Inspection on 14/08/06 for The Salisbury

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Salisbury 30/07/07

The Salisbury 06/10/05

The Salisbury 23/06/05

The Salisbury 15/12/04

The Salisbury 26/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Salisbury 20 Marine Crescent Great Yarmouth Norfolk NR30 4ET Lead Inspector Hilary Shephard Unannounced Inspection 14th August 2006 09:45 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 Salisbury DS0000027419.V308667.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 Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Salisbury Address 20 Marine Crescent Great Yarmouth Norfolk NR30 4ET 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) 01493 843414 Dr Suman Nagpal Dr Sunita Nagpal, Dr Surrinder Batra, Mrs Indira Batra Mrs Karen Bradnum Care Home 26 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (26), of places Physical disability (1) The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Twenty six (26) older people of either sex may be accommodated. One service user with a physical disability, who is under 65 years of age and is named on the Commissions records, may also be admitted, at any time, provided care needs have been assessed and these can be met at The Salisbury. No other person under the age of 65 years is to be admitted. Six service users over the age of 65 years, with dementia, may be accommodated provided care needs have been assessed and these can be met at the Salisbury. The new manager must complete specialist dementia care training within 6 months of date of registration and NVQ level 4 in care management within 18 months of date of registration. 6th October 2005 3. 4. Date of last inspection Brief Description of the Service: The Salisbury is a care home providing care and accommodation for up to 26 older people and is situated approximately one mile from the centre of Great Yarmouth. Accommodation is provided on two floors and there are 16 single bedrooms, four with en-suite facilities, and five shared rooms. There are two lounges and a dining room and a pleasant secure garden to the rear of the building. The home made the Commission aware of its current scale of fees on 14 August 2006. The fees charged are from £262 to £378 per week. Extras such as toiletries, newspapers, hairdressing and chiropody are not included and the home expects that residents will pay for these separately. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgments for each outcome group. Many improvements have been made by the manager since she has been in post, however, the last visit was October 2005, 10 months ago, and the August 2006 visit shows areas such as staffing levels, training, care planning and the environment that have not improved significantly enough to change the homes current quality rating. The home changed its registration in October 2005 to allow for up to 6 people with dementia to be accomodated. Training in dementia care has been provided and some improvements have been made to the premises, but again, these improvements are not significant enough to allow the home to further increase their accomodation for people with dementia. A total of 6 requirements were made as a result of this inspection. What the service does well: The home is well managed by a competent manager who has developed her management skills and her dementia care skills. She also recognises areas within the service that need improvement and is working on those. Most of the care staff are competent and provide care in a kind, gentle and thoughtful way. Residents said the care they receive is good. Residents’ monies are safely managed, and the home regularly monitors the quality of service provided. Food is of good quality and is well prepared by a competent chef. The home is safe for the residents but has not always been well maintained. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 6 The communal areas of the home are comfortable and homely and well used by residents who enjoy using these rooms. The home is clean and pleasant smelling. The home is in a nice location allowing residents views of the garden and seafront. What has improved since the last inspection? What they could do better: Information given to residents before admission needs to be improved and updated and provided in ways to suit the residents’ needs. Pre-admission information that is gathered by the home needs to include reference to residents’ social and emotional needs. Care plans need further improvement to ensure they contain good, clear and detailed guidelines for staff to follow and include reference to residents social and emotional needs. Care plans must also reflect the information gathered in the life history. The provision of occupation and activity for male residents needs to be improved. Staffing levels need to improve to ensure the residents need for occupation, stimulation, interaction and activity are addressed. Staff need to develop their skills and knowledge regarding the provision of food for people with dementia. They also need to develop their dementia care skills further. More staff need to complete NVQ training. The home needs to ensure that all residents understand how to raise concerns and the manager must ensure all concerns raised by residents are logged. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 7 The home needs to improve the internal and outdoor environment to meet the needs of people with dementia. Some improvements have been made to the signage around the home making it easier for residents to find the toilet and their bedrooms, but residents find it difficult to move around the ground floor freely because there are heavy doors in the corridors. The garden could be difficult to locate for someone with memory problems because it is right at the back of the home. The garden needs to be re-developed to ensure it is suitable for people with dementia. Some areas in the home are looking tatty and poorly maintained. It is not always possible for residents to have a choice about moving into a single room because the home has a high number of shared bedrooms. 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 Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 the following standard(s): 1, 3 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home provided residents with up to date information in a format that can be easily understood and the assessment format used covers the residents full range of needs in a more detailed way and is reflected in the plan of care. Residents are not provided with up to date information about the home preventing them from making an informed choice about living there. The preadmission assessment is adequate but does not include residents’ social and emotional needs. This judgement has been made using available evidence including a visit to the service. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 10 EVIDENCE: Two new residents were case tracked during the August 2006 visit and their files were checked as part of this process. The pre-admission format and procedure has not changed since the previous visit in October 2005. The assessments omit information about residents’ social needs. Some information gathered from social workers and the hospital has not been transferred to the care plan. Two residents were spoken with about the information provided by the home before they were admitted. One could not remember and one had been given two brochures, both out of date, one significantly so. The manager is aware of this and plans to update them. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the care plans were more detailed, they contained assessments and guidelines relating to residents social and emotional needs and information gathered in the life history was reflected in the care plan. Medication management has improved significantly, residents are treated with respect and dignity and their health care needs are met by appropriate professionals. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans have improved significantly in the past two years and have changed little since the previous visit to the home in October 2005. The home completes an informative life history about the resident and involves residents’ families with this. Some information is used as part of the care plan, but not enough information is being recorded about residents’ social and emotional needs. The manager is aware that care plans need updating and plans to address this soon. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 12 Care plans showed the residents’ healthcare needs are properly managed and 82 of residents comment cards said they felt they received the medical support they needed. Medication was checked at the August 2006 visit as the previous visit in October 2005 had identified some errors. A requirement was made at the last visit regarding the correct recording and administration of medication and significant improvements have been made to the way medication is managed. No issues regarding privacy and dignity have been noted at previous visits to the home and at the August visit one resident spoken with said staff treated her with respect. Staff were observed caring for residents in a kind and respectful way. A requirement regarding care plans has been repeated. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. The outcome of this group of standards could be excellent if staff made more effort to ensure male residents need for occupation was addressed and the home ensures enough staff are provided to enable residents social needs to be met. It could also be better if staff had a greater understanding of the specific dietary needs of people with dementia. Generally residents’ social needs are met but there are areas the home needs to improve. The residents benefit from good food, however a choice of lunch meal should be routinely offered. This judgement has been made using available evidence including a visit to the service. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 14 EVIDENCE: Previous visits to the home in June and October 2005 showed that activities, interaction and occupation for residents was improving, but needed addressing for all residents and was not always included in the care plans. The visit carried out in August 2006 found that they were short staffed because of recent staffing issues and the manager was undertaking more hands on care than normal. Staff were very busy and residents were not receiving much interaction or stimulation throughout the day. However, entertainment was going on in one lounge during the morning, which some residents chose to be involved in. Comments from residents indicate its mostly men who are not provided with suitable activities. Two male residents were spoken with, one said there was not enough for him to do and the other said he was quite happy and rarely bored. Previous visits have found that relatives are welcomed and residents are able to spend time with them privately in their bedrooms. The August 2006 visit showed this remained the case. The food continues to be good. Meals are well prepared and nicely presented and the chef is well aware of residents’ likes and dislikes. Choice of lunch meal is not routinely offered but staff go round and ask residents what they would like for their evening meal. Special diets such as diabetic are catered for, but staff need more information about providing different types of food for residents with special food needs created by their dementia. One resident was seen having difficulty sitting down and eating and at times she was experiencing difficulty recognising cutlery and her lunch. Staff were not assisting her with her lunch and lacked understanding of how they should be helping her. A requirement has been made regarding activities. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 the following standard(s): 16, 18 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home followed the correct reporting procedure immediately following adult protection issues and made sure all residents had a clear understanding of how to complain or make suggestions for improvement. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Two adult protection issues have occurred at the home since February 2006. Both were referred to the adult protection units and investigated by them. The correct reporting procedure was not followed for the second incident, however the manager has gained knowledge and experience from dealing with these issues and is confident the correct reporting procedures would be followed in the future. Information received in June 2006 from residents indicates that 60 knew how to make a complaint and 27 did not. 68 of residents knew who to speak with if they were unhappy and 18 did not and 90 of relatives were aware of the homes complaints procedure. One resident spoke of his dissatisfaction with the service and the manager advised she speaks with him regularly making every effort to address his issues. None of his concerns have been properly logged except for minor reference in the daily records. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 16 Home has complaints procedure which is displayed in front hall area, however it is not clear how residents with dementia are enabled to make their concerns known. A requirement has been made regarding complaints. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 26 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home increased the number of single rooms, improved the internal and external environment further to ensure the specific needs of people with dementia are addressed. Residents are not always able to choose the option of a single room which compromises their well being, the environment needs improvement to the decor and further adaptation in order to meet the needs of people with dementia as currently it does not do this very well. The home is clean and safe and offers comfortable and homely communal areas, but has not been well maintained over the past year. This judgement has been made using available evidence including a visit to the service. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 18 EVIDENCE: The August 2006 visit showed some improvements have been made to the decor and environment since the previous visit in June 2005. The manager has improved the signage around the home by placing laminated photographs on various doors indicating the purpose of the room behind. This has also been done with some of the residents bedrooms, however further research needs to be undertaken into providing the best environment as residents with dementia may not recognise themselves as they are now. The August 2006 visit showed that some parts of the home were looking tatty and worn, particularly corridor and stair carpets. The manager said she is in the process of having much of the home repainted and the proprietor plans to replace the worn carpets. The home has three lounge areas on the ground floor furnished with a variety of comfortable armchairs. Having lots of different armchairs adds to the homely feel of these rooms. The home has a large secure garden at the back of the home with a summerhouse. This area of the home is used occasionally by some residents, but because the access to it is via corridors and a fire exit it is not easy to find. The garden is mostly lawn with some flower beds and fruit trees, but has some shrubs and trees that may be poisonous and the layout does not meet the needs of people with dementia. There is also a large garden around the side but this is not accessible to residents. Residents are free to walk around the home as they wish, however, this is sometimes difficult because heavy doors make access through the corridors difficult and creates barriers. These corridor doors close with a loud bang, which is intrusive to residents, particularly those with dementia. Two residents indicated in a recent survey (June 06) that they want a single room and do not want to share and the manager has promised them the option of a single room when they become available. Requirements have been made regarding the premises. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area adequate. The outcome of this group of standards could be good if the home provided more staff at key times to meet residents needs, if all staff were trained and able to competently care for residents specific dementia care needs and more staff were undertaking NVQ training. Recruitment practices have improved significantly and residents’ benefit from staff undertaking induction and training in basic care practices. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The previous visit in June 2005 found staffing levels at a minimum but at that time the home only had 15 residents and 11 vacancies. The August 2006 visit found the home was full and more staff had been employed but staff were struggling to meet the residents needs during the visit. After 2pm on the same day, observations showed care staff busy with non-care tasks leaving residents unattended for periods of time. Care staff also serve the evening meal about 5pm which has usually been prepared by the chef. The manager plans to increase staffing to 4 carers in the morning and is currently recruiting. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 20 The previous visit in October 2005 found that 2 care staff had NVQ 2 and 2 were due to start. The August 2006 visit showed that 3 care staff have NVQ2 and 1 has NVQ3. These staff are deployed on day and night shifts. Training opportunities have improved over the past year and observation showed all staff competently carrying out basic care tasks and some staff were better at caring for people with dementia than others. Residents said they thought staff cared for them well. Some training has been carried out over the past few months and staff advised that dementia care and adult protection training is planned. Evidence on one staff file shows induction has been carried out and this member of staff confirmed her induction was useful and helped her to learn how to look after the residents. Recruitment practices were poor at previous visit in October 2005, because the home had allowed staff to start work without proper references or POVA checks. The August 06 visit showed significant improvement to their recruitment practices with no discrepancies noted on new staffs files. Requirements have been made regarding staffing levels and staff competency. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good. The outcome of this group of standards could be better if the home made significant improvement in all outcome areas without prompting from the Commission and showed they were able to sustain a good level of quality. Residents’ benefit from living in a well-managed home run by a competent manager. This judgement has been made using available evidence including a visit to the service. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 22 EVIDENCE: A new manager (previously the deputy) was appointed in October 2005 and registered by the Commission in December 2005. She is due to commence her registered managers award in September 2006, has NVQ3 and has also attended a short course about dementia care. The manager has experienced two adult protection issues which she managed well. Unfortunately, one resulted in the termination of the staffs employment leaving the home short of senior staff. The manager has been working long hours, many including hands on care so has been unable to make significant improvement to all of the areas identified at the previous visit in October 2005. However, a deputy will be appointed shortly and more care staff will be employed enabling the manager to fulfil her management duties. The manager advised their quality survey was undertaken in March 2006 and improvements have been made to the survey tool. The proprietor also visits the home and undertakes formal quality monitoring. The manager sees residents daily to monitors the quality of care being given and is well aware of the areas in the home that need improvement. The visit in October 2005 found residents finances being managed safely and the August visit showed no changes made to this practice. The October 05 visit found that staff were not having formal supervision and the August 06 visit found this had improved. Evidence of this was seen on staff files. The October 2005 visit found the home being managed safely, and the August 06 visit identified no issues with safety. Information received from the home in June 2006 indicates that fire alarm tests are carried out weekly and equipment and water/heating systems are serviced regularly. The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 2 X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 24 One 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 OP7 Regulation 15 Requirement The registered person must ensure that care plans contain assessments of the residents need for activity and meaningful occupation and guidelines detailing how these are to be met. Repeated, deadline of 30/11/05 not met. The registered person must ensure that all residents are consulted with regarding their social interests and suitable activities are provided for all residents. The registered person must ensure that the complaints procedure is appropriate to the needs of the residents. The registered person must ensure that • the premises are suitable for achieving the aims and objectives set out in the statement of purpose • The physical layout and design of the premises meets the needs of the residents DS0000027419.V308667.R01.S.doc Timescale for action 29/11/06 2. OP12 16 (m, n) 29/11/06 3. OP16 22 (2) 29/11/06 4. OP19 23 (1 a) (2 a, b) 28/02/07 The Salisbury Version 5.2 Page 25 5. OP20 23 (2 o) 6. OP27 OP28 18 (1 a) The premises are kept in a good state of repair. The registered person must ensure that the gardens are suitable, safe and accessible for all residents. The registered person must ensure that suitably qualified, competent and experienced staff are working in the home in such numbers as are appropriate for the health and welfare of the residents. • 29/11/06 29/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Salisbury DS0000027419.V308667.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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