Inspection on 15/01/07 for The Cedars

This inspection was carried out on 15th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Cedars 28/02/06

The Cedars 21/10/05

The Cedars 04/11/04

The Cedars 21/08/04

The Cedars 29/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE The Cedars 23/25 Threshfield Road Baildon Bradford West Yorkshire BD17 6QA Lead Inspector Karen Westhead Key Unannounced Inspection 15th January 2007 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 The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cedars Address 23/25 Threshfield Road Baildon Bradford West Yorkshire BD17 6QA 01274 531125 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) Mrs Nada Green Mrs Nada Green Care Home 12 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (9), of places Physical disability over 65 years of age (2) The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: The Cedars is a large terrace property. It is on the main road about half a mile from the centre of Baildon. It is registered to look after twelve older people. There are two double and eight single bedrooms. Three of the single rooms have en-suite facilities. There is one lounge and dining room on the ground floor, which opens out to a decked seating area in an enclosed garden. There are toilets and bathrooms to both floors. Access to the first floor is by staircase only; there is no passenger lift. The home is on a direct bus route between Bradford and Baildon. There is a bus stop directly outside the home. The current fee level is between £344 and £394 per week. Additional charges are made for hairdressing and private chiropody treatment. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the Manager. This meant the inspector was able to observe how the home is run on a day-to-day basis, without any changes being made to the usual routines of residents and staff. The inspector arrived at 9.00am and left late afternoon. At the end of the visit, the senior carer was told how well the home was being run and what needed to be done to make sure the home meets the required standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with the standards. Before the inspection information received about the home was reviewed. This included looking at the number of reported incidents and accidents, the action plan provided following the last inspection and reports from other agencies such as the fire safety officer’s report. This information was used to plan the inspection visit. A number of records were looked at during the visit; all areas of the home were seen. The inspector also talked to residents and staff. CSCI comment cards were left at the home for relatives and visitors to complete. At the time of writing this report none had been returned. Therefore only the verbal feedback from residents is included in this report. Most of the day was spent talking to residents and staff, to find out what it is like to live and work at The Cedars. The owner is also the manager of The Cedars; she is referred to throughout this report as the manager. What the service does well: The Cedars is a friendly home. Staff continue to focus on the residents welfare and the standards of the care they provide. Plans of care and supporting records are very good. The home has a good format for pre admission assessments, which has compensated for the poor quality of information received from referring agencies. Staff are proud of the care they deliver. They see The Cedars as a ‘home for life’ and take their duty of care seriously. Particularly care of the dying. If they are able, they will look after a resident in the home with additional The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 6 resources and support to make sure people remain comfortable and with people they know in the final stages of life. Staff took an interest in the residents they were caring for and were knowledgeable, competent and prepared to accept suggestions for improvement. Particular attention is given to new residents on their first day. They are appointed to one member of staff who is on hand to show them round and become familiar with the home. Residents see The Cedars as their home and they all talked positively about their surroundings and the staff looking after them. There was evidence that residents could retain their skills and feeling of usefulness by assisting with simple domestic tasks. The building and facilities are very good and exceed the National Minimum Standards. A number of requirements have been made but this should not overshadow what is a pleasant and comfortable environment for residents. What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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 The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 (6 N/A) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives have enough information about the home to decide if it will meet their needs. EVIDENCE: The Statement of Purpose and Service User Guide provides enough information for residents and their relatives to make an informed choice about whether they think this might be a suitable home. The staff on duty thought it could be produced in larger print on request, for those with poor sight. The document itemises the services, which are not included in the fees, and informs people they can stay for lunch and trial visits as part of their introduction to the home. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 9 Four pre admission assessments were looked at and showed that assessments had been carried out before admission. They each had a good background history to give staff some insight into the needs of the person they were caring for. Within the admission process, staff follow a checklist, which gives a step by step account of each stage of a persons admission. For example, a member of staff is identified as the person to welcome the new resident into the home, to introduce them to the other residents and staff, to help unpacking if required. This made sure the new resident knew what to do and where things were on their day of admission. This is an example of good practice and attention to detail. One resident, spoken to during the visit, recalled moving in and remembered the staff member who had taken her through her first day. At the time of the visit there were no vacant rooms and the staff confirmed this was the usual case. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care are written in a way, which makes sure residents needs are fully met. However, medication records in a small number of cases were not up to date. EVIDENCE: A selection of care files were examined before meeting the residents. Two doctors visited residents during the course of the day. In all cases residents were seen in private. Staff accompanied residents to give the doctors up to date information regarding their conditions and so they were able to discuss any changes in medication or treatment. It was clear after talking to one of the doctors, that they were more than happy for the poorly resident to stay in the home whilst receiving treatment saying, ‘she has everything she needs here and will be better looked after than if she went to hospital.’ The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 11 The format of the care plan provides guidance to care staff. It includes any identified needs, aims, objectives and an action plan. All of which is ‘person centred’ and specifies such things as denture care, preferred methods of bathing, ways to improve skin condition and reporting of any unexplained bruising or marks. Staff are also keen to make sure they know exactly what the resident wants in the event of their death and this is clearly documented. In some cases the relative has provided key information if the resident is not able to give their view. If possible arrangements are made for residents to be looked after in the home, with additional resources and support to make sure they remain comfortable and with people they know in the final stages of life. The daily records written by staff could be cross-referenced to the care plans and gave a good description of how each resident was. If there had been any changes in the care required, this was added to the care plan and a verbal instruction followed at the handover between staff. It is expected that there is an entry on a residents daily records at least once a day. Risk assessments had been done. A particularly good management plan was in place for a person who was at risk of leaving the home and getting lost. There was evidence of contact with district nurses, dentists and other health professionals. Staff spoken to on duty had a good working knowledge of when to involve other professionals and they were able to give examples of how they would treat pressure sores and what steps would be taken to minimise any risk to those residents who may go on to develop them. Comments from residents showed they were very satisfied and content with the care provided. One newly admitted resident was finding it hard to settle but staff were aware of this and were working closely with the resident and their relatives to try to overcome this. The lunchtime medication round was observed. The member of staff administering the medication was knowledgeable and competent. The medication systems were correctly followed. She said staff had received training from the pharmacy supplier and from a local college. However, on checking the records there were gaps in the record, which did not have a signature despite the medication having been given. It was clear during conversation that staff take an interest in the well being of each resident and try to provide them with a good quality of life. Areas of good practice were seen. For example the way in which staff were able to assist residents when using inhalers, their approach to residents who were resistant to attend to their personal care needs and residents needing encouragement to drink. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The programme of activities aims to provide interest and diversion for everyone. This is done by drawing on peoples’ past life experiences and skills. Resident’s lifestyle in the home matches their expectations and they are helped to exercise choice and control over their lives. EVIDENCE: Residents said staff were very good at keeping them entertained, and that they were not made to join in with games and other activities if they didn’t want to. Only a small number of residents had stayed at home during the Christmas period, but they had had a ‘lovely time’. Residents said they were satisfied with the activities and enjoyed having visitors and company of other relatives who came regularly to the home. Staff said they made good use of the local facilities and that the home was part of the local community. The main meal of the day was sampled. The food, which was very well cooked, tasty and well presented. Residents said the meal served was typical of the high standards at every mealtime. The menus for the week are The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 13 displayed on the notice board in the hallway. The cook said she regularly speaks to the residents to see if they want to make any changes to the menu. There are choices available at all meal times and alternatives are offered if they do not want what is on the menu. Residents’ also said they had a choice of where to eat, be that in the dining room, or in their own rooms, and said they could also choose where they wanted to spend their leisure time. The kitchen was clean, tidy and well organised. Records of cleaning schedules, food delivery, serving temperatures and fridge temperatures are kept. One resident, who will be 100 in May, said she was proud to be part of The Cedars and to contribute to this report. Other residents reflected this. To use some of their comments: • • • • • • • • • • They (staff and manager) are very good to me. The girls are all the same. At 8.00 in the morning, they get me up and I’m always ready to go to bed at 9pm. The food is lovely. If I don’t like what’s on the menu they give me something else. They know my favourites. We get a hot snack at teatime with puddings and cakes if you wanted them. The hairdresser comes every week. They use my room if I’m not using it. I don’t mind that. I’ve had the chiropodist and optician to see me. The physio comes every fortnight; she gives us chair exercises to do. In the good weather we go outside on the veranda to sit. We keep our minds active by doing quizzes and playing cards. There was plenty of reading material around, magazines, large print books and newspapers. One resident, who is no longer able to watch television, said she didn’t feel left out when they watched dancing competitions for example. Staff would describe what the dancers were wearing and she felt able to enjoy the music and imagine it for herself. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that any concerns they might have will be listened to, taken seriously and acted upon. The level of staff understanding gives assurance that complaints will be taken seriously and service users will be protected from abuse. EVIDENCE: There had been no complaints since 2004, either to the home directly or to Commission for Social Care Inspection. Residents said they knew how to complain and who they could talk to if they felt unhappy. Staff spoken to on the day said they had received training on adult protection and further training is scheduled to take place in March 2007. Copies of the adult protection procedures and the local authority adult protection procedures are kept in the manager’s office, and available for staff to read. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of decoration and maintenance of the home exceeds the standard required. However, some requirements have been made to make sure this is maintained. EVIDENCE: The home is very well maintained both inside and out. One part of the main lounge has patio doors that open out onto a decked area with a small-enclosed garden. The home is maintained to an excellent standard and the standards of décor and furnishings are good. There are bathrooms and toilets on both floors. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 16 Resident’s bedrooms are individually decorated and furnished giving the feeling of individuality and ownership. The home does not employ dedicated cleaning staff. Care staff are expected to keep the home clean and tidy. The home was very clean and tidy. All areas smelt fresh. Staff work together to achieve this and were seen to be well organised and committed to the task in hand without overlooking any attention residents might need. This should be reviewed according to the needs of residents and if the task becomes too much when residents needs rise alternative arrangements will need to be made. Requirements: • The maintenance record showed that the hard electrical wiring had been inspected in October 2004. And that a further inspection was required within 12 months to make sure it remained safe. • The kitchen area was very hot on the day of the visit, despite the time of year. The cook had to have the door open for extra ventilation. Alternative methods need to be found to make sure the area is properly ventilated at peak times. • The washer does not have a sluice cycle. This could compromise the management of infection control. Recommendation: • One bathroom has a bolt to the outside of the door. This is high up and it is unlikely that anyone would be locked in the bathroom by accident. Staff said this was used when they were running a bath for a resident and it was left unattended whilst they called the resident or were collecting towels or other items required. It is recommended that a risk assessment is carried out if the reason for the bolt remains valid. • It is recommended that a dishwasher is provided in the kitchen. If care staff are to continue carrying out domestic tasks in the absence of a domestic. Despite the above, the home continues to provide a pleasant and comfortable environment for residents. Staff can be proud of the hard work they invest to keep the home looking and smelling nice. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. However, staff are appointed before the proper checks are in place. This judgement has been made using available evidence including a visit to this service. Staff are competent to look after the residents. The manager lives on the premises and takes an active role in the home. However resident’s welfare could be compromised if the home continues to recruit staff without carrying out the necessary pre employment checks. EVIDENCE: The manager was not present during the inspection. The senior staff on duty dealt with the visit competently and conducted themselves in a professional manner. A group of the staff team have worked at the home a number of years. One member of staff measured the level of care provided by saying ‘I would book my own mother in here’. The recruitment files were not available during the visit. These are kept by the manager, for reasons of confidentiality. The information provided before the inspection showed that four members of staff had been recruited in September and November 2006 and although a Criminal Record Bureau Check (CRB) had been applied for, no result had yet been provided. The manager was contacted subsequently to confirm this was correct and to discuss what other The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 18 measures had been put in place to safeguard residents. She confirmed that staff were not left unsupervised until the CRB result was known, and that in the absence of this she had prior knowledge of the member of staff. The manager said she was aware of the reasons for carrying out the checks but also felt aggrieved by the length of time it can take for the CRB to be returned. Staff are responsible for reading all procedures and staff instructions and they sign to say they have read these. Two staff members are provided at all times during the day and evening. At night there is one waking night staff with the second person sleeping-in. The manager lives on the premises and if not working alongside staff is on call at all other times. At the time of the visit, the manager was on holiday. However suitable arrangements were in place to cover her absence. As stated above, the home does not employ domestic staff. However, the staff team have a good routine and work together to make sure the home is kept nice. Staff training is provided and a forthcoming programme of courses includes topics such as; moving and handling; food hygiene; first aid and adult protection. Staff said they had attended courses in the past. However, it was not clear whether staff are paid for the time they spend attending training. The National Minimum Standards suggest ‘All staff receive a minimum of three paid days training per year (including in house training).’ The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed and run in the best interests of residents. EVIDENCE: The manager is a very experienced and is well thought of by her staff and the residents living at The Cedars. Residents’ spoken to said they were looked after very well and they still had a say in what they could and couldn’t do. They said The Cedars felt like home and this was because of the way the manager and staff were. Residents said the owner’s husband kept the place nice and that they got on well with him. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 20 The manager confirmed in the pre inspection questionnaire that resident’s finances were not dealt with by her. One resident was subject to Guardianship. Otherwise resident’s relatives or a third party dealt with any financial arrangements if residents could not do this for themselves. If the home pays for anything over and above the weekly fee, the family is invoiced for the expense and charged accordingly. All records are kept in a locked filing cabinet in the office when not being used by the staff. There were no concerns regarding health and safety. The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 21 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 4 3 3 4 4 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 3 3 The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement The registered person must make sure medication records reflect what has been given to residents. a) The registered person must produce a certificate to show that the hard wiring in the home is safe. This must be tested by a competent person and meet the necessary standards. b) The registered person must make sure the kitchen is sufficiently ventilated. The registered person must provide a washer which has a sluice cycle to make sure infection control is managed properly. The registered person must make sure the necessary pre employment checks are carried out before employing staff. Timescale for action 26/02/07 2 OP19 23(1)(a) and 23(2)(b) 26/03/07 3 OP26 16(2)(g) and 23(1)(a) and 23(2)(p) 13(3) and 23(2)(k) 14/04/07 4 OP29 7, 9, 19 Schedule 2 7(a) or (b), and 18, 33 26/02/07 The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 23 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 OP21 OP19 OP30 Good Practice Recommendations The registered person should make sure the bolt on the outside of the bathroom door is necessary and if remains carryout a risk assessment. The registered person should consider providing a dishwasher in the kitchen if care staff are to continue carrying out domestic tasks in the absence of a domestic. The registered person should make sure staff attend a minimum of three days training per year (including in house training). The Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cedars DS0000001304.V324558.R01.S.doc Version 5.2 Page 25 - 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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