Inspection on 28/04/05 for Swallows, The

This inspection was carried out on 28th April 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

Swallows, The 11/07/07

Swallows, The 18/05/06

Swallows, The 04/10/05

Swallows, The 02/09/04

Swallows, The 11/05/04

Similar services:

Queen Elizabeth 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 The Swallows 318 Brownhill Road Catford London SE6 1AX Lead Inspector Sean Healy Announced 28 April 2005, 9. am 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. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Swallows Address 318 Brownhill Road 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 8461 3391 020 8461 1200 Mr Alan Wilde Mrs Susan Wilde CRH care home PC care home only 19 Category(ies) of DE dementia (12) registration, with number OP old age (19) of places The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for 19 elderly persons of whom up to 12 may have dementia Date of last inspection 2 September 2004 Brief Description of the Service: The Swallows is a private care home managed by the proprietors since opening in 1984. It is a large Victorian house situated between Lee and Catford, within walking distance of shops and public transport. It is registered for older people and people with dementia. The home is no longer registered for those who are physically disabled. The home has 13 single rooms and 3 shared rooms. It is centrally heated and attractively decorated. Washing facilities are available in all bedrooms and there is a 24-hour nurse call system. There are two lounges, dining areas and a conservatory. There is a garden with a patio area for use in good weather. Service users are encouraged to bring in personal items of furniture and mementos to personalise their bedrooms. Bathrooms and toilets have aids and adaptations available. Visitors can be entertained in all of the communal areas and in private bedrooms. There were no vacancies at the time of inspection. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out in one day on the 28th April 2005. The registered manager and provider were present and took part in the inspection process. The registered manager provided complete cooperation during the inspection. Information regarding the quality of care was also provided by a visiting GP and a visiting District Nurse. The inspector interviewed two staff individually and met informally with a group of 6 service users over lunch. The inspector met individually with two service users. Comments from all are included in this report. The inspection included a tour of the home and examination of records on care plans, staff records and building maintenance records. During the inspection staff interaction with service users was observed to be very regular and conducted in a respectful manner, despite being very busy day. What the service does well: What has improved since the last inspection? Facilities and aids within the home have now been assessed by an occupational therapist and a written assessment has been produced outlining some areas for work to be done such as installing a grab-rail at the front door and painting a step with non slip paint. The home has produced a business plan, which has been forwarded to the Commission for Social Care Inspection, and the homes management is giving serious consideration to the issue of reducing the number of rooms occupied by more than one service user, although this is not included in the business plan as yet. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 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. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 and 6 The homes Statement of Purpose is not complete and needs to be updated to ensure that service users are making an informed choice about where they live and commissioners are fully aware of the level of service being offered. Service users are not fully informed regarding contractual terms and conditions without which they are not fully aware of their rights. Service users at the home are only admitted on the basis of having a full assessment of need provided by the local authority or referring agency. EVIDENCE: The home’s Statement of purpose and Service User Guide have been given to service users. The home’s manager and service users confirmed this and copies are available on file. While advocacy support is promoted in the home on a notice board not all service users are aware of this and there is no reference to it in the complaints policy. Some service users expressed that having someone help them to speak up is important as they may not feel confident to do so themselves. The Statement of Purpose contains some detail of staff experience but does not yet include a reference to NVQ training staff have achieved. The manager agreed that this omission will be addressed. (Refer to requirements) The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 9 The majority of service users are funded by the local authority with about one third of service users being privately funded. Terms and conditions are not specified in the home’s Statement of Purpose and Service User Guide for local authority funded service users and privately funded service users do not have contracts specifying their rights and obligations, fees to be paid, what is covered by the fees and allocation of rooms. The home’s manager also confirmed that these terms and conditions are not given to service users in any other written format. Some service users confirmed that they would like to have these details explained to them and are not clear about who pays for their placement and whether they should pay something towards their care if asked to. (Refer to requirements) The last admission to the home was on the 23rd February 2005, which was supported by a full assessment of support needs provided by the placing authority. There is evidence on file of a placement review taking place in the first week in April involving the service user, the social worker and the service user’s daughter. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9,10 and 11 Service users’ medication is well managed, monitored and safely administered. Consideration is given to individual abilities to understand and self-administer medication. The home’s arrangements for health and personal care support ensures that service users’ privacy and dignity are respected, with involvement of service users. The home takes care to involve service users, relatives and other professionals as appropriate in making judgements regarding individual levels of support required in health, personal care and legal matters. EVIDENCE: There is an up to date policy on medication in place. One service user is selfmedicating. As part of the assessment process there is evidence to show that the home actively seeks to promote independence amongst service users by asking specific questions regarding abilities and support needs. This is then translated into a support plan. Clear and consistent medication sheets are kept and signed by staff administering medication. Medication is prescribed monthly by the homes GP and is collected weekly from the pharmacy to avoid keeping large stocks on the premises. A visiting GP and a district nurse commented that the home’s staff are knowledgeable and experienced in managing the medication system. A homely remedies list is available in the medication storeroom which has been approved by the GP. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 11 An activities of daily living needs assessment and care plan used by the home is comprehensive and addresses issues such as personal cleaning, dressing, mobility, breathing, sleeping and daily routines. A district nurse visits the home at least twice weekly to deal with such issues as blood pressure, pressure sores, continence and general health support and promotion of best practice. Service users spoke well of the support they receive from staff in this area and said that they find the manager very approachable whenever they have any concerns. The provider has a record on each service user’s admission sheet as to procedures to be followed in the event of a death including the service users wishes and details of next of kin and any particular legal issues to be aware of such as solicitors details and Court of Protection details where appropriate. Staff were observed to be respectful of service users’ right to privacy when entering bedrooms and bathrooms. Service users said that this is done with their permission. The home has local authority guidelines in place for dealing with arrangements for funerals. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The home ensures that the assessed and expressed individual social cultural religious and recreational needs of service users are identified. However, the home does not have an effective method of monitoring individual service users recreational and social activities to ensure needs are consistently met. Service users’ life histories are not comprehensive and improving these would ensure that staff are better informed regarding topics for reminiscence. Meals are nutritious and well balanced. Although service users are consulted about menus, the home does not adequately ensure that expressed preferences are current and up to date, which is important to service users being allowed to exercise choice and control regarding meals and mealtimes. EVIDENCE: There is evidence of a good assessment process, which is transferred into support plans for each service user. A range of activities within the home are offered to service users. However, the recording system for showing what has happened is a general day-book which contains information on all service users which does not lend itself easily for the purpose of monitoring what each individual service user has done and does not show when planned activities were cancelled and the reasons for this. One service user commented that her “activities only happen consistently when certain members of staff are on shift.” Refer to recommendations. The residents’ religious support needs are either Church of England or Catholic, but the home is not restricted by this when responding to referrals for The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 13 placements and offers places to people with other religious support needs. The Deacon comes in every Saturday for a service and a Vicar comes in monthly. Service users confirmed that they have regular contact from family and friends and that there was no restriction on visitors to the home. One service user stated ”My daughter visits me regularly and is made welcome by staff and particularly the manager.” Family are actively involved in the planning and review process and a number of service users confirmed that family attendance is at their request. One service user who goes out independently spoke about being able to easily go to local shops and regular outings to a reminiscence group or museum at Pumphouse and of regular group outings. A senior carer has done some training in this area of support. Service users are offered access to advocacy support and notices are displayed. Service users meetings take place every 3 months where they can air their views. One service user said that “the home is well run and the staff listen to me though sometimes they are very busy”. The home assesses service users’ dietary needs and preferences on admission and seeks views on the food provided via service user meetings. Some service users said that they would like to see some of their preferred meals on the menu more often and also would like to be able to have an alternative choice to what is on the menu. While the manager described some flexibility in menu setting and in being able to respond to individual requests for change more could be done here to explore current feeling on this subject. Refer to requirements. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 Complaints within the home are generally handled properly and service users feel confident that their concerns will be listened to. However, the staff-team as a whole does not have a full understanding of the home’s Adult protection policy, which means that service users may not be consistently protected from abuse. Service users legal rights are adequately protected. EVIDENCE: The home has an up to date complaints policy. There is a separate Adult Protection policy and Whistle Blowing policy, which are made available to service users and their representatives from admission, and is written in a manner understandable to the majority of service users. Where service users are unable to understand the policy family members are involved in the complaints process. One service user said “I trust the manager to talk to when I am worried.” The home has a register of complaints showing three complaints being reported and investigated in the past 12 months. All three were partly substantiated and appropriate action taken to ensure service users’ needs were addressed. However, one complaint was of the nature of a potential Adult Protection issue, but was not reported quickly to the manager and was not considered for referral under the Local Authority’s Adult Protection policy. The home’s training records show that only two of the nineteen staff have had formal Adult Protection training, though the manager stated that she has directed staff as to how to respond. Discussion with two staff showed a lack of clarity in understanding the difference between a complaint requiring less The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 15 urgent action and a complaint where potential abuse was inferred. The manager agreed the need to address this training issue as soon as possible. (Refer to requirements) All service users are supported to exercise their legal right to vote and most are supported to do so either by postal vote or by attending the polling station. This was confirmed by service users. The home’s practices show a history of involving family, the local authority, advocacy or legal representatives as appropriate in supporting service users. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,22,23, 26 The home’s location and layout generally meet the assessed needs of the service users and is well maintained, comfortable hygienic and safe. However, there are not sufficient shower room facilities, which limits service users opportunity in maximising independence in personal care. Minor adjustments to the environment are required to the home to ensure that it is safe for service users who have physical support needs, and with regard to access to hazardous waste materials. EVIDENCE: The home is located in a residential street within walking distance of shops and public transport. The co-proprietor of the home is responsible for routine maintenance in the home, which is generally well decorated and maintained. The home benefits from a lift to allow access to floors above ground level. The garden is well maintained and fully accessible. The home has sought guidance from the local Fire Authority as to the suitability of the building and has complied with all requirements. There is a CCTV monitor in the staff office that the registered person confirmed was only used to monitor exits for security reasons. There are a number of magnetic door closure mechanisms within the The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 17 home. Records of fire equipment checks were examined and found to be in good order. A recent Occupational Therapist assessment report states that there is a need for the home to have additional shower room facilities to meet the needs of the nineteen service users. Currently there are two bathrooms and no shower room facilities which falls short of best practice recommendations. In addition the report showed a need to install a handrail to the front door area and to paint a step to facilitate better definition for the sight impaired. (Refer to requirements) Of the homes nineteen residents, thirteen have single rooms and six residents share three rooms. All rooms are adequate in the provision of facilities such as sinks and furniture but the number of single rooms falls short of the recommended target of 80 . The home manager said she will be addressing the issue of the grab-rail and the painting of the step, but expressed a need for time to evaluate the feasibility of carrying out work on the development of a shower room and reduction of the number of shared rooms. (Refer to requirements) A swing-bin is used for the disposal of used continence materials in one of the bathrooms. This presents a risk to service users some of whom have support needs which may cause them to access these materials un-intentionally. (Refer to requirements) The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29,30 The home, in general, applies good practice in recruiting, inducting and training its staff. Staff are experienced in the care of the elderly and are of sufficient numbers and abilities to meet service users’ needs. However, the home cannot yet demonstrate that staff are fully trained, or adequately inducted and competent to do their jobs. EVIDENCE: The home operates a good recruitment process, which includes formal interview, taking up two references, CRB checks and POVA checks prior to appointment. All staff have an employment contract which include details of their terms and conditions of employment. Files were available and inspected which confirm consistent application of these processes. The home does not employ practicing nursing staff and does not currently employ or use volunteers. The staff training records, which were confirmed by the registered manager, show that four of the nineteen care staff have completed level 2 NVQ in care, and that five other care staff are in the process of completing NVQ 2 in care. In addition one other senior care worker is doing NVQ level 4 as they have a supervisory role when the manager is absent from the home. Should all be successful in completing their respective NVQ courses then the home will at that point have met the requirement of having a minimum of 50 of care staff trained to NVQ level 2 or equivalent. The manager expressed a commitment to achieving this by the end of 2005. (Refer to inspection requirements.) The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 19 The homes induction for new staff is not comprehensive, and is not in line with the TOPPS certified training programme. The manager confirmed that this is the case and she has begun work on changing the induction training process. The manager also stated that she will be training two senior members of staff in implementing this induction schedule. (Refer to requirements.) Two staff confirmed that they are in receipt of their terms and conditions and that training is consistent with the induction process. The home’s records show that there have been no referrals under POVA to date. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,34 The home is being well managed by a manager of good character, long standing experience in care of the elderly, who is open and supportive in her management approach. However, the manager has not yet completed required training for this post, which if not completed may affect her abilities to demonstrate fully her competence in managing this service. Accounting and financial procedures in the home are adequate and safeguard service users interests. EVIDENCE: The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 21 The registered manager holds a nursing qualification and is currently undertaking the NVQ Level 4 Registered Managers Award. She has completed three modules on Leading Meetings, Management and Performance of Teams and Individuals and Developing/Enhancing Teams and Individuals’ Performance. The registered manager has been managing this home for approximately 20 years, since it opened. The manager confirmed that she has not yet completed this NVQ level 4 course. (Refer to requirements) It was a requirement of the last inspection that a business plan be produced and submitted to CSCI. This has now been done. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 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. 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 3 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 2 2 x x 2 STAFFING Standard No Score 27 x 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 3 2 2 x x 3 x x x x The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 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 OP1 and 16 Regulation 4(1) c 22(1) Requirement The registered manager and provider must ensure that the homes Statement of Purpose is updated to advise service users of their right to advocacy when using the complaints and compliments policy procedure, and to include details of care staff NVQ qualifications The registered manager and provider must ensure that each service user is provided with a statement of the terms and conditions of their contract to include rooms to be occupied fees payable and services to be provided The registered manager must review the menu setting system within the home to seek service users current views on individual choice of meals and ensure that the system facilitates their choice in relation to meals and mealtimes The registered manager must ensure that all of the homes care staff are fully trained and informed regarding the requirements of the homes Adult Protection policy. Timescale for action 31/08/05 2. OP 2 5(1) b,c 30/09/05 3. OP 12 16(2)i 30/09/05 4. OP 18 18 (1) c i 18 (4) 30/09/05 The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 24 5. OP 22 23 (2) j 6. OP 22 23(2)n 7. OP 26 13.4 a&c 8. OP 28 18© (i) & (ii) 18© 9. OP 30 10. OP 31 9(2)b (i) The registered provider must ensure that a strategy is put in place to action the Occupational Therapist assessment report recommendations regarding the provision of additional shower room facilities. The strategy must detail the work to be done and the timescale for completion. A copy of this plan must be forwarded to the Commission for Social Care inspection. The registered provider must ensure that Occupational Therapist assessment recommendations regarding the installation of a hand-rail and painting of a step are implemented The registered manager must ensure that soiled waste is stored in appropriate areas that are not accessible to service users. This was a requirement of the last inspection timescale 2/10/04 and is repeated The registered provider and manager must ensure that a minimum of 50 of care staff attain NVQ level 2 The registered manager must ensure that a staff induction programme which meets the National Training Workforce specifications is put in place The registered manager must adhere to Sector Skills Council requirements and complete NVQ level 4 in management and care 31/10/05 30/09/05 30/09/05 31/12/05 30/09/05 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. The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 25 No. 1. Refer to Standard 12 Good Practice Recommendations The registered manager should consider introducing a more individual system of activities planning and recording to enable an easier means of monitoring individuallevels of activity. The registered manager should review the current system of recording service users activities to ensure that individual information for each service users is recorded in a seperate section for each service user. This record should also reflect when planned activities do not happen and thereason why The registered manager should develop more expansive individual histories and backgrounds about each service user, with the involvement of the service user and their representatives, as an aid to reminiscence activities. This information should be made available to support staff only with the permission of the service users. The registered provider should begin now to consider how the home can offer at least 80 of its places in single rooms by April 2007. Details of this financial planning should be included in the business plan for the home. This recommendation is repeated from last inspection 2. 12 3. 12 4. 23 The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 46 Loman Street London SE1 0EH 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 The Swallows G52-G02 S25645 TheSwallows V220941 280405 stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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