evidence to support this in the care plan. At the time of the inspection the resident was having a lie in until lunchtime. She appeared to be very comfortable and had received adequate diet and fluids – this was documented on an intake/output chart. Personal daily care was documented for each individual resident. This care is carried out in the privacy of residents’ own bedrooms. The staff that were spoken to talked about service users in a respectful way and understood the need to promote their dignity. This was confirmed by the visitors spoken to who stated that staff were always respectful toward their loved ones. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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 and 15 The routines of daily living and activities were not made as flexible and varied as they should be. Nor were they suited to residents’ preferences and capacities. Residents were not offered adequate social stimulation or diversional therapy. The recruitment of an activities co-ordinator is essential to developing a programme of social activities within the home. This has been a requirement at previous inspections. Mealtimes were uninteresting and not conducive to dining and the advice of other healthcare professionals is required in ensuring that meals provided are nutritionally adequate for the residents. EVIDENCE: The number of residents without dentures was concerning and this was discussed with the manager at the time of the inspection. He stated that residents had been seen by the Dentist but due to the length of time that had elapsed since they wore dentures that this would now be very difficult to arrange. There were a considerable number of residents receiving soft diet. This had been evidenced at a recent complaint visit to the home. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 13 There has been a requirement made for the manager to contact the dietician for further advice and guidance in this area. A request has also been made by the CSCI for a healthcare professional from the dental department of the hospital to visit the home to assess the residents in relation to the wearing of dentures. The menus seen were based on a four weekly rotation and offered nutrition and variety. These had been amended since the last inspection. There were a significant number of residents requiring help to eat and on the day of the inspection the staff were seen helping residents to eat their meals. Meals were not taken in a conducive setting. Most of the residents stayed in the easy chairs where they had been sitting all morning. There were only five residents sitting at the dining table eating lunch at the time of the inspection. Mealtimes appeared dull and uninteresting and did not inspire residents to eat well. Dining tables were bare, with no clothes and/or tablemats. This was discussed with the manager and proprietor at the time of the inspection and recommendations have been made in relation to this. The programme of entertainment and activities needs to be developed. There was no dedicated activity co-ordinator. Staff were seen to be attentive to the needs of the residents but there is a lack of stimulating therapy for the residents in this home and a requirement has been made in relation to this. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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 Training in recognising the signs of abusive practice is provided to staff by the home. There is a clear and accessible complaints procedure in place and relatives were aware of whom to approach if they had concerns. EVIDENCE: The complaints procedure was displayed in the entrance to the home. The CSCI have received one recent complaint prior to the inspection. The issues of this complaint were partly upheld and requirements have been made. The issues focussed mainly on the availability of adequate diet and fluids for these residents and this has been discussed under standard 15. The visitors spoken to stated that they would know who to approach if they had concerns and that any they had had in the past had been addressed without delay. Four staff members were spoken with and the personal files of 2 of these staff were looked at. The staff said that they were given written information by the manager about what could constitute abusive practice, and how to recognise the signs of abuse. The manager later checked with each member of staff that they had read this information and that they understood the content. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 15 The manager confirmed that this training had taken place. The home should ensure, however, that a record of the receipt of this training is kept on each staff file, as this was not seen in the 2 files that were looked at. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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, 20, 21, 22, 24 and 26. The layout of the home was suitable for its stated purpose but would benefit from a formal programme of redecoration and refurbishment to include the exterior of the home. The home offers a safe environment for the residents to live. The provider will need to ensure that standards of cleanliness in the home are not allowed to slip. EVIDENCE: A tour of the home was conducted where all the communal rooms and most of the bedrooms were inspected. There had been some redecoration in the main lounge including a new carpet since the last inspection. The bedrooms had been adapted to the needs of individual residents and some personalisation was seen with some individuals having had items from home brought in. Some of the furniture was showing signs of wear and tear and there was some broken furniture in need of repair Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 17 or replacement. One of the visitors spoken to stated that her husband’s bedroom flooring had been replaced. There was a need for general redecoration throughout the bedrooms. A requirement has been made for the proprietor to produce a programme of redecoration and refurbishment for the home to include timescales of when the work will be carried out. The home should also be made more stimulating for residents with pictoral signs to help with orientation. There were aids and adaptations in the home including two mobile hoists, fixed bath chairs, toilet frames and grab rails. Bedrails were used with protective bumpers and only used following a risk assessment. The cleanliness of the home was unacceptable on the day of the inspection. Bedrooms were in need of vacuuming and sinks and toilets were in need of cleaning. It was identified that there was no domestic on duty on the day of the inspection. The manager stated that this had been an oversight and that there was usually a domestic on duty daily. Examination of the staffing rota confirmed this. A requirement has been made to ensure that there is a domestic assistant on duty every day at the home. There was a laundry assistant on duty each afternoon. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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) 27,28,29 and 30 The staffing numbers and skill mix were appropriate to the assessed needs of the residents in the home. While some training towards NVQ’s and other mandatory and specialised training is in place this is an area that needs to be improved. Attention must also be paid to recruitment practices, and in particular ensuring that CRB and POVA checks are received before the commencement of employment. These improvements are required to ensure that the service user are in safe hands at all times. Induction Training and recording must also improve. EVIDENCE: On the day of the inspection there were 22 residents in the home including one who was receiving residential care and the reminder had nursing needs. The duty rotas were seen and these showed that there was 1 qualified nurse and 4 care staff rostered to work on the morning shift (7am-2pm), 1 qualified nurse and 3 staff in the afternoon/evening (2pm-9pm), and 1 qualified nurse and 2 care staff on duty overnight. The Commission considered that this number of staff were sufficient to meet the needs of the residents currently accommodated in the home. At the visit the number and people on the rota tallied with the staff on duty. Staff were concerned that on a number of occasions staff who were scheduled to work did not always arrive, particularly at weekends, and other staff were called in on their day off to provide cover. This was causing the willing staff to Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 19 become tired. A concern of the Commission was that on occasions these staff would not be available, potentially leaving the home understaffed. Management confirmed that the unauthorised absence of a few staff was causing some problems. It is recommended that the manager makes clear to all staff their contractual responsibilities, and that management action is taken should this bad practice continue. Staff were asked about the training that they had received, and it became apparent that induction training requires improvement. 3 of the staff said that they had not received a full induction, and there was no record of induction training found on the staff file that was examined. Further discussion with both staff and management also showed that staff were immediately counted on the rostered hours at the start of their employment. Staff should be supernumerary while induction takes place. While there had been some improvement in mandatory training, such as moving and handling, with 12 staff having completed this in February 2005, other staff still required this training, and further mandatory training such as food hygiene, health and safety and infection control were out of date. The Commission was informed that first aid training was planned for the day following the inspection. At the time of the inspection two care staff were seen moving and handling a resident inappropriately. The resident was obviously unable to weight bear and yet she was not moved with the aid of a hoist. Instead, the two members of staff attempted to move her under her arms from chair to wheelchair. This resulted in the resident swinging on the arms of the two care staff. This type of move has been deemed as bad practice and must cease immediately. A requirement has been made in relation to moving and handling training updates. Specialised training to meet the needs of the service users was patchy. Records showed that some staff had received training in behaviours that challenge and staff said that they had also had some instruction about choking hazards for some of the service users. However, training such as dementia awareness had not been addressed. The home is required to provide appropriate induction training for staff, and to keep all mandatory and any relevant specialised training up to date for all staff. The manager was further advised that a training matrix would enable easy identification of when any training was due for staff. He said that he was in the early stages of completing this, and it was seen that some limited improvement had been made in the maintenance of training records since the last visit. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 20 There were 32 staff in total. 9 of these are qualified staff, 2 of the care staff have NVQ2 and the proprietor informed the Commission that he was in the process of recruiting 3 people with qualifications equivalent to NVQ3. With these appointments the home will be on target to meet the 50 required to be trained to NVQ2 or above by 2005. All 4 staff on duty were asked about the completion of a Criminal Records Bureau (CRB) check by the home. While this had been completed for 3 of the 4 staff before they started working, 1 of the staff members said that she had been asked to complete the application after working at the home for about 4 weeks. Her personal file was checked and it was clear that an enhanced disclosure was not received by the home until 2 months after she had started. The manager confirmed that no Protection of Vulnerable Adults (POVA) First check had been undertaken whilst waiting for the CRB check to be completed. The manager and provider are reminded that a satisfactory CRB and POVA check must be received on every occasion before a staff member commences working in the home. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 21 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) 31,32,36 and 38 The manager has an ‘open door’ policy and the staff feel well supported. Further development of leadership and direction are required to ensure continuity of care and the health and safety of the staff employed. EVIDENCE: All 4 staff spoken with were full of praise for the manager and his approach to them. They spoke about an ‘open door’ policy and how the manager would always take the time to explain anything to them. Some visitors came to the home and they were equally supportive. The home has recently had a new proprietor. The visit was too early for the staff to be able to pass any judgement on the leadership style of the owner. He told the Commission that he visited the home on a daily basis, and was available by telephone to support the manager and staff at all other times. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 22 Some of the issues about staff commitment to the home need to be addressed by management to prevent further staff unrest. While staff were clear that they could talk to the manager about any issues, it was apparent that no formal supervision takes place on a 1:1 basis. The staff had no understanding about formal supervision and no records were available. The manager confirmed that he had regular discussions with staff whenever they wanted to speak to him, but no planned programme for supervision was in place. All staff must receive formal supervision at least 6 times per year and the discussion that takes place at the meeting must be recorded. Minutes were seen of a staff meeting that had been held the previous week with the qualified members of staff. The proprietor said that he intended to hold these on a regular basis, along with meetings for the care staff. Records relating to the maintenance of a safe environment were examined. The testing and servicing of equipment at the home had taken place as required. This included PAT testing and visual monthly inspections of electrical equipment, inspections and servicing of fire fighting equipment had taken place. The testing of hot water temperatures had been carried out regularly and records kept. Emergency lighting had been tested monthly and records kept. There was a contract in place for the disposal of clinical waste. Staff had not received fire drills as required. The last documented drill was 19/4/05 and the one before that was 10/8/04. It is a requirement that all staff employed by the home receive a minimum of two fire drills per year and that this is documented for each individual. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 23 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 x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 1 COMPLAINTS AND PROTECTION 2 2 3 3 x 2 x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 2 x x x 2 x 2 Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 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 4 and 30 Regulation 18 (1) Requirement Timescale for action By 20/8/05 2. 15 3. 12 4. 19 5. 26 6. 7. 29 30 More staff must receive training in dementia care and other specific training targeted at meeting the needs of the residents. 13(1)(b) Advice must be obtained from a suitably qualified nutritionalist in relation to residents receiving soft and liquified diets and advice on dentures. 16(2)(mn) The home must employ a dedicated activity co-ordinator and develop a programme of activities and entertainment for the residents. PREVIOUS REQUIREMENT. 23(2)(bd) The proprietor will need to provide the CSCI with a programme of refurbishment and redecoration for the home including timescales. PREVIOUS REQUIREMENT. 23(2)(d) The home must employ a domestic assistant every day to ensure that satisfactory standards of hygiene are maintained. 19, New staff do not commence in schedule post until a satisfactory CRB 2 clearance has been received. 18(1) All staff must receive induction E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc By 20/6/05 By 20/6/05 By 20/6/05 On going On going On going Page 25 Silverdale Nursing Home Version 1.30 8. 30 18(1)(a) 9. 30 18(i)(ac) 10. 31 10(i) 11. 36 18(2) training to National Training Organisation standards and there must be a staff training and development programme introduced. PREVIOUS REQUIREMENT. New staff must be classed as supernumerary to the planned rotas until induction is completed. The training for all staff for mandatory and any specialised training required must be up to date Management must investigate instances where any staff have unauthorised absence, and if found necessary disciplinary action must be taken to address this. All staff must receive formal supervision at least 6 times per year, and a record of the meeting must be kept. On going 30/6/05 On going 9/7/05 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. 3. Refer to Standard 15 30 19 Good Practice Recommendations Mealtimes should be made a more pleasurable experience and the mealtime procedure should be reviewed. Introduce a training matrix to allow easier identification of staff training requirements. The home should be made more stimulating for residents with pictoral signs to help with orientation. Silverdale Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Nursing Home E51-E09 S60541 Silverdale V227259 090505 Stage 4.doc Version 1.30 Page 27 - 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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