CARE HOMES FOR OLDER PEOPLE
St Agnes 31/33 Silverbirch Road Erdington Birmingham West Midlands B24 0AR Lead Inspector
Jill Brown Announced Inspection 9th November 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service St Agnes Address 31/33 Silverbirch Road Erdington Birmingham West Midlands B24 0AR 0121 350 4212 0121 350 4212 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Residential Care Limited Ms Lesley Keeling Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 05/05/05 Brief Description of the Service: St. Agnes was originally two large three storey, Victorian style houses. These have been converted and extended to provide a care home for a maximum of 25 older people. The home is situated in a residential area between the Wylde Green and Erdington shopping areas in a road directly off the Sutton Road. Both the shopping areas and the centre of Birmingham are accessible by public transport. The bedrooms are spread over the three floors of the building and are a mix of singles and doubles, some with en suite facilities. The home has a lift to the upper floors however access to some of the bedrooms on each floor require service users to negotiate some steps. On the ground floor are three lounges, a dining room with the main kitchen leading off, a small laundry and an office. Assisted bathing or showering facilities are available on the ground and first floors and there are ample toilets throughout the home. There is level access into the home and off road parking for a few cars at the front of the home. There is a very large, well-maintained and pleasant garden to the rear. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The announced inspection was undertaken in one and half days by 2 inspectors. Four resident case files and two staff files were looked at. Fourteen residents were spoken with and two staff. A tour of the building was undertaken, medication administration was looked at and maintenance records for the homes services such as gas, electric waste and so on. The Commission received a complaint in September 2005 and this report includes the outcome of that complaint. What the service does well: What has improved since the last inspection?
The home has improved on the attention to the personal hygiene needs of the residents since the last visit in September. Also there was some attention given to ensure that residents’ dignity and privacy was maintained during care giving. The home had responded to a number of previous requirements carpets that had bumps that could cause a trip hazard had been replaced, new wheelchairs, bedding and leads to nurse call alarms had been bought. The ground floor corridors and the middle lounge had been decorated The home not admitted any new residents since the inspectors last visit as there had been concerns about the dependency levels of the residents.
St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 6 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. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 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 the following standard(s): 3&4 The home had appropriate assessment information on residents but this was not always consistent with the care given and this puts residents at risk. EVIDENCE: The home had assessment information on all residents and these covered the areas required by the standard. No new residents had been admitted since the last inspection. The information on the assessment on occasions did not correspond to the care given to the residents, for example a resident whose assessment clearly stated they could not manage stairs was being assisted up a small flight of steps. Residents at the home had deteriorated in their abilities and a substantial number had dementia. The home was not registered to care for residents with dementia and could not demonstrate that they were able to successfully care for these residents extra needs. A previous requirement on additional visit required that the home have assessments in place to lessen the risk for people with dementia. These were not adequate on the day of the inspection. A
St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 9 number of residents had substantial physical disabilities and the home was not able to demonstrate how these needs were being met for one resident. A previous requirement not to admit residents with high needs or with a diagnosis of dementia remains in force. The home’s residents are currently all from the white British communities and no further cultural arrangements for care were needed. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 & 9 Medication administration was good and this helps to keep residents well. Care planning had gaps, gave contradictory advice and was not updated when health conditions change. This could result in risks to residents. EVIDENCE: The homes care planning information was confused with assessments and were not signed or dated. This meant that a number of instructions to staff were out of date and this could potentially put residents at risk. Care plans were contained in the assessment part of the file and the care planning part of the file. The care plans for the same need such as personal care were repeated on different formats in different parts of the file and at times did not agree with each other. The home had included a number of core plans. Core plans list a number of actions for staff and are not individualised to the resident. Whilst core plans can be useful as a checklist they do not ensure that residents receive a personalised care service.
St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 11 Detail on how personal hygiene care was to carried out for individual residents was generally poor with phrases such as ‘all care to be carried out by two staff’ being found on the care plans. However on the day of the inspection residents had their personal hygiene needs met and residents were dressed appropriately and this was an improvement on the additional visit in September. Moving and handling and mobility assessments did not reflect the practice in the home. The inspectors saw two poor moving handling manoeuvres during the inspection. The Commission is taking enforcement action about the poor practice in care planning and moving and handling in this home. Health care needs were not always planned for, for example identifying a need of diabetes did not result in a plan of monitoring for deterioration or a diet plan where necessary. Weights were sporadically taken. Where it was not possible to weigh residents no other measure was being taken. Follow up or outcome on a number of health issues raised, in daily records, could not be found. The home ensured that residents had access to district nurses, specialist health services and chiropody where this was required. Residents had access to GPs when the need arose. This was now recorded in the case records. Residents at the home did not appear to have many accidents however the inspector was concerned that bruising on a resident had not been recorded in the home’s accident book in a timely way. Medication administration was generally good. The home did not have a controlled drug register and there were two omissions of medication. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 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 the following standard(s): 12 & 14 The arrangements for activities and choice of how care is given was variable. These arrangements did not show that the home meets residents’ interests or give control to residents about their lives. EVIDENCE: The home had a record of planned activities for residents. Activities did not reflect the individual needs of residents with dementia. Residents with wandering behaviour did not have a clear plan of engagement throughout the day to improve their quality of life. Music and singing was provided on the day of the inspection by an outside entertainer. One resident said that this hadn’t happened for a long time but it was nice when she (the entertainer) came because it broke up the day. Residents spoken to said the choice of entertainment were limited. One resident said that they would like the option of a cooked breakfast more than once a week. Another resident said that the home provided good food and lots of it. Inspectors saw that when residents said they were thirsty or hungry that arrangements were immediately made to provide food and drinks in addition to the planned meals and drinks. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16 Residents felt safe about voicing complaints and thought their complaints would be dealt with. Better recording of the outcome and action on complaints and grumbles would enable the home to improve their service. EVIDENCE: The homes complaints book showed that there had been complaints but the home had not recorded in enough detail the outcome of the complaint and action taken. The Commission received a complaint and visited the home in September at which time serious concerns were identified in assessment (standard 3), care planning (standard 7) and care of residents (standards 4 and 8) as well as the levels of staffing for the dependency level of residents (standard 27). The outcome of this visit is outlined through this report. Residents spoken to felt that they could talk to staff if they had concerns about how they were cared for and they felt it would be sorted out. The adult protection standard were not inspected on this occasion but staff at the home had yet to receive adult protection training and the requirement for a restraint policy was brought forward. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 19, 22, 25 & 26 Whilst the home had improved the ground floor of the building and bought new wheelchairs there were still areas of the home that needed attention. These areas affect the homes ability to provide a safe, homely environment for residents. EVIDENCE: It was clear that the homeowners had put some financial investment into the home since the last inspection. The ground floor had had new carpets in the communal areas and new lounge chairs had been bought. The middle lounge, ground floor corridors and the outside of the building had been painted since the last inspection. It was clear that he bedding in the home had been replaced. A number of bedrooms required redecoration and maintenance. A bathroom needed redevelopment and these were outstanding requirements. The home provided the inspector with a refurbishment plan and the Commission during additional visits to the home will monitor this plan. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 15 New wheelchairs had been bought for the transport of residents and leads to improve access to the nurse call alarm system purchased since the last inspection. The water temperature from a bath hot water outlet was too hot this was dealt with during the inspection. However this bath’s thermostatic control has had some difficulties maintaining a safe temperature and a thermometer must be kept in this bathroom and action taken should it get too hot again. A number of bedrooms were found to be very warm and the inspectors found that this had been the subject of a complaint to the home earlier in the year. The home was cleaner than the last inspection however offensive odours were still found in a number of bedrooms and this has not been resolved. In one bedroom the issue appeared to be with a drain and remedial action was taken immediately but this needs to be monitored. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The arrangements for recruitment and training of staff were not robust enough to protect residents. Staffing numbers whilst adequate were not sufficiently trained and competent in the areas of need and the level of dependency of the residents. EVIDENCE: There was adequate staffing on the day of the inspection. Rotas showed that the home had planned for the appropriate amount of staff. Some management hours should be available at the weekend above the direct care time. A complaint about the staffing level in the home was not upheld. Although the increasing level of dependency of the residents has demonstrated that more appropriate interventions are needed for some residents. The rota did not always show the person who was in charge of the shift. A number of staff have completed the NVQ2 with the home almost achieving the 50 required. Whilst the home’s staff files are slowly improving the home are accepting Criminal Record Bureau checks from other employment and employing staff before their own checks have been completed. Staff must not be employed before the homes checks are completed unless a risk assessment with the Commission is completed. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 17 The home has latterly arranged training with staff but the Inspectors did not judge that some of the training was in the required depth to make staff competent. Concerns on moving and handling and dementia care have resulted in the Commission taking enforcement action. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 & 38 The lack of sustainable improvement in the management of the home potentially puts residents at risk. The home has ensured that the health and safety maintenance and servicing of utilities and equipment are in place to protect residents. EVIDENCE: Since the last inspection the manager has left and a previous manager has returned. This lack of consistency of manager over the last four years has meant that improvements can be sustained by the home. Regular monthly reports by the responsible individual were not being sent to the Commission. The home does not have a clear view of what they need to achieve and so have not shown they are able to plan to get there. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 19 The home do not handle the money for any resident in the home preferring to pay for services such as chiropody and hair dressing and subsequently invoice the resident or their relative. Maintenance and inspection records were in place for the homes services such as Gas, electrical wiring, water quality, and moving equipment. The homes building risk assessment had not been reviewed and this must be undertaken. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 1 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 X X 2 X X 2 1 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 2 St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 13(4)(c) Requirement Residents that have behaviour associated with dementia must have a risk assessment to lessen the risk. (Outstanding since 11/09/05) The home must not accept residents that are outside their conditions of registration. (This requirement remains in force since 11/09/05) The home must not accept residents that have high care needs. (This requirement remains in force since 11/09/05) Where the home cannot appropriately care for a resident because of their dependency level (and this includes a specified resident) they must be referred for an assessment for nursing care. All care plans and other associated assessments for each individual are consistent and give clear instructions to staff about how care is to be given. All care plans must show how any assessed need is going to be
DS0000016757.V263465.R01.S.doc Timescale for action 15/12/05 2 OP4 Care Standards Act Care Standards Act 14(1)(a) 12(1)(a) 31/05/06 3 OP4 31/05/06 4 OP4 17/11/05 5 OP7 15(1) 12(1)(a) 15/12/05 6 OP7 15(1) 15/12/05 St Agnes Version 5.0 Page 22 7 OP7 15(2)(b) 8 OP7 15(2)(b) 9 10 OP7 OP8 17(3) 13(4)(c) 13(5) 11 12 OP8 OP8 13(4)(c) 13(5) 13(5) 15(1) 13(4)(c) 13 OP8 13(5) 15(2)(b) 14. OP8 12(1)(a) 13(1)(b) 15 OP8 12(1)(a) met. All service user plans must reflect the up to date position in relation to a service users health needs. A system must be put in place that ensures that service user plans are routinely updated and updated when a service user’s needs changes. A copy of this procedure and evidence of the senior staff receiving this must be sent to the Commission. All care plans and assessments must be signed and dated. A system must be put in place to ensure that all service users are moved or transferred in ways that are not contrary to their assessed needs. All moving and handling of service users must be safe for the residents and staff. Moving and handling assessments for each service user must result in action to ensure safe moving including: clear instructions for staff, set up of rooms and where necessary procurement of equipment. A system must be put in place to ensure that the moving and handling needs of residents are kept under review and a copy of this must be sent to the Commission. Monitoring charts must be used and reviewed regularly for all residents whose condition demands this such as: - fluid intake, behaviour and so on. (This remains outstanding since 31/05/05) Analysis of falls and falls or gains in weight must be undertaken and action taken and recorded in the care plan if required. (Outstanding since 31/05/05)
DS0000016757.V263465.R01.S.doc 15/12/05 15/12/05 15/12/05 10/12/05 10/12/05 10/12/05 10/12/05 31/12/05 31/12/05 St Agnes Version 5.0 Page 23 16 OP8 37 17 OP8 12(1)(a) 18 OP8 12(1)(a) 17(2) 13(2) 16(2)(n) 19 20 OP9 OP12 21 OP16 22(8) 22 OP18 13(7) 23 24 OP18 OP19 13(6) 13(4)(c) 23(2)(b) 25 OP21 23(2)(j) 26 OP23 23(2)(b) (d) Unexplained bruising on residents must be recorded in daily reports and accident records, reported to the Commission and investigated. Another measure must be considered for residents that refuse to be weighed. (Outstanding since 30/09/05) Health issues raised in daily records must be followed up and the action and outcome recorded. A register of controlled drugs must be purchased. The home must ensure that all residents with dementia have access to activities and record must be kept what activities individual residents have taken part in. The home must keep a clear record of grumbles and complaints including whether the complaint was substantiated and any action taken. The home must devise an appropriate restraint policy. (Oustanding since 10/02/04 but not inspected on this occasion) All staff must receive adult protection training. (Outstanding since 31/05/05) The home must ensure the flooring in a shared bedroom is repaired and does not constitute a trip hazard. (Outstanding since 31/05/05) The 2nd floor bathroom must be made fit for use by residents (outstanding since 11/11/04) And plans made for it meet the needs of the residents in that area. Bedrooms must be audited for redecoration, repair and odour control and remedial work undertaken.
DS0000016757.V263465.R01.S.doc 11/11/05 15/12/05 15/12/05 30/12/05 30/12/05 30/12/05 30/12/05 28/02/06 30/12/05 28/02/06 31/03/06 St Agnes Version 5.0 Page 24 27 OP25 13(4)(c) 28 29 OP25 OP26 23(2)(p) 13(3) 30 OP27 Sch 4 (6)(e) 31 32 OP28 OP29 18(1)(a) 19 Sch 2 (7)(8) 18(1)(c) 33 OP30 34 OP30 18(1)(c) 35 OP30 18(1)(c) 36 OP31 9 37 OP32 12(3) (Outstanding since 30/06/05) A thermometer must be kept in the bathroom to ensure a safe water temperature is maintained and remedial action must be take if this temperature continues to fluctuate. The home must ensure that all bedrooms remain at a comfortable temperature. The home must devise a procedure to ensure odour in the home is kept to a minimum and monitor adherence to this. (Outstanding since 31/05/05) The member of staff in charge for each shift must noted on the rota. (Outstanding since the 28/02/05) Some management hours must be available at the weekend. No new staff must be employed without a valid CRB and POVA check. (Oustanding since the 23/10/03) Moving and Handling training must be provided in sufficient detail to ensure that all care staff are competent in moving and transferring service users. Dementia Care Training must be provided in sufficient detail to ensure that care staff have appropriate strategies to assist service users with dementia. The home must ensure that all training is of an appropriate standard to meet the Skills for Care requirements. The home must ensure that appropriate manager is consistently in place and this person undertakes the fit person process. The home must investigate strategies to gain the opinions of
DS0000016757.V263465.R01.S.doc 30/12/05 30/12/05 30/12/05 30/12/05 30/12/05 15/12/05 31/01/06 31/01/06 15/12/05 28/02/06 28/02/06 St Agnes Version 5.0 Page 25 38 OP32 26 39 OP36 18(2) 40 OP37 17(2) 41 42 OP38 OP38 13(4)(c) 13(3) service users and that these have affected how the service is delivered. (Outstanding since 21/12/03 but not inspected on this occasion and brought forward) The responsible individual must undertake unannounced monthly visits to the home and a report of these visits must be sent to the Commission. All care staff must have recorded supervision for no less than six times a year. (Outstanding since 20/01/04 but not inspected on this occasion) A cross gender and intimate care policy must be written. (This requirement was not assessed and is brought forward previous date 31/05/05.) Risk assessments for building, must be undertaken. (Outstanding since 30/06/05) COSHH must be kept in a locked cupboard and separate to foodstuffs. (This was not inspected on this occasion and this requirement was brought forward.) 15/12/05 31/01/06 28/02/06 30/12/05 28/02/06 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 OP7 OP14 OP16 Good Practice Recommendations It is recommended that the home dispense with core care plans. It is recommended that the home consult with residents about the choices available at breakfast. It is recommended that the home collects concerns that are not raised as complaints to assist in improving the
DS0000016757.V263465.R01.S.doc Version 5.0 Page 26 St Agnes 4 5 OP28 OP30 home. It is recommended that the home devise a plan of how they increase the number of NVQ2 trained staff and maintain this level. It is recommended that the home place the dates of staff’s achievement of courses to enable the planning of up date training. St Agnes DS0000016757.V263465.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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