CARE HOMES FOR OLDER PEOPLE
Sutton House Nursing & Residential Home Kingfisher Rise Ings Road Sutton HU7 4UZ Lead Inspector
Eileen Engelmann Unannounced 26 April 2005 at 9:30 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. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Sutton House Nursing & Residential Home Address Kingfisher Rise Ings Road Sutton Kingston upon Hull HU7 4UZ O1482 784703 01482 377881 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) Mr Barry Potton Care Home with Nursing 38 Category(ies) of DE Dementia 38 places registration, with number DE(E) Demential over 65 - 38 places of places PD Physical Disability 38 placeS PD(E) Physical Disability over 65 - 38 places TI Terminally Ill 38 places TI(E) Terminally Ill 38 places OP Old Age 38 places Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: The Registered Person must ensure a Fire Risk Assessment is carreid out by 1st December 2004 and periodically reviewed as required by the Fire Precautions (Workplace) Regulation 1997 (as amended 1999). The Registered Person must provide management support within the home until a Registered Manager is in place. The Registered Peson must ensure that the Residential Staffing Forum hours are achieved by 1st November 2005, this will reviewed on this date. Date of last inspection 26/10/04 Brief Description of the Service: Sutton House is a large elegant looking period building set in extensive grounds. It is located in the village of Sutton and is tucked away discreetly from the main road. The home is a registered nursing home providing nursing and personal care to 38 male and female service users within the categories of physical disabilities, dementia, terminal illness and old age. Accommodation is provided in eight single rooms and fifteen double rooms, all with en-suite toilets and wash hand basins. The home has three floors with a passanger lift and stairs to the upper levels. Equipment and aids/adaptations are in place to ensure service users are cared for in a safe manner whilst allowing them to be as independant as possible. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the acting manager, staff, residents and visitors at Sutton House. The inspection took 7 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Four of the staff on duty, one visitor and nine of the thirty-five residents were spoken to and their comments have been included in this report. One additional visit has been made since the last announced inspection and was in response to a complaint received by the Commission about poor care practices within the home. The investigating officer found the complaint to be proven and the provider was asked to take specific action around staff training to ensure the care within the home improved. What the service does well: What has improved since the last inspection?
There is a daily programme of leisure and social activities, which are carried out by an activities co-ordinator. Residents enjoy participating in these and said ‘they are looking forward to more opportunities of going out in the future’. Food at the home is made from fresh ingredients and the menus offer the residents a good choice and variety of meals. Residents are now offered a choice of food at lunchtime and they said ‘that this had made a huge difference to their enjoyment of their meal’. The homes policies and procedures have been improved and offer the staff guidance around practice, resulting in a safer environment for the residents.
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 6 Bedrooms are being decorated and supplied with new curtains and bed linen in line with a planned programme of maintenance. One individual is looking forward to her room being done and has chosen the colour she prefers. Special beds have been purchased for nursing residents, which staff and people living at the home say ‘have made their lives more comfortable and the care tasks easier to complete’. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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 Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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) 1, 3 and 4. All residents have a full needs assessment carried out and are given enough information about the home and its facilities before admission, for them to be confident that their needs can be met by the service. EVIDENCE: The home’s statement of purpose and service user guide were not on display within the home, and the acting manager said that these had been recently brought up to date and were in the process of being printed. Nine service users spoken to were able to show a clear understanding of what services and care were on offer at the home and were satisfied that they had been given enough verbal information from the staff/manager before deciding to come into the home. Two individuals said they ‘were able to visit the home before coming in and had a good understanding of how it was run as they had friends or relatives living there before they became residents themselves’. Each resident has their own individual file and all four of those looked at had a full needs assessment completed within them, including one for a privately paying individual. The information from the assessment process is used to develop the individuals care plan.
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 9 There is a mixture of experienced and inexperienced staff at the home, which is leading to some inconsistencies in care. The staff-training files show that new staff members do not have induction and foundation training to meet TOPSS specification. There is no evidence that they are receiving the support and guidance they need to develop the necessary skills for giving care and as a result the needs of the residents may not be met in full or to a high standard. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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. Limited progress has been made on improving arrangements to identify and meet the health, personal and social care needs of the residents. These shortfalls have a potential to place residents at risk. EVIDENCE: Four care plans looked at included information about the health; personal and social care needs of the individual residents. Staff documentation of the daily care being given is poor, lacks detail and does not clearly show the progress being made by the residents. This poor practice was also picked up on at the additional visit made to the home in response to a complaint about care not being given to a resident. Action must be taken to remedy this shortfall; the delays that have occurred are not acceptable. Five residents said that they have good access to their GP’s, chiropody, dentist and opticians, with records of their visits being written into their care plans. They all attend outpatient appointments at the hospital and records show that they have an escort from the home if wished. The acting manager said that residents could self-administer their medication following a risk assessment being completed, but all nine of the residents
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 11 spoken to prefer the staff to give them their tablets. Staff need to sign every time for medication received into the home and that being administered to prevent any mishandling of medication and to protect the residents wellbeing. All the residents spoken to felt that staff were meeting their personal needs most of the time, but said that ‘the level of care being given can be up and down’. Three residents said that ‘care at the home is generally good, but the way it is given can depend on how the staff are feeling when they come to work’. Two individuals said that staff did not always come to see if everything was okay, but had to have things pointed out to them by the residents before taking action’. Three staff spoken to said that ‘there is a need for more staff on duty so care can be person centred and not task orientated, and sufficient time can be spent with each individual to talk to them and discuss any issues’. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Improvements have been made in both the food and activities being provided for the residents, resulting in a wider range and choice being offered to those living at the home. Residents have good contact with relatives and visitors and links with the community are being developed to enrich the residents social and leisure opportunities. EVIDENCE: One staff member who was spoken to has taken on the role of activities coordinator for 16 hours each week, and has produced a weekly programme of events. Six residents said they ‘were looking forward to taking part in activities and hoped that regular trips out were going to take place as well’. Talking to the residents showed that they enjoy their weekly bingo, having their hair done by the hairdresser and getting outside of the home for a breath of fresh air. One individual said she ‘couldn’t wait for better weather when they could sit outside in the garden and enjoy the sunshine’. One visitor was happy with the welcome she received from the staff and acting manager, she said that ‘she has been visiting people at the home since it first opened and had seen some improvements over the last few months’. The home has developed a visitors’ policy and procedure since the last inspection and this is displayed on the notice board in the entrance hall.
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 13 Four service users spoken to were very happy with the recent improvements in the quality of the meals and said that ‘the introduction of a choice at lunch time has made a big difference to our enjoyment of the food provided’. The acting manager said that the provider has asked for fresh produce to be used wherever possible, to promote the health of residents. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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. Progress has been made to develop the complaints system and residents feel that their views are listened to and acted upon. Adult protection training and procedures have improved since the last inspection with clear evidence that residents are being protected from abuse. EVIDENCE: The home has a complaints policy and procedure that is displayed on the notice board within the home. The information within this is very detailed and not easy to read and understand, and it would benefit individuals living at the home if a clear and simple version were produced. Residents spoken to did not know that the policy was there, but two individuals were aware that they could talk to the staff or acting manager if they had any concerns. Staff said that they were confident about the procedure to follow if anyone made a complaint and that the acting manager would deal with these quickly. Records show that three complaints have been made since the last announced inspection and one of these was referred to the CSCI for their investigation. The complaint looked at by the CSCI was around poor care practices and was proven because staff had not recorded the care being given on a daily basis and therefore could not evidence what care had taken place. The additional visit report produced requirements and recommendations about the need to improve the staffs written evidence of the care being given. As a result of the complaint investigation staff received training around care planning and report writing. This has brought about a limited improvement in the care plan documentation, but needs further action taking to ensure care records are detailed and up to date.
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 15 The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of service users money and financial affairs. The acting manager said that she has attended Protection Of Vulnerable Adults (POVA) training and that this information has been given to other members of staff. The staff on duty displayed a good understanding of the vulnerable adults procedure and three residents spoken to said they ‘felt safe at the home’. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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, 21, 24 and 26. The standard of decoration within the home is improving gradually with evidence of maintenance and future planning taking place. Residents are provided with a safe, warm and comfortable environment that is homely and welcoming. EVIDENCE: The home was registered with a new owner in November 2004 and he is working towards improving standards and meeting the requirements from the last inspection report (October 2004). Replacement of the corridor carpets was requested in previous inspection reports and this work still needs to be carried out. Portable access ramps have been supplied for the front entrance of the home, making it easier for residents in wheelchairs to access the home. Bedroom carpets are stained despite regular cleaning and should be replaced; room 12 needs a new floor covering as the carpet is frayed, worn through and is presenting a health and safety risk to the resident and staff. The upstairs
Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 17 corridors need re-painting as wheelchairs and trolleys have caused damage to the doors and walls. The home has three normal size toilets and one disabled-person toilet on the ground floor. Three residents said they were ‘fed up of queuing to use the facilities especially before meal times, and that staff found it difficult to fit a wheelchair into the non-disabled toilets’. They would like to have more of the larger toilets so staff can see to the residents needs more effectively. One resident spoken to is having her bedroom re-painted and said that she ‘couldn’t remember what colour it was going to be, but it would be nice as she liked the colours in the rest of the home’. There has been some new furniture purchased for the bedrooms and also bed linen and curtains. These are being replaced gradually as the rooms are decorated. The owner of the home is currently buying special profiling beds for the nursing residents and staff said that ‘the new beds have made the residents’ more comfortable and the job of caring much easier’. The home is clean, warm and comfortable and no malodours were present. Two residents remarked that ‘ the domestic staff do a lovely job and make sure the home looks fresh and welcoming’. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 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 deployment and number of staff available in the early morning and evening is not sufficient to meet the needs of the residents. Limited progress has been made in the induction training available for new staff members and as a result staff do not have the necessary skills; this could put the residents’ health and safety at risk. EVIDENCE: Information from the staffing rota shows that there is six staff on duty in a morning, five in the afternoon and four at night, with one trained nurse being included in these figures at all times. Four residents said that ‘the staff on duty are always busy and we have to wait for some considerable time before getting attention, especially when we are wanting to get up or go to bed’. There is a mixture of older and younger people at the home with different care needs, some have severe physical disabilities and need constant attention. Staff spoken to, are aware of the problems and are frustrated by the lack of time available for each resident. Three staff files were looked at and showed that all employment and police checks have been carried out and references obtained. The manager said she had to follow up the Personal Identification Number (PIN) for one of the nurses and this would be done immediately. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 19 The home needs to introduce an induction and foundation programme, which will meet TOPSS specification and the manager said that this has been sent for. The staff training programme offers staff access to mandatory training and some specialist subjects linked to the needs of the residents. 18 of the care staff have achieved an NVQ 2 or 3 with six others doing the training. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 37 and 38. The acting manager has a good understanding of the areas in which the home needs to improve. Progress forward has been limited by the lack of support she has received from the trained staff in giving clear leadership to the care staff throughout the home. This has resulted in inconsistencies in care being offered to residents, which affects their health, safety and welfare. EVIDENCE: The home is without a registered manager and the acting manager is only working in a temporary capacity. A condition of registration for the new owner is that the Registered Person must provide management support within the home until a Registered Manager is in place. The acting manager said that the provider is currently recruiting for an individual with the knowledge and skills to carry out this role. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 21 Quality assurance systems are in place at the home, but the acting manager said that she ‘is still waiting for the new audit paperwork from the owner in order to carry out the monitoring necessary to measure the progress being made by the service’. The commission has not received any regulation 26 reports from the owner since he took over the home and no evidence of these was seen at the inspection. Three people living at the home had attended the residents’ meeting last week, but said ‘it was difficult to hear what was said due to the large dining room being used’. Staff supervision files showed that individuals are starting to attend formal supervision sessions with their line managers. There is lack of consistency in the standard of work being provided by the trained and care staff that must be addressed through this process. Policies and procedures are being reviewed and up dated by the acting manager and work is progressing to make sure that records required for the protection of service users and the running of the business are in place. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately, and hot water signs have been placed in all bedrooms as asked for in the last inspection. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 x 2 3 x 3 x 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 1 x 2 x x 2 2 2 Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 23 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 1 Regulation 4 Requirement The statement of purpose must contain the details asked for by standard 1, regulation 4 and schedule 1 of Care Homes for Older People 2003 (given timescale of 16/6/04 was not met). The service user guide must contain the details asked for by standard 1.2 and regulation 5 of Care Homes for Older People 2003 (given timescale of 16/6/04 was not met). Staff, individually and collectively, must have the skills and experience to deliver the services and care which the home offers to provide (given timescale of 1/2/05 was not met). The residents care plans must clearly document the health, personal and social care being given by the staff on a daily basis and the progress being made by each individual. Accurate records must be kept of all medications , recieved, administered, leaving the home or disposed of to ensure there is no mishandling.
J45_s62875_Sutton House_v221189_260405_Stage 4.doc Timescale for action 25/7/05 2. 1 5 25/7/05 3. 4 18 25/7/05 4. 7 15 25/7/05 5. 9 17 25/7/05 Sutton House Nursing & Residential Home Version 1.20 Page 24 6. 10 12 7. 16 22 8. 9. 10. 19 19 21 23 23 23 11. 27 18 12. 13. 27 30 18 18 14. 15. 31 33 8 24 16. 33 12 17. 36 18 Staff must ensure the health and personal care being given to residents respects the individuals privacy and dignity at all times. There must be a simple, clear and accessible complaints procedure which includes the stages and timescales for the process. The worn carpeting in room 12 must be replaced. The first and second floor corridors must have the walls and woodwork redecorated. There must be sufficient accessible toilets provided for the residents, close to the lounge and dining areas. Staffing numbers and the skill mix of staff must be appropriate to meet the assessed needs of the residents. Additional staff must be on duty at peak times of activity during the day. There must be a induction and foundation training programme in place to meet NTO specification (given timescale of 1/2/05 was not met). A manager must be appointed and register with the Commission. Effective quality assurance and quality monitoring systems must be in place to measure success in meeting the aims, objectives and statement of purpose of the home. Action must be progressed within agreed timescales to implement requirements identified in CSCI inspection reports. The employment policies and procedures and procedures
J45_s62875_Sutton House_v221189_260405_Stage 4.doc 25/7/05 25/7/05 25/7/05 1/9/05 1/9/05 25/7/05 25/7/05 25/7/05 1/10/05 25/7/05 1/10/05 25/7/05 Sutton House Nursing & Residential Home Version 1.20 Page 25 18. 36 18 19. 37 17 20. 38 12 adopted by the home and its induction, training and supervision arrangements must be put into practice. Supervision must cover all 25/7/05 aspects of practice, philosophy of care in the home and any career development needs. Individual and home records 25/7/05 must be kept up to date and in good order (care plans, supervision records, induction and safe working practice training records to meet TOPSS). All staff should be given 25/7/05 induction and foundation training and updates to meet TOPSS specification on all safe working practice topics (given timescale of 9/8/04 was not met). 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 19 21 28 Good Practice Recommendations The first and second level corridor and bedroom carpets that are stained and worn should be replaced. Consideration must be given to how the two unassisted bathrooms could be adapted to become useable bathing facilities. 50 of care staff should have achieved an NVQ 2 by 2005. Sutton House Nursing & Residential Home J45_s62875_Sutton House_v221189_260405_Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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