Inspection on 04/05/07 for Three Bridges Nursing & Residential Home

This inspection was carried out on 4th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Three Bridges Nursing &... 08/06/06

Three Bridges Nursing &... 01/12/05

Three Bridges Nursing &... 25/07/05

Three Bridges Nursing &... 17/05/05

Three Bridges Nursing &... 07/10/04

Three Bridges Nursing &... 07/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Three Bridges Nursing & Residential Home Three Bridges Nursing Home Nook Lane Latchford Warrington Cheshire WA4 1UB Lead Inspector Anthony Cliffe Unannounced Inspection 08:45 4 and 8th May 2007 th 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 Three Bridges Nursing & Residential Home DS0000005158.V333984.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. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Three Bridges Nursing & Residential Home Address Three Bridges Nursing Home Nook Lane Latchford Warrington Cheshire WA4 1UB 01925 418059 01925 414818 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) Southern Cross Care Management Limited Ann Woods Care Home 52 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (20), Old age, not falling within any other of places category (32), Physical disability (2) Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 52 service users to include:* Up to 32 service users in the category of OP (old age not falling within any other category). * Up to 2 service users in the category of PD (physical disability under the age of 65) to be accommodated within the beds registered for OP * Up to 20 service users in the DE (E) category (dementia over the age of 65) * Up to 2 service users in the category of DE (dementia under the age of 65) to be accommodated within the unit registered for DE (E) Date of last inspection 8th June 2006 Brief Description of the Service: Three Bridges is a care home providing nursing and personal care and accommodation for 54 older people, 20 of whom may have dementia. Three Bridges is located in the Latchford area of Warrington, close to a shops and pubs. It is a short bus ride from Warrington town centre. It was opened in 1989 and consists of a two-storey building with all resident accommodation on the ground floor. There is a separate unit for the residents with dementia. There are 52 single bedrooms and 1 double bedroom. Four of the bedrooms have en-suite facilities. The home has car parking to the front and a large garden to the sides and rear, which is easily accessible. Fees range from £326 to £670. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 4th and 8th May 2007 and lasted sixteen hours. A Regulatory Inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services provided. Questionnaires were provided for residents, families, and health and social care professionals to find out their views. During the visit various records and the premises were looked at. A number of residents and staff were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? Residents’ care plans included consistent information about them that reflected their needs and was reviewed regularly. Policies and procedures for managing medicines were followed and residents received their medicines safely. Residents personal monies were managed accounted and individually stored. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 6 The maintenance of the building and provision of safety equipment were maintained so residents’ safety was not placed at risk. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is gathered on residents’ needs prior to them moving in so their needs can be met. EVIDENCE: Three Bridges accommodates mainly people from the Warrington area and is welcoming to anyone from outside the area or with a disability, different ethnic or cultural needs or sexual orientation. Two files of residents who had recently moved into Three Bridges were examined. The residents had met with the manager or deputy manager and where possible discussed their needs and care prior to moving in. Information was gathered and this was recorded. This included information on their physical and mental health. Copies of these documents were on residents’ files. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 9 Copies of social workers assessments and care plans were on file with information from the NHS hospital or where the residents were living. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed records of care, liaison with health and social care professionals and good medicine management ensures residents’ health and welfare needs are met. EVIDENCE: The care files of three residents were examined. Each care plan had a pre admission assessment and an assessment by the social worker or nurse assessor. From looking at care plans, observing staff working practices and talking with residents, staff and visitors the health needs of residents were met. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 11 There were good examples of care plans in place that monitored residents’ health. Southern Cross Healthcare use standardised documents for recording information gathered on residents, which included a dementia assessment. Using this information staff had completed a plan of care before residents moved into Three Bridges in the form of a pre admission care plan. Care plans were individualised to each resident. The plans related to medical conditions and gave guidance to staff. There had been an overall improvement in care plans that reflected the involvement of families. There were good examples of staff monitoring residents health needs with monthly recording of their blood pressure and weight. Care plans demonstrated that identified risks were recorded in detail with risk assessments and risk management plans in place to monitor residents identified at risk of falling. The manager had notified the CSCI about a resident who had been aggressive to other residents. The resident had regularly been seen by his General Practitioner (GP) and aggressive behaviour linked to a medical problem. Staff were monitoring the resident’s condition and contacting the GP as necessary. Another resident’s care plan recorded how the residents was independent with help and described where the resident needed assistance with personal care and mobility. Another resident’s care plan had been renewed with the resident’s son who had provided some commonly used words in her first language for staff to use and recognise. The resident could use English and was encouraged to do so. Reviews of care plans were more detailed and recorded how progress was made in residents’ care. Staff had devised a communication chart for a resident to use. This was made up of a set of pictures the resident could recognise to make them self understood. A relative talked about the standard of care and medical care and said, “ My husband was diagnosed with dementia and had to be moved from another care home. I was advised to look at several but chose this one, as it was nice, comfortable and clean. It’s been a very good choice. He was poorly before he came here and staff was aware of that. Staff have been very good, as he needs them for everything. When he came here he was still not well so they got the GP out straight away. We were able to keep our own GP. He was not eating very well and the arranged for him to have supplementary drinks and puddings. They still encouraged him to eat but he wouldn’t so they got the GP back again and he had a chest infection. He was admitted to hospital. Hopefully he won’t be there long as he gets lots of individual time and care here and a very good standard of care. He’s always clean tidy and shaved so I want him back here. He’s got a lovely comfortable bedroom and bed with a special mattress and bed rails which I wanted to stop him falling out of bed”. Medicines management and administration was examined. No errors were noted on medicine administration records. A monitored dosage system was used throughout the care home. Stocks of medicines were replaced monthly. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 12 Receipts of monthly supplied medicines were recorded. Where medicines were supplied in original packages and not supplied each month the stocks of these were transferred from one month to the next so staff knew when to reorder medicines. Records were maintained for the destruction of medicines. Controlled drugs records were checked on each unit and no errors found. The manager and deputy audited medicines as part of the quality assurance system. They had identified some errors in the recording of the receipt of medicines and a staff meeting of the registered nurses arranged to discuss this. The manager demonstrated via the audit how random samples of residents’ medicines were looked at and errors easily identified. The home keeps a record on any drugs that were potentially open to abuse and a running total of these were recorded. Three Bridges Nursing & Residential Home DS0000005158.V333984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in making choices about their lifestyle so they have more control over their lives. EVIDENCE: Three Bridges employs an activities coordinator for 25 hours a week. She had commenced employment in December 2006 following the resignation of the previous coordinator. The activities coordinator was on duty during the site visit and was involved in activities. She did exercise to music sessions, a quiz, and coffee morning and opened the residents’ shop. There were activities outside of Three Bridges with photographs of residents attending a ball, musical evenings and films at other care homes in the Southern Cross Healthcare Group. Regular outings for meals and days out were arranged. Three Bridges shares a mini bus with another care home in Warrington. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 14 The activities coordinator had improved the level of activities available to residents, and monitoring visits from the operations manager made reference to this in her report when she visited in February 2007 residents were more satisfied with the level of activities available. A volunteer assisted the activities coordinator. The activities coordinator said she was responsible for planning activities and had changed the programme of activities, as some residents didn’t like them. She said she had attended a days training on chair based exercise and as a result of this residents were having regular exercise groups with her and a qualified instructor. She said she had training in dementia care, food hygiene, adult protection and moving and handling as part of her induction. She said she was still learning about her role but was part of a local group of activity organisers who got together with the dementia care advisor who advised on appropriate activities. She said, “When I first started I thought that I had to produce an end product with activities that you had something to show for it. Following the training I realised it was more about the taking part and the interaction. People may not be able to physically or psychologically do an activity which increases their frustration so you keep activities simple aimed at participation”. The activity coordinator kept records of what she did and what worked and what didn’t. The records reflected residents’ participation. The volunteer said that residents had made scones for the coffee morning and these were being sold at the shop based in the activities room. This was open to both residents and visitors. Residents said they had visited the shop to buy brick a brac. The volunteer said, “ My mother was a resident here, she was very well looked after. I can’t praise them enough and am the type of person who would say if I was not happy with something. I decided to be a volunteer after the support they gave me after mum died. The manager was really supportive you can approach her about anything. I enjoy working with the activities coordinator she a doer and the residents have really taken to her. You can see a big change. One of the residents who has lived here a long time was really reserved and he now joins in the activities and comes to the shop for a chat. She’s put life back into some people’s lives. She does a lot of one to one with residents and encouraged me to do so. I noticed a lady watching me knit with another resident and so I asked her if she wanted a go and she could crochet. We now do this with her regularly. The resident is much more confident”. There was a weekly newsletter that Three Bridges contributed to. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 15 A visitor said that she was actively encouraged to be involved in her mother’s care and said, “I’m taking her to hospital as I’ve been so involved in her care and like to know what’s going on. I give the information form hospital visits to staff and know it’s recorded. Staff know about her health, as she’s prone to infections. They keep me informed oh what’s going on with her. I attend the residents/relatives meetings and speak on behalf of mum as she can’t speak for herself. The meetings are really useful apart from the few who repeat the same old things but the number of the same old moans has gone down and down. You can say to or tell the manager a problem and be confident it will be acted on. You are always sure of a nice welcome”. Breakfast and lunch were seen being served. Residents had the choice of a cooked breakfast or lighter option. Residents were able to choose their meals. Menus were on display to inform residents of the alternative choice. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are acted on to demonstrate they are taken seriously. An informed staff group and manager protect residents from abuse. EVIDENCE: There were three recorded complaints since the last site visit. One complainant contacted the CSCI and the complaints were sent for the provider to investigate. A suitable resolution was reached. Another complaint was dealt with under the local council adult protection procedure and Three Bridges cooperated with this and the local council did not uphold the complaint. A further complaint was made about the limited choice of activities. This was investigated by the provider and agreed with. The employment of a new activities coordinator and monitoring visits by the operations manager noted an improvement in the activities provided. The staff training programme on adult abuse and protection of vulnerable adults was ongoing with dates planned throughout 2007. Two protection of vulnerable adults referral involving Three Bridges were made since the last site visit. Three Bridges cooperated with the local council on these and were found not to be at fault on both occasions. Three Bridges Nursing & Residential Home DS0000005158.V333984.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and well-maintained environment, which is equipped to meet their needs. EVIDENCE: On the dementia care unit the former office has been made into a reminiscence kitchen to enable residents to eat in and use this room when supervised by staff or relatives. It had been equipped with period furniture and an electric cooker, which was not connected. A number of maintenance issues identified at the last site visit on the dementia care unit had been attended to as required. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 18 The handyman had redecorated some bedrooms and matching curtains, bedding and lighting provided to match the colours. These were used as show rooms as they were unoccupied. The existing built in furniture detracted from the décor as it was chipped around the edges in places. Three Bridges Nursing & Residential Home DS0000005158.V333984.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are adequate to meet residents’ needs. Staff recruitment ensures that residents are protected. The induction and training programme provides a skilled workforce that protects residents’ welfare. EVIDENCE: Staffing levels were appropriate and the manager confirmed that staffing numbers were determined by the dependency of residents and could change. Each unit had an appropriate mix of qualified and unqualified staff. The registered nurses on each unit were experienced in the care of the residents for that unit. The pre inspection questionnaire returned prior to the site visit recorded that two of the twenty-one care staff employed had an NVQ level 2 qualification. Three records of recently employed staff were examined. Staff had commenced employment and had been supervised through an induction programme, which included training on the protection of vulnerable adults. All contained appropriate identification documentation and completed POVA First and Criminal Record Bureau disclosures. All files had two written references. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 20 Files contained copies of the induction programme. The personal identification numbers of registered nurses were checked with the Nursing and Midwifery Council. Staff completed the induction programme supervised by the deputy manager or registered nurse. The induction programme was discussed with staff. A staff spoken to had her induction programme with her. She said, “ It’s only my second week here and I’m still on my induction. I complete this when I’m on duty with the deputy manager. On my first two days I shadowed the experienced staff and they have been very supportive. I can ask questions I’m not sure about and have a staff handbook. I am currently doing my NVQ level three and the deputy manager has said I’ll be starting the Yesterday, Today, Tomorrow training on dementia care. I’ve not worked with people with dementia before but staff said it would really benefit me. So far it’s been great and I’ve just completed my food hygiene certificate. I’ve settled in really quickly and can’t believe it’s only been two weeks”. Staff had been provided with and had completed a variety of training. This included: care planning and documentation, health and safety, CoSHH, infection control, Yesterday, Today, Tomorrow form the Alzheimer’s Society, food awareness, fire, and moving and handling as some examples. Training was planned to be repeated for mandatory training and communication skills and challenging behaviour. A training plan for 2007 was completed. Three Bridges Nursing & Residential Home DS0000005158.V333984.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust quality assurance systems, financial procedures and maintenance of the building and equipment safeguards residents and ensure they are safe. EVIDENCE: The home manager has been in post for four years. She is a registered general nurse and has the registered manager award. The deputy manager was a registered mental nurse and advised on the care in the dementia care unit. In addition a full time administrator supported the management team. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 22 A social care professional said of the improvements made at Three Bridges, “I have recently attended reviews of residents’ care. It had been some time since I had been there and was very impressed with the knowledge of staff about residents and the manager had really turned the place around”. There were residents/relatives meetings held at least twice a year. The last meeting took place in January 2007. Heads of department and staff meetings were held at least monthly and included catering and housekeeping. The manager and deputy were responsible for audits that complimented the quality assurance system. Each month they randomly completed an audit of a small number of care plans and medicine administration records of individual residents. The audits identified errors in the writing and recording of both care plans and medicine administration records. Medicine administration audits identified errors and how these would be addressed, or if the matters were discussed with individual staff during supervision. The care plan audits seen identified a number of errors, which had been addressed. As part of the quality assurance system there were audits of accidents, equipment, water temperatures, the building, staffing, sickness, cleanliness and health and safety as some examples. The operations manager then audits the care home each month using the original information gathered by the manager. No personal monies other than personal allowances were held on behalf of residents. Relatives were billed directly for additional services such as chiropody or hairdressing. Residents’ personal allowances were safely secured and records for credits and debits maintained. Information provided by the provider in a pre inspection questionnaire and records held on site were examined. All the required maintenance and health and safety checks of the building and equipment had been completed. Three Bridges Nursing & Residential Home DS0000005158.V333984.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X 3 X X 3 Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP28 Good Practice Recommendations Further opportunities should be provided to ensure staff has access to NVQ training so a skilled workforce cares for residents. Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Three Bridges Nursing & Residential Home DS0000005158.V333984.R01.S.doc Version 5.2 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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