CARE HOMES FOR OLDER PEOPLE
The Northwood Nursing Home 24 Eastbury Avenue Northwood Middlesex HA6 3LN Lead Inspector
Neil Fernando Unannounced 22 June 2005 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 Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Northwood Nursing Home Address 24 Eastbury Avenue, Northwood, Middlesex, HA6 3LN 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) 01923 826807 01923 841624 M D Homes Mrs N Dimaiwat CRH N 35 Category(ies) of MD - Mental Disorder 40 - 60 years - 19 places registration, with number MD(E) - Mental Disorder over 65 - 19 places of places OP - Old Age - 35 places PD - Physical Disability - 35 places TI - Terminally Ill - 1 place The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: This home may accommodate 35 older people who require respite nursing care. Within the overall capacity this home may accommodate a total of 19 people aged 40 years and over with a Mental Disorder, excluding Learning Disability or Dementia. Date of last inspection 21 October 2004 Brief Description of the Service: Northwood Nursing Home is mainly for older people with 19 beds registered for adults aged 40 years and over with a physical disability who may also have mental health problems and one place for a terminally ill person. The building is a period house with extensive modern additions, situated in a pleasant residential area of Northwood. The accommodation is arranged on three floors, which are served by two passenger lifts. Service users’ rooms vary in size and some have en-suite facilities. Six bedrooms are currently registered as double rooms. The day facilities currently comprise of a large sitting room and an attractive and heated conservatory, which is also used as a dining room. A further, smaller day room has been agreed for the younger residents. Access to the attractive, enclosed rear garden is via a ramp with handrails. Ample off street parking is available to the front of the building. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the first inspection for the year 2005/6 against the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection (Unannounced) was carried out on 21.10.04. Northwood Nursing Home is one of four homes owned and managed by MD Homes. It is registered to accommodate up to 35 older people including 19 persons with a physical disability and who may also have mental health problems, and who are 40 years and over, requiring nursing care. In addition, the home may accommodate 1 service user who is terminally ill. On the day of the visit, there were 32 people accommodated. The unannounced inspection took place on 22.06.05 between 10.35 am and 5.45 pm. A total of 12 service users, 8 staff members including the Registered Manager and Operations Manager, and 2 visiting relatives and the home General Practitioner were spoken to, in order to seek their views regarding the quality of life at Northwood Nursing Home. In the main, evidence available suggests that the care for service users has remained consistently good. The receptive attitude of the staff team including the Managers to the inspection is also acknowledged. What the service does well:
The staff team including the Registered Manager and Operations Manager continue to embrace and deliver on the National Minimum Standards for Care Homes for Older People and Young Adults. The inspection main finding is that all of the Standards assessed on this occasion bar four, have been achieved. The arrangements to enable service users and their relatives the opportunity to visit and make an informed decision about the facilities offered at Northwood Nursing Home is being well managed. The assessment of needs carried out prior to any resident being offered a place is comprehensive. There is ample evidence to demonstrate that the health and personal care needs are being identified through a clear planning process and monitored through a review system, involving the service user and significant others. Service users are treated courteously and their privacy is upheld. Social and recreational activities facilitated are tailored to suit the individuals and resident group as appropriate. Service users are being proactively empowered to raise any concern/complaint they may have, if they are dissatisfied with any aspect of the service offered to them. The protection systems including staff recruitment are robust and these
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 6 ensure a high degree of safety for residents. Service users, visiting relatives, the General Practitioner and staff members spoken to felt that the quality of services offered at this home is of a “high standard”. The environment continues to be well maintained and furnished. Health and safety issues are being attended to and good care is taken to ensure that service users are not exposed to any hazard. The home is comfortable and service users are encouraged to make it their home, through inclusion in decision-making and encouragement to personalise individual rooms. A high standard of cleanliness was evident throughout. The day and night staffing arrangements remain satisfactory. The members of the management team are supportive and competent to manage this establishment. Another commendable strength of the management team is their openness and willingness to cooperate and work with the Commission. 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 Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5. The arrangements to enable the prospective service user and significant others to make an informed decision regarding the suitability of the home remain satisfactory. Service users and their relatives are being pro-actively encouraged to visit and meet with staff members and other residents. A comprehensive assessment of needs of the prospective service user is undertaken and this ensures that the home only admits people whose identified needs are achievable. EVIDENCE: The home has an up-to-date statement of purpose and a service user’s guide to the home. Evidence available indicates that a copy of the guide is made available to every service user, their representative and professionals, as appropriate. Service users and visiting relatives reported that they were offered comprehensive information to enable them decide if this home is suitable to their needs. The Registered Manager and Operations Manager are very clear that any prospective service User and their family will be offered every assistance by the care staff team to access the details on the services provided at Northwood Nursing Home. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 10 The service user is admitted on a trial basis to give them ample opportunity to decide if they wish to stay and also to give the home’s staff time to further assess the needs of the new resident. A review meeting is held at the end of the trial period with the service user, relatives and placing authority, and only then the placement is made permanent. Good evidence is available to demonstrate that service users and their relatives are being empowered to participate in the decision making process, on issues that matter to them. Information gained from seven case files, three recently admitted residents, staff members and two visiting relatives suggests that the prospective service user, relatives/friends and the Care Manager where appropriate, would be visiting the home before the prospective resident is admitted. They would spend time looking around, speaking to other service users and a meal is offered if required. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 11 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 and 10. The care planning and review process is effective and service users’ participation is beneficial to them. Service users, visiting relatives and the General practitioner expressed a high degree of satisfaction in the quality and manner personal and health care needs are being delivered to residents. Observation of care practice indicates that residents are treated with respect and the right to privacy, promoted. EVIDENCE: Information gathered from care plans, service users and staff members indicates that the needs of residents are being identified and addressed satisfactorily. The care plan indicates how the identified needs are to be met. Staff members record the care given, progress made and interactions with service users. Residents are encouraged to sign their care plans where this is appropriate. Service users provided many examples of how their key workers assist them. Records show that care plans are being reviewed on a monthly basis to reflect the changing needs and objectives for health and personal care. Monthly review notes are maintained and these are noted to be satisfactory. All service users are registered with a GP and weekly surgeries are held at the home. Residents spoken with expressed a high level of satisfaction in the manner their health care needs are being addressed. The outcome of the
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 12 Doctor’s visits is clearly recorded in the care plans. The visiting GP indicated in no uncertain terms the following three points: 1) Staff have always “followed any health instruction “ given with respect to a service user; 2) The staff “work very hard and are always amidst the resident group”; 3) The service users “receive very good care” at this home. Service users have access to a telephone facility where they are able to make and receive calls without being overheard. The home operates a “knock and wait” policy on entering service users’ bedrooms, toilets and bathrooms. Staff members on duty were observed to deliver care and to attend to service users’ needs in a manner that is conducive to respect to their privacy, dignity, choice and wishes whilst actively promoting independence where possible. Personal and nursing care practice is carried out behind close doors. Shared rooms are provided with curtain, in order to ensure the privacy and dignity of the service users. Both visiting relatives were very positive regarding how well staff members treat residents. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Residents’ interests, expectations and aspirations are being sought by staff members and fulfilled as appropriate. Social contact is being pro-actively encouraged and social and recreational activities currently facilitated, provide a satisfactory level of stimulation for the service users’ wellbeing. The catering facilities are managed efficiently and it is evident that the quality and variety of food offered is of a “High standard” - a view echoed by all residents spoken. EVIDENCE: The home aims to create a relaxed atmosphere with a flexible approach to daily routines. Individual interests, expectations and aspirations are sought by staff members and fulfilled wherever possible. Service users are pro-actively encouraged to maintain their social, cultural, religious and recreational interests as evidence through the sample of care plans viewed. There are a number of Ministers of religion who visit residents regularly. There is a notice board with details of group activities and staff members routinely remind service users before an event is due to occur. An Activities Coordinator is available to facilitate social and recreational activities. A driver is also available to take service users out on various shopping trips. Residents spoken to expressed satisfaction with respect to the level and variety of social and recreational activities facilitated. Relatives are encouraged to visit the home at any time and are always made welcome - as verified by service users and relatives spoken to. Many service
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 14 users retain several past contacts, from whom they receive visits. Residents are able to entertain their visitors in the communal areas or their own bedroom, if they so wish. Evidence shows that as well as being information obtained as part of the admission process, service users’ culinary likes and dislikes are taken into account in the preparation of menu. The cook consults service users daily, in order to ensure that their preference is catered for. Hot and cold drinks are served throughout the day and mealtimes are seen as a social occasion. The menu of the day is displayed in the main lounge and staff members seem to also routinely inform residents about it. Lunch was observed and food served was well presented and of good nutritional value. Staff members were observed to be sat next to service users and assisting them in an unhurried manner. Any special, medical and cultural diet required appears to be well met. Service users were consistent in their views that the variety and quality of food offered to them is of a “high standard”. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The complaint procedures are well-publicised and service users and significant others should be capable of making a complaint. There are systems in operation, which should offer adequate protection to service users from harm. Providing essential training on the Protection of Vulnerable Adults for all staff members is a positive indication of the Organisation’s commitment to effectively protect and promote the welfare of service users. EVIDENCE: The procedures for dealing with complaints are satisfactory. Information on how to make a complaint is given to each service user and their relatives on admission to the home, as part of the terms and conditions of service. Staff members interviewed demonstrated an understanding of the complaint procedures and felt able to respond to complaints satisfactorily. Service users spoken with felt able to make a complaint if they are dissatisfied with any aspect of their care. There have been no complaints received by the home or the Commission about any aspect of care, since the last inspection on 21.10.04. Information gained suggests that the staff team should be capable of dealing with complaints satisfactorily. The whistle blowing policy is available and accessible to the staff team. The home also has procedures on the protection of vulnerable adults from harm. The procedures are included in the induction programme for all new staff members and also as part of NVQ assessment, for those people undertaking this course. Staff members spoken to are clear that any allegation or incident of abuse would be reported to the Registered Manager or a senior member of staff and followed up immediately. Evidence shows that all of the current staff members have received training on the Protection of Vulnerable Adults, in April
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 16 2005, facilitated by a London Borough Social Services, which is to be commended. Overall, the systems in place should be adequate to protect service users. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Northwood Nursing Home continues to provide good living conditions and is satisfactory for the individual and collective needs of the service users. The standard of cleanliness was exceptionally high and residents appear to appreciate and enjoy their physical environment. However, the frequency of fire drills requires some attention. EVIDENCE: Northwood Nursing Home is homely and comfortable. The communal areas and bedrooms are decorated and furnished in a style to reflect the period features of the building. Many of the rooms look out onto the front yard and private gardens. The communal and corridor areas are decorated with mirrors, watercolours and displays of fresh flowers assembled by staff members and service users. All areas viewed are accessible and well maintained. The building complies with the requirements of the local fire service and environmental health department. However, the frequency of fire drills must be increased to once every three months.
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 18 There is a high standard of housekeeping throughout those areas viewed during this visit. Considering the high level of incontinency (85 ) with the current service users, there were no mal-odours present – a view echoed by the visiting General Practitioner and two relatives. This is quite an achievement and the ancillary staff team are to be commended for their achievement. Liquid soap and paper towels are provided in areas where personal care is carried out and in high-risk areas such as the laundry. Staff members are conversant with infection control procedures. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. The establishment continues to provide the staffing levels required by day and night, and service users’ needs are being well addressed. The recruitment process for staff is robust, which means that service users are in safe hands. The training needs of the staff team are being addressed and no doubt, this ensures an improved level of service delivery for residents. Nevertheless, NVQ assessment for care staff needs attention. EVIDENCE: Information available from staff duty rotas for the period of one month and discussion with staff members including the Manager shows that the numbers of day and night care staff available are adequate to meet the needs of the service user group. There are sufficient ancillary members in dedicated roles for catering and housekeeping. The numbers of staff members on duty during the day of the inspection are noted to reconcile with the rotas for the day. The Activities Coordinator and Registered Manager’s times are excluded from the staffing calculation. The staffing levels are reviewed as and when required to ensure that the needs of service users are met. The organisation’s procedures for the recruitment, induction and training of staff members are satisfactory. The recruitment files for seven staff members were scrutinised and these reflected all the documents required by the Care Homes Regulations 2001. All staff members interviewed reported that they have had their CRB checks completed where appropriate. The organisation also seeks a police check report/character reference from the applicant’s
The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 20 country of origin for those people coming from abroad on “Adaptation Training”, which is very commendable. Information gained indicates that staff members have received mandatory training to assist them to do their work competently. Staff members interviewed, expressed a good deal of satisfaction with respect to training courses they have completed. “Adaptation” nursing students are employed as carers prior to obtaining their registration in the UK, thus giving a high ratio of significantly experienced staff members on each shift. There are no care staff members who have achieved or currently undertaking the NVQ 2 assessment or equivalent. A recommendation is therefore made for NVQ assessment to be given a higher profile. Nevertheless, good evidence is available to indicate that staff members are experienced and competent to undertake their tasks. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 and 38. The overall management of this establishment is good, which therefore means that care and staff management systems including health and safety matters are being implemented to good effect. The Northwood Nursing Home is a safe home for service users to live in. Records required are available and are maintained in good order. EVIDENCE: The current Manager has been in post since 28.05.04 and her application to become the Registered Manager of Northwood Nursing Home was approved by the Commission on 9.06.05. The Manager was able to demonstrate that she and her staff team have undertaken regular training so as to keep abreast of changes in best care practice for elderly people, which no doubt also ensure safe working practice. The Manager is capable of discharging her responsibility satisfactorily in the management of this establishment. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 22 “Resident and Relatives” meetings are held once every three months and minutes are maintained. There is good evidence to suggest that service users are empowered to direct positive change in the home. A few service users feel that “Residents’ meetings should occur more frequently. With this in mind, a recommendation is made. Information gathered from staff members including the Manager shows that arrangements are in place for staff members to receive formal supervision. Details of supervision sessions are recorded. The frequency of supervision requires some improvement, in order to reflect standard 36.2 of The National Minimum Standards. Health and safety issues are attended to. Ancillary staff members have received training on Control of Substances Hazardous to Health. All members have received fire safety training. Hot water temperature is monitored regularly, in order to ensure a safe limit of 43 degrees Centigrade at the point of outlet. Windows have been fitted with restrictors for the safety of service users and security of the building. Risk assessments are in place and updated regularly. Records show that the fire alarm system and portable electrical appliances are checked as appropriate. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4
COMPLAINTS AND PROTECTION 2 x x x x x x 4 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 2 x x 2 x 3 The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 24 NO 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 OP19 Regulation 23 (4) (e) Requirement Increase the frequency of fire drills to once every three months, at minimum. Timescale for action 15.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP28 OP33 OP36 Good Practice Recommendations NVQ Level 2 assessment for care staff should be given a higher profile (A previous recommendation). Residents meetings should be held every 4 to 6 weeks. The frequency of staff 1 to 1 supervision should increase to once every 2 months, at minimum. The Northwood Nursing Home I52-I02 s19581 Northwood v234484 220605 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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