Inspection on 16/08/05 for The Quinta Nursing Home

This inspection was carried out on 16th August 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

The Quinta Nursing Home 30/05/08

The Quinta Nursing Home 17/05/07

The Quinta Nursing Home 30/05/06

The Quinta Nursing Home 11/04/05

The Quinta Nursing Home 03/11/04

The Quinta Nursing Home 29/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Quinta Nursing Home Bentley Nr Farnham Hampshire GU10 5LW Lead Inspector Anita Tengnah Unannounced 16.08.05 10:00am 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 Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Quinta Nursing Home Address Bentley, Nr Farnham, Hampshire, GU10 5LW 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) 01420 23687 Doctor M Chohan Ms P Alishah CRH 41 Category(ies) of OP - 41; TI(E) - 10 registration, with number of places The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 11.04.05 Brief Description of the Service: The Quinta nursing Home is a registered to provide nursing and personal care to 41 service users in the older people category. The home is situated in the village of Bentley with some local amenities close by. Accommodation is provided on two floors with a passenger lift that allows access to both floors. All the bedrooms are single with en suite facilities. There is a variety of aids and 5 assisted baths to meet the needs of the residents. The service also benefits from gardens that are enclosed and accessible to service users where seating is available. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken on the 16th of August 2005. The inspection took place over 6 hours. As part of the inspection process a tour of the building was undertaken. The inspector spoke to 14 service users, two visitors, 7 staff and the manager. The process included examining care records, staff records and discussions with service users, staff and visitors. What the service does well: What has improved since the last inspection? Service users spoken to reported that meals have improved since the last inspection. Service users said that they are now consulted about their choice of meal from the daily menu and that meals were very nice. The garden to the side of the building was well tended and seating was available for the use of service users. A number of rooms had single lever locks fitted following the last inspection. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 6 What they could do better: Some service users had care plans in place, however the inspector found that two service users records did not have care plans. This is poor practice as the home cannot demonstrate how the care will be delivered and information that is needed by care staff to deliver care safely was not available. Risk assessments were not reviewed and updated in order to reflect how service users changing needs would be met and to inform practice. There were limited care plans about the management of pressure ulcers and the equipment used in the prevention and treatment of pressure ulcers. The provider has fitted locks to two communal bathrooms in the new part of the home. However these locks were not appropriate as staff would not be able to access these in an emergency. This was discussed with the manager and must be changed. There are five bedrooms that do not have single lever locks and must be changed, as the present locks are unsuitable may be detrimental to service users’ safety. There is limited training available at the home. Records of training and induction showed that not all staff have undertaken an induction on employment. Staff reported that induction comprised of working with another carer for one day and then they are allocated their workload. The manager has failed to introduce a structured supervision programme for care staff and ensuring that staff are supervised and supported as part of their working practice. The service has no internal audit system in place to seek the views of service users and ensuring that the home was meeting its commitments as stated in the statement of purpose. There is limited activity programme for service users. Staff and service users reported that a relative attended the home once a week for one- hour activity with service users. The service users spoken to stated that they were ”bored” as there was nothing going on during the day. Service users reported that there were no cooked breakfast available and that this would be welcomed. This had been highlighted at the previous inspection and there has been no improvement. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 7 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 Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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 Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 3 The home has a satisfactory process of pre-admission assessment in place to ensure that service users needs are met. EVIDENCE: The manager assesses service users prior to admission and care management assessments are also secured at that stage to ensure that the home can meet the needs of service users. The statement of purpose is available to all prospective service users so that an informed choice can be made. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 7,8.10 The system of care planning and review was poor and did not provide staff with the information they need to meet the needs of service users, nor personal or social needs. Risk assessments in particular fall risk assessments, healthcare and manual handling assessment were inadequate and did not safeguard the welfare of service users. EVIDENCE: The care records of 5 service users were examined as part of the inspection. Care plans were in place for some service users; however there was no care plans for two service users. This included one service user that has been recently admitted to the home with history of falls. There were no fall assessments or needs assessments including manual handling, nutritional, pressure risk assessments available in his records. Although service users are assessed prior to admission these assessments did not form part of the initial care planning. This was discussed with the manager. The lack of care planning is detrimental to the welfare of service users as care practices would be inconsistent and reliant on carers memories/ skills and perceptions. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 11 The record of another service users showed that the manual handling assessment was undertaken in 2003 and there was no record of any review. The staff reported that this service user needs had changed; a relative supported this as she was visiting on the day of the inspection. This service user needed a hoist for transfer, her care records did not reflect this and staff continue to lift her without the use of any equipment. This undoubtly be to the detriment of the service user and staff. Access to the GP was maintained and the GP visits the home on a weekly basis and as requested. Records of the GP visits and any change in treatment were recorded in the service users care records. Service users spoken to confirmed that they were treated well and staff respected their privacy. Telephone access was available in service users bedrooms and the home had no restriction on visiting times. Relatives confirmed that they visited at various times and that staff were always pleasant and helpful. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 12,14,15 The main meals are well managed with evidence of choice offered to service users. However breakfast is not properly managed due to lack of kitchen staff and there is no choice available. The limited activity programme does not meet the aspirations and needs of service users. EVIDENCE: Service users spoken to said that they liked living at the home. Some of them go out with friends and family once a month. The vicar visits on a monthly basis and a mobile library service also attends the home. Service users, staff and relatives reported that there were very limited activities for service users. Comments from service users included that they were “bored” and “there is nothing going on”. External entertainer attends the home once a month and service users stated that the programme was the same and they did not enjoy these sessions. It was evident from discussion with staff and service users that the home needs to provide a varied activity programme. This has been brought to the attention of the provider at previous inspections and there has been little progress in the provision of suitable activities for service users. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 13 Lunch was observed being served at the time of the inspection. Meals were varied and a choice was available. Service users reported that lunchtime meals were nice and that they had the facility of choosing from the daily menu. Staff were observed to be available and to offer support with meals in a sensitive manner. Lunch was taken in the large communal dining room and meals appeared wholesome and well presented. Service users reported that they were not offered a choice for cooked breakfast and this would be welcomed. Care staff reported that they prepared breakfast and only offered cereal and toast as there was no kitchen staff at breakfast time. This has been previously discussed with the provider and assurance was given that a cooked breakfast would be available and service users would have a choice. This has not improved since the last visit. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 16,18 The home has good information with regards to complaint procedures that are available to all service users. Lack of training in the prevention of abuse is detrimental to the welfare of service users. The management approach to dealing with staff complaints is unsatisfactory and may be to the detriment of service users. EVIDENCE: The home has a complaint policy and procedure in place. The manager investigates all complaints. A complaint log was available and there was one complaint recorded since the last inspection. The complaint procedure was displayed in all service users bedrooms seen. Service users spoken to said that they would raise any issues with the staff. An Adult Protection procedure and the Hampshire abuse procedure were available. Staff spoken to were not aware of the abuse procedure or the process for reporting any allegation of abuse. They stated that they had not received training in adult protection and there were no record of this training available. The provider must ensure that training in the prevention of abuse is available to ensure that staff are aware of the procedures in reporting all allegations of abuse for the safety of service users.. It was evident from staff comments that management approach to complaints from staff was not encouraged. Staff commented to “fear culture” that if they complained this would not be received appropriately. These are serious issues The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 15 that the provider must address in order that complaints are investigated in line with the home’s procedure for the protection of service users. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 19,21,24 26 Service users live in a homely, clean, comfortable surrounding, all bedrooms were personalised. However the lack of seating in the communal lounges do not meet the needs of service users. The décor in the two communal bathrooms do not provide a homely appearance. EVIDENCE: A tour of the premises was undertaken as part of the inspection. The home was clean and homely. All service users rooms were personalised and call bells were available. Service users were complimentary regarding their rooms and the communal areas of the dining room and lounge. Furnishing in the new part of the building was of good standard and appropriate to the needs of service users. The service has two gardens to the side of the building that were well maintained, safe and enclosed. Seating had been added in the garden and service users commented that they enjoyed the gardens and that it was much better. The gardens were accessible to wheelchair users. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 17 It was noted that some furnishing was missing, in particular easy chairs, in the communal lounge. This was discussed with the manager and the inspector highlighted that these were available and adequate at the time of registering the new build. Staff reported that some of the furnishing have been removed and sent to the other home owned by the provider. This is unacceptable and the provider needs to address this issue. The first floor lounge furnishing was inappropriate to the needs of the service users. Staff reported that as these were very low seats and were unsuitable for the service users. It was also noted that a number of service users were left in wheelchairs that were used for the purpose of transferring them from their rooms and they were not designated wheelchair users. The provider is required to ensure that there are adequate seating and that these are appropriate to meet the needs of service users at all times. There has been some progress in the fitting of single lever locks to some service users bedrooms. There are 5 bedrooms that require single lever locks that remain outstanding. The provider is required to ensure that there is a risk assessment in place with regards to these bedrooms and that the outstanding locks are changed for the safety of service users. The home has adequate bathing facilities. Assisted baths and hoists were available. Locks to the two bathrooms in the new build were not appropriate as staff would not be able to gain access in an emergency. The provider is required to change these locks to single lever locks. The two communal bathrooms in the old part of the building were in poor state of repair, tiles falling off the wall and cluttered with equipment. This was highlighted in the last inspection report and has not improved. The bathrooms did not provide a homely environment and restricted access for service users. Storage of equipment should be reviewed and action taken to ensure the safety of service users. The inspector noted that the communal toilet in the first floor bathroom was out of order. The manager stated that this had been out of use for 6 days. As part of the programme of refurbishment the provider must ensure that furnishing in service users bedrooms in the old part of the service are replaced in particular bedside cabinets and tables in some service users bedrooms as some are in poor state of repair. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 27,29,30 The inconsistency in hours worked and the long hours worked by some staff can be detrimental to the welfare of service users. The staff training and induction are badly managed and can be detrimental to service users and staff. The recruitment procedures at the home are unsatisfactory and do not protect the welfare of service users. EVIDENCE: The home has a duty rota for carers and a separate rota for ancillary staff. The home has a few staff that have worked at the home for a long time and are committed in providing a high standard of care. The record of duty rota seen showed that one carer had worked from 8-8 on a day shift followed by 8-8 on night duty. There was inconsistency in the record of hours that carers worked. Staff reported that as part of care hours they also undertook kitchen duties including preparation of breakfast and food preparation at weekends such as heating of soups and making sandwiches. Care staff also undertook the laundry at weekends as there is no laundry staff. Staff said that this took them away from providing care. The provider is required to ensure that there are adequate staff on duty at all times to meet the needs of service users. Care hours must not be eroded by non-care duties. The provider must ensure that hours worked are recorded accurately. The long hours worked by some carers can be detrimental to the welfare of service users. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 19 Staff reported that they enjoyed working at the home and had developed good relationship with service users. The inspector spoke to six staff members as part of the inspection. It found that staff morale was low and staff reported that they felt unsupported in their work. They have no regular staff meetings with the last one was about six months ago. Staff records showed that some improvements have been achieved. However carers were employed prior to Criminal Records Bureau (CRB) had been completed. References are sought but did not include those from the last employer. One staff member ‘s work permit related to the last employer and there was no CRB check available or a reference from the last employer. The manager reported that the home has a training plan. Record showed that newly appointed staff had not undertaken mandatory training such as manual handling on commencement of employment. There was no structured induction programme for staff. Two staff members confirmed that they had been employed for 5-6 months and had not completed an induction. Staff stated that they were expected to undertake any training including mandatory training in their own time as the provider has refused to pay for training time. They stated that the service viewed training as low priority and staff were not supported/ encouraged and were reluctant to undertake training in their own time. This issue needs to be addressed by the provider as the lack of training does impact on the safety of service users. The provider is required to ensure that all staff receive induction training within six weeks of appointment. Mandatory training in health and safety must be in place for all staff to ensure that staff have training that is appropriate to the work that they are employed to do. This should include a minimum of three paid days training per year. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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) 33,35, 36,37,38 The lack of internal audit does not reflect an open and inclusive culture within the home. Records are maintained securely, however the reporting of incidents affecting the welfare of service users are unsatisfactory. The safety and welfare of service users are put at risk through the lack of training in food hygiene and health and safety. EVIDENCE: The manager reported that regular meeting are held with service users and she is available at other times as required. The home does not have an internal audit in place to seek the views of service users and others to monitor the service delivery and whether the home was meeting the aims and objectives as identified in the statement of purpose. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 21 Staff reported that the provider did visit the home at regular intervals. The provider has been required on two previous inspections to provide the commission with reports of his unannounced visit as required by Regulation 26. The provider has failed to meet this requirement. The inspector spoke to staff and looked at the staff supervision arrangement within the home. The home has failed to put in place a structured supervision programme for staff. All records were maintained securely and the manager reported that service users could access their records as requested. The inspector found that three service users had been admitted to hospital in the last month. The manager failed to provide reports to the commission. This included one service user who had suffered a fall and sustained a fracture of his femur. Records showed that lifting equipment was serviced appropriately. Fire doors were maintained appropriately and door guards were fitted. Staff reported that all carers are involved in the preparation of meals due to the lack of kitchen staff. There were limited records with regards to training in basic food hygiene for care staff. Six staff members were spoken to and one had the training in food hygiene. There was no record of any staff that has undertaken first aid training. This was discussed with the manager and action is required. The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 2 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x 2 x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 2 x 3 2 2 2 The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .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 7 Regulation 15 Requirement The manager is required to put in place assessments, individual care plans and risk assessments including falls assessmnets, nutritional screening for all service users in order to meet their needs. This is a repeated requirement of December 2004, April 2005. Service users must be given the choice at breakfast time to include the availibilty of cooked breakfast as required. Timescale of december 2004 and April 2005 not met. The locks to the two communal bathrooms must be changed to aappropriate locks for the safety of service users. The remaining five service users bedrooms must be fitted with single lever locks. This is a repeated requirement of December 2004 and April 2005. The provider is required to put in place furnishing that is appropriate and adequate to the needs of service users. The manager is required to ensure that duty roster reflect Timescale for action 30/09/05 2. 14 16 30/09/05 3. 21 12(1) (a) 30/09/05 4. 24 12 30/09/05 5. 20 (23) (2) 30/09/05 6. 27 17(2) schedule 30/09/05 The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 24 4 7. 27 18(1) (a) 8. 29 19 9. 30 18(1) (c ) (i) (i i) 26 10. 33 11. 12. 36 38 18(2) 18(1) (a) accurately the hours that staff have worked. The provider must ensure that there are adequately trained staff and in sufficient numbers including domestic staff to meet the needs of service users at all times. The manager must ensure that there is a robust recruitment procedure in place and that all checks are undertaken prior to employment including CRB. All staff records must be maintained as per schedule 2. The provider is required to provide a training plan with all staff being supported to undertake mandatory training. The provider must submit reports of visits relating to regulation 26. This is a repeated requirement of December 2004, April 2005. The manager must put in place a structured supervision programme for all care staff. The provider is required to provide staff training in health and safety including food hygiene, first aid . 30/09/05 30/09/05 30/09/05 30/09/05 30/09/05 30/09/05 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. Refer to Standard Good Practice Recommendations The Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 25 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Quinta Nursing Home H54 S11656 THe Quinta NH V244743 160805 .doc Version 1.40 Page 26 - 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. 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