Inspection on 04/05/05 for Springfield Care Centre

This inspection was carried out on 4th 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

Springfield Care Centre 21/09/06

Springfield Care Centre 10/02/06

Springfield Care Centre 02/02/05

Springfield Care Centre 02/06/04

Springfield Care Centre 28/01/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Springfield Care Centre 20 Springfield Drive Barkingside Ilford Essex IG2 6BN Lead Inspector Gwen Lording Unannounced Inspection 04 May 2005 9:30am 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. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Springfield Care Centre Address 20 Springfield Drive, Barkingside, Ilford. Essex IG2 6BN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8518 9270 020 8518 0813 Life Style Care Plc Mary Oniah CRH Care Home 80 Category(ies) of DE Dementia (15) registration, with number MD Mental Disorder (15) of places OP Old Age (55) PD Physical Disability (10) Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02 February 2005 Brief Description of the Service: Springfield Care Centre is a purpose built care home registered to provide nursing care. The home can accommodate up to eighty people, in three categories: older physically frail people (55); older people with dementia/ mental disorder (15); and younger people who have physical disabilities (10). The home is operated by Lifestyle Care plc. All residents have single rooms with ensuite facilities. The building is divided into units, where smaller groups of people with similar care needs share communal rooms. The home is situated close to shops and public transport - buses and underground. There is ample parking space within the grounds. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30am. It took place over five hours during the morning and early afternoon. The Inspector spoke to a total of twelve residents across the four units of the home. In addition the relatives of three residents were also spoken to whilst they were visiting the home. Discussions took place with the registered manager, deputy manager and several members of nursing and care staff. A tour of the home took place and a number of staff and care records were inspected. The current registered manager has only been in post for a short time but has a good understanding of the areas in which the home needs to improve and develop. She is well supported by the deputy manager and staff spoken to commented that the manager has their full support and are committed to improving standards in the home. A referral to a specialist pharmacy inspector was also made as a result of this inspection, and took place on 6th May. The views of a range of health and social care professionals were sought prior to the inspection and comments are incorporated in this report. What the service does well: Residents, relatives and visiting health care professionals have all commented that staff are very welcoming, approachable and helpful. Nursing staff are responsive to people’s concerns and there is always a senior member of staff available to speak to. The manager and deputy manager have a visible presence in the home and are committed to improving the standard of care people receive. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: There are clear medication policies and procedures for staff to follow. The manager needs to ensure that there is consistent practice in the recording of medication and a system for monitoring the medication of service users who refuse prescribed medication. The Inspector made a referral to the Commission’s specialist Pharmacy Inspector to undertake a more detailed inspection of the management of medication in the home. This inspection was undertaken on 6th May and the manager has been provided with a full report on the action to be taken regarding the safe administration of medication. Consideration should be given to the environment on the Dementia unit to best utilise the layout and design to meet the specialist needs of people with dementia. For example through the use of decor, visual cues such as colour, signage and the use of familiar things from a persons old setting such as photographs and other familiar objects. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 7 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. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 8 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 Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 9 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 6 A comprehensive pre-admission assessment is undertaken by the manager or deputy for all residents prior to their admission to the home. This ensures that all the care needs of the individual are understood and met. EVIDENCE: Individual records are kept for each resident and a number of records were inspected on each unit of the home. All records inspected had full assessment information recorded. The records showed that residents and their relatives/ representatives are involved in the process. Where appropriate, information provided by the placing authority was also included. The home does not offer intermediate care. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_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, 9 and 10. There are clear medication policies and procedures for staff to follow. However, there are some inconsistencies in the recording of medication and practices of staff resulting in unsafe practices It was not clear that where it is considered that an individual is not able to make all of their own decisions, for example because of an illness such as dementia, that all available information had been recorded to ensure that any decision taken is in the individual’s best interest. Where the monitoring of fluid/ food intake is indicated, records must be accurately maintained by staff to ensure the information available on the chart is current at any time, when examined and to ensure nutritional needs are effectively being met. There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily identify and meet residents’ needs. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 11 EVIDENCE: There are policies and procedures for the handling and recording of medicines in the home. Where medication was prescribed on an “as required” basis it was not always clear from the recording on the Medication Administration record (MAR) chart whether the resident had refused the medication or that the medication was not required by the resident i.e. no pain relief required. Staff must use a consistent code (R) – to indicate refusal by the resident and (O) – other, to indicate the reason why medication was not administered. (This refers to requirement No.3) It was noted that one resident had consistently refused an item of prescribed medication for a period of nearly three weeks. The registered persons must introduce an effective system for monitoring the sporadic or continued refusal of prescribed medication. Any such non-compliance with prescribed medication must be referred to the GP to ensure that there is no detrimental effect on a resident’s health. (This refers to requirement No.2 and is a requirement which was made at the last inspection and is not yet met) Where instructions are received to change the frequency of administration of any prescribed medication, staff must clearly record the name of the doctor authorising such changes. This was recorded on MAR charts in most instances but not on all MAR charts examined. Such omissions may result in unsafe practices putting residents at risk of not receiving the correct dosage of prescribed medication (This refers to requirement No. 3) There has been a noticeable improvement in the standard of care planning since the last inspection. Care plans are developed for all residents based on the assessed needs of individual residents. Daily entries made by staff relate to specific care plan goals and outcomes. Routine monitoring by the manager and the deputy manager is undertaken on a monthly basis to determine a consistent standard throughout the home. More recently a system of “peer” audit of care plans has been introduced. Staff have found this helpful in highlighting areas of both good practice and those areas requiring more development. There was evidence that the health needs of service users were being met through good multi-disciplinary working and the appropriate and timely referral of residents to other health care professionals. Staff were noted to be completing the recordings of fluid intake/ output for two service users retrospectively. At 11.30am the charts had no recordings, although the Inspector was aware that the service users had received fluids prior to this time. In addition not all charts recording food intake were detailing Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 12 the amount of food eaten by a resident. For example some charts recorded “soup, porridge, custard, or toast”, but did not record the actual amount or size of portion. It is essential that all monitoring records for service users are maintained accurately and up to date to ensure that nutritional needs are effectively met (This refers to requirement No. 1 and is a requirement which was made at the last inspection and is not yet met)) There is a section on the admission assessment form headed CPR Status (Cardio Pulmonary Resuscitation). Of those forms examined the detail was limited and only included for example, the wishes of relatives and directions of medical doctors. In light of the Mental Capacity Act 2005 it is imperative that all relevant information available is considered and detailed as part of the decision making process. An individual must not be denied the chance to make a decision or be involved. An individual should be assumed to have capacity unless proven otherwise. Where it is considered that an individual is not able to make their own decisions, any such decision made on their behalf must be in the individual’s best interest and not based on assumptions and should include the views of key people in their lives. (This refers to requirement No. 4)) Staff talked about and were observed to treat residents in a respectful and sensitive manner. They understood the need to promote their dignity through practices such as in the way they addressed residents and when entering bedrooms, bathrooms and toilets. Residents and their relatives spoken to said that all staff were respectful and thoughtful when attending to their personal care. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 13 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 The employment of an additional full time activity co-ordinator has meant that a more varied and stimulating programme of activities is available, which suits individual needs, preferences and capacities. Visiting times are flexible and people are made to feel welcome in the home so that service users are able to maintain contact with their family and friends as they wish. EVIDENCE: There are two activity co-ordinators employed in the home. They each take responsibility for arranging activities in particular units of the home. The most recently employed activity co-ordinator is currently undertaking personal history profiles for residents on the units for older people and the dementia unit. This will identify their individual expectations, interests, preferences and capacities around planned activities. It is a requirement that the personal history profiles are extended to the unit for younger physically disabled people to ensure that there specialist needs are understood and they are provided with a daily programme of variation and interest. (This refers to requirement No. 7) Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 14 Visiting times are very flexible and visitors commented that staff always make them feel very welcome and tea/ coffee is offered during the visit. Residents are able to receive visitors in one of the lounges or in their own rooms. One resident and his wife are shortly due to celebrate their Golden Wedding Anniversary. Arrangements are being made for facilities in the home to be made available to the couple so that they may celebrate this occasion with their family and friends. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 15 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 & 18 The home has a satisfactory complaints policy and procedure in place and residents and their relatives/ representatives feel their views are listened to and acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: Since the last inspection the complaints policy has been amended to include information around referring a complaint to the Commission, at any stage, should the complainant wish to do so. Residents and relatives spoken to considered that staff were always very responsive to any concerns or issues of dissatisfaction raised. There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. There is an ongoing programme of training in Adult protection/ Abuse Awareness and this is extended to all staff working in the home including administrative and ancillary staff. In discussion with several members of staff it was evident that they are conversant with the procedure for dealing with or reporting any suspected or witnessed abuse. A concern was raised during the last inspection around outside contractors’ access to the bedrooms of residents whilst undertaking work in the home. A policy has now been introduced and all contractors are aware of the standards Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 16 of practice expected of them whilst undertaking work in residents’ bedrooms. Staff are aware of their monitoring role in order to protect residents and ensure that their privacy and dignity is respected at all times. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 17 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 & 26 The standard of the environment within the home provides residents with an attractive, safe and comfortable place in which to live. The environment of the dementia unit could be better utilised to meet the specialist needs of people with dementia. EVIDENCE: The standard of the décor, furnishings and fittings are maintained to a good standard. There is an ongoing programme of refurbishment and re decoration. The home employs a full time maintenance person and there is an effective system in place for staff to report items requiring repair or attention. As the ability of people with dementia to communicate with words decreases, the use of non-verbal cues and the environment is important in enabling them to cope better with daily life. The general environment on the dementia unit must reflect good practice guidance on dementia care within care homes. A copy of the Commission’s “Dementia Care Within Care Homes Guidance” has previously been given to the registered manager. Consideration should be given to utilising the existing design and layout of the unit to meet the Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 18 specialist needs of people with dementia. For example through the use of visual cues such as colour and signage. Staff must also be aware of factors such as noise. On the day of the inspection noise form the television was competing with music being played on a tape and this can be very distracting for residents and have a direct impact on their behaviour. (This refers to requirement No. 5) Staff and visitors spoken to commented that the general standard of cleanliness in the home has improved over the past few months. On the day of the inspection the home was found to be clean and free from offensive odours throughout. At the last inspection a requirement was made around staff disposing of used gloves/ aprons appropriately and safely to ensure effective infection control. Cleaning routines have been changed and infection control procedures reinforced with all staff. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 19 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 The staffing levels and skill mix of qualified/ unqualified staff must be reviewed to ensure that that they are appropriate and sufficient to meet the dependency levels and assessed nursing care needs of residents at all times. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: On the day of the inspection, staffing levels were observed to be sufficient to meet the needs of residents. However, in discussion with a number of staff on Nightingale Unit they commented that at peak times during the day, and particularly during the morning, one member of qualified nursing staff was not always sufficient to meet the immediate nursing care needs of all residents. One example given was that sometimes residents are left waiting for care to be given, as the one qualified nurse on duty is involved in care elsewhere on the unit. Nightingale can accommodate up to 25 residents and the majority have a high level of physical dependency and require significant nursing care and attention. The registered persons must undertake a review of the staffing levels and skill mix of qualified and unqualified staff on this unit to ensure that there are sufficient staff at all times to meet the dependency levels and assessed nursing care needs of all residents. (This refers to requirement No. 6)) Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 20 The home’s administrator is adequately managing documentation and related checks around the recruitment of staff. The staff files examined of three staff members employed since the last inspection indicated that the home is undertaking all the necessary recruitment checks to ensure the protection of residents. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_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 The home is being managed well and provides a safe environment for the residents in the home. EVIDENCE: The current registered manager has only been in post for a short time. She has worked for the registered providers, Lifestyle Care plc since 2002 in a senior nursing position. She holds a registered nursing qualification and has experience in providing and managing nursing care services. She has recently completed the Registered Manager’s Award. She has a good understanding of the areas in which the home needs to improve and further develop. The manager is ably supported by a deputy manager who is also an experienced nurse. Both the manager and the deputy manager have a visible presence in the home and are clearly committed to improving standards in the home. Staff commented that one or both do daily “rounds” as well as random Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 22 monitoring visits to all units in the home. Staff are responsive to this style of management as they are feel it creates an open, positive and inclusive atmosphere where they feel their opinions are listened to and understood. The manager was observed to communicate a clear sense of direction and leadership and the process of managing the home is clear and transparent to staff, residents and their relatives. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_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 8 Regulation 12 Requirement Timescale for action 4/05/05 and ongoing 2. 9 12 & 13 3. 9 12 & 13 The registered persons must ensure that where the recording of fluid/ food intake is indicated for a resident, that these recordings are up to date, accurately maintained and not completed retrospectively (Timescale of 1/04/05 not met) The registered persons must 31/05/05 ensure that there is an effective system in place for the continuous or sporadic refusal of prescribed medication by an individual resident. Any noncompliance must be referred to the GP to ensure that there is no detrimental effect on a residents health (Timescale of 30/04/04 not met) The registered persons must 31/05/05 develop and implement a robust system of monitoring to ensure that all medication is administered safely in line with the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971 and that all nursing staff abide by the Nursing and Midwifery Council Version 1.30 Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Page 25 4. 8 12 5. 19 23 6. 27 18 7. 12 16 (m) (n) Standards and professional guidance (Timescale of 30/04/05 not met) Where it is considered that a resident is not able to make their own decisions, for example because of an illness such as dementia, the registered persons must ensure that all available information is recorded to ensure that any decision taken is in the individuals best interest, not based on assumptions, and must include the views of key people in their lives. The existing layout and design of the environment on the dementia unit must reflect good practice guidance on dementia care within care homes to ensure that the specialist needs of residents on this unit are met. The registered persons must undertake a review of the staffing levels and skill mix of qualified/ unqualified staff on Nightingale Unit to ensure that there are sufficient staff at all times to meet the dependency levels and assessed nursing care needs of all residents. It is a requirement that the completion of personal history profiles, as being undertaken by the activity co-ordinator, is extended to include the unit for younger physically disabled people. 30/06/05 30/06/05 30/05/05 30/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 26 Springfield Care Centre 1. Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Springfield Care Centre G55_S0000025962_Springfield Care_V224681_040505_Stage 4.doc Version 1.30 Page 28 - 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. 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