Inspection on 27/10/05 for Woodland Care Home

This inspection was carried out on 27th October 2005.

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

Woodland Care Home 05/06/07

Woodland Care Home 12/06/06

Woodland Care Home 28/04/05

Woodland Care Home 30/09/04

Woodland Care Home 01/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Woodland Care Home 189 Woodland Road Hellesdon Norwich NR6 5RQ Lead Inspector Susan Golphin Unannounced 27 October 2005 th 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. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodland Care Home Address 189 Woodland Road, Hellesdon, Norwich. Norfolk. NR6 5RQ. 01603 787821 01603 403874 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) Alphacare Services (UK) Ltd Mrs Jane Bunyan Care Home 46 Category(ies) of Older people, not falling into any other category registration, with number (46) of places Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Forty-six (46) Older People may be accommodated. Date of last inspection 28th May 2005 Brief Description of the Service: Woodland Nursing Home is situated in the residential area of Hellesdon. Purpose built in 1990 the accommodation is on the ground and first floors comprising of eighteen single rooms with en-suite facilities a further four single rooms with en-suite bathrooms, and 12 double rooms. There are five communal lounges, which are within easy access of service users own rooms. The home also offers a range of adaptations and aids to promote mobility and independence. The grounds are accessible by wheelchair users and there are car parking facilities to the front and side of the premises. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine inspection was announced, and took place between 9.15am and 5.30pm. A short tour of the premises was undertaken whilst making contact with resident’s staff and visitors. The inspection was carried out with Jane Bunyan, registered manager. Three comment cards from other health care professional were received and two from residents. All the comments were positive and expressed satisfaction with the service. During the visit the inspector met with five residents and also visited a small group of residents whilst engaged in one of the social activities. Three care staff and the housekeeper and three visitors also gave their views. All the comments have been incorporated into the report, with the exception of personal or individual references made and these have been passed to the management for their attention. The management of the home are currently dealing with two complaints received recently which have been referred to the CSCI. Initial investigations by the home have been instigated. The requirements made at the previous inspection have been met or acknowledged as work in progress as with the NVQ training programme for staff. Feedback was given to the manager and the nurse care manager Mrs Yvonne Delph, and Kumar Patel one of the directors for Alpha Care Services (UK) Ltd., at the end of the inspection. What the service does well: Residents and visitors and relatives seen on the day say that the home meets their needs and that they are satisfied with the service provided, and were complimentary about members of staff and the support given. On the day of the inspection nursing members of the staff team were observed supporting the relatives of a resident who remains critically ill. One resident recently admitted to the home said, they have made me very comfortable and staff are very helpful, and I know I have made the right decision. Another resident said that whilst they would prefer to be in their own home and not have to be dependent on others to meet their personal needs – the home and staff do a good job and are kind. One relative said that they are very happy with the service and facilities, adding that they feel able to make a fair comparison as they have prior experience of other homes. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 6 What has improved since the last inspection? Since the last inspection the management have reviewed the nurse care practices and routines providing better staffing levels at key times of the day. This has included changes to meal times and staff breaks. An additional person has been allocated to assist nursing and care staff with helping residents to eat or where they may need feeding. The changes have provided better supervision and more time. • One of the immediate outcomes of the current complaint investigation has been the development of a separate information document which relates directly to the use of the ‘transitional’ beds in the home. The information is being offered to all prospective residents or their relatives and placing agencies and gives specific details about the protocol in place for the transitional bed service. • The annual customer survey was carried out in September 2005 and forty six questionnaires were issued to residents relatives and other healthcare professionals. Seventeen were returned. The information has been collated and the results displayed in the home. The overall outcome is positive and constructive criticism has been acknowledged and response made in the action plan document. Both the outcome of the survey and the action plan will be distributed before the end of the year. • NVQ training opportunities are continuing to be offered to staff including NVQ assessors course. • A new alarm / call bell system has been installed. Additional longer leads have also been ordered. The site of the call bell in the communal rooms is also under review to promote better access. Pendant alarms or hand held alarms that are compatible with the newly installed system are to be considered. • A new portable assisted bath hoist has been ordered to reduce the waiting time for residents who wish to use the traditional bath – this is one of the actions arising from the survey outcome. • Changes to the care planning process have also been introduced to improve the way in which information can be quickly retrieved from daily records. • The manager has revised the way daily care records are maintained and the system now evaluates the agreed plan to ensure it is in place and being met rather than brief and sometimes repetitive statements being made about the residents. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 7 What they could do better: The management are continuing to review the service to promote improved service. It is acknowledged that there are areas of specialist training which need to be made available to all staff including :• Dementia training and managing residents who present challenging behaviours. • First Aid • POVA training at all levels – manager has completed trainer courses and is cascading information. Updated training and new initiatives in the following :• Wound care • Tissue viability • Peg feeding management /training. • Pressure area care. • • • • Basic food hygiene Further NVQ training at levels 2 and 3. Continue to monitor the response time to call bells and assess the process used to prioritise the urgency of calls. Continue to assess the way in which staff supervise and monitor residents who are unable to use the call bell system. The home provides care and nursing in seven transitional beds. The level of staff input and care service depends on the needs of the residents /patients being accommodated at the time and their assessed health care needs- which can be complex and wide ranging. At the last inspection it was agreed that the management would review the current provision to ensure that the expectations and outcomes of this part of the service are clear and robust. Also for the need to explore the merits of managing this resource separately so that it does not impinge on the care input of long term residents and meets the transitional needs of residents waiting for more permanent placements. 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. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 Information about the services and facilities is available which enables prospective residents and their representatives to make an informed choice about where to live. There is a clear assessment process in place which gives a good account of each residents health care needs. EVIDENCE: The manager has recently devised an additional booklet in conjunction with the service users guide and the statement of purpose. The document relates directly to the transitional bed service and has been drawn up as a direct outcome of two complaints currently being jointly investigated by the registered providers and CSCI which relate to care and service input to residents in the transitional beds or receiving respite care. It is hoped that the additional booklet will clarify and provide better explanation of the service. All prospective residents and their representatives are encouraged to visit the home prior to any placement being agreed or admission made. The manager is also maintaining an enquiries diary so that the visits and views expressed at Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 10 the initial visits can be recorded and in the event of queries made about visits or requests for further information. Staff can use the diary entries and observations about the pre admission visit as a reference point in the event of any query. Five residents care plans were seen on the day of the inspection. Each related to the residents interviewed and where possible linked with the key carer or named nurse. Each plan of care had a completed needs assessment in place, and how the care needs will be met. This includes manual handling risk assessment and any special care notes. Staff can access the information easily and confirmed that they refer to the information as needed. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 10, 11 There is a care planning process in place which provides staff with the information needed to meet healthcare needs of residents, including specialist and clinical nursing support. Personal support in this home is offered in a positive way, upholds resident’s privacy and dignity and encourages and promotes independence. The emotional needs of relatives and families of residents during the end of life stages are well supported and demonstrated by staff. EVIDENCE: As stated in the summary the manager is revising the way in which care plans are being used by staff. It has been acknowledged that the current way of accessing information for the review process or simply to assess the standard of care over a period of time can be a lengthy process. The manager is currently experimenting with a new style of recording for the home whereby the agreed care plan for each resident is continuously evaluated each day to ensure it is being met Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 12 appropriately. Trained nursing staff monitor and maintain the clinical care records, and are responsible for the weekly audit. Accountability for meeting resident’s care routines is under review and being discussed with the nursing staff and carers and to reiterate that staff input and practice must remain resident focused. The manager is looking at ways in which care staff will also contribute to the daily reporting as care tasks are performed or routine care applied the relevant member of staff will record their action and assessment of the care and also record any response from resident. ( see recommendation) During the discussions with residents, family members and visitors good practice examples were given including examples of personal kindness and support. During the discussions with staff they were able to give good examples of practice and routines and demonstrated an understanding of individual care needs and preferences. During the course of the day both the care and nursing staff were observed dealing discreetly and sympathetically with members of the family of a resident who is critically ill. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The meals in this home are good offering both choice and variety and also catering for special dietary needs. EVIDENCE: As stated in the summary changes have been made to the way meals are served and supervised. The changes have been made to ensure residents who have to be fed or need help with eating get the appropriate assistance from staff. Slight adjustments have been made to resident’s meal times and also to the established break times for staff. The routines in place now ensure that all the staff on duty are available to assist at meal times and immediately afterwards to ensure residents are comfortable, and personal needs have been met. There is a four week menu in place and staff also remind residents each day about meal choices and options. One resident said the food is lovely and well cooked and always plenty of it. Another resident said that she gets offered far too much food, and would like less. This information was passed on to the staff for them to action. The catering staff do discuss dietary needs with residents and relevant details are recorded both in the plan of care and in the kitchen. The menu states a main meat or fish dish of the day and in addition offers a daily choice of cold meats, salads or omelettes. The meals served on the day of the inspection looked appetising and well presented. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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 There is a satisfactory complaints process in place with evidence that any complaints made by or on behalf of residents are listened to and acted on. Arrangements for the protection of vulnerable residents are in place. There is evidence to show that staff knowledge and understanding of adult protection is growing and being maintained. EVIDENCE: Since the last inspection there have been two complaints brought to the attention of the management which relate to the care and support of two residents admitted to the home for short periods of time. Some aspects of the complaints have been addressed to the satisfaction of the complainant. Both complaints have been referred to the CSCI for review and further investigation. During the investigation of the complaints the management of the home have taken the opportunity to review some of the routine care practices and nursing input and especially the supervision of meals and the monitoring of residents with special dietary needs. They are also introducing a more detailed information folder for residents admitted into the transitional beds, so that an appropriate placement can be reasonably assured and an informed choice made about the placement based on clear information about the service. In addition the manager has introduced a diary where all referrals and enquiries and information relating to prospective residents for transitional beds; their representatives; and social work contact if there is one, will be recorded so that staff can access accurate information more easily. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 15 The manager is also looking at ways in which visitors and relatives can be encouraged to address any concerns they have directly with staff at the time of their visit or request a member of staff to telephone them or arrange a meeting so that matters can be dealt with quickly and directly. During the discussions the management acknowledged that they are taking the complaints seriously and although the complaint investigations have yet to be concluded, they are reviewing practice and routines and making changes that will ensure the focus of care is on the residents. Staff confirmed that they have received in-house training about protecting vulnerable people. The manager has attended a course on ‘training the trainers’ and is developing an information /guidance pack for the staff group. Training sessions on adult abuse awareness, understanding dementia and managing challenging behaviour are planned for this year. ( see requirement) Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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) 21.22,26 The overall standard of the premises is good and provides a well maintained environment for residents. EVIDENCE: The inspector was advised that there are plans in place to replace /upgrade the kitchen areas in the home. The installation will take place within the next three months. All the residents require assistance to bathe, and the home have a small range of aids which can be used with conventional baths. Currently the home have only one portable bath chair hoist and two bath slings in use. A second chair hoist is being sought in addition to the other bath aids. ( see recommendation). A new call bell system has been installed throughout the home, and is fully functional. Additional extension leads have been ordered so that residents can access the call bell from their bed or chair. It was acknowledged that the management need to review the positioning of the call bell in each of the communal rooms to ensure it can be accessed by all residents. Consideration Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 17 should be given to the use of pendant or hand held alarms which are compatible with the newly installed system. ( see requirement). Not all areas of the premises were inspected on this occasion. A small number of residents rooms and communal areas were seen whilst talking to residents and staff and visitors, The areas seen were clean and well maintained. During the discussion with the housekeeper it was confirmed that the domestic and laundry staff have appropriate equipment and materials to appropriately maintain the furnishings and fabric of the premises. Arrangements are in place for the management of, and safe disposal of continence materials and medical waste. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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) 27,28,30 Progress continues to be made to promote the stability and skill mix and training of the staff group to maintain the consistency of care in the home. EVIDENCE: The staffing rota reflected the numbers of staff on duty and the minimum standards to meet residents care needs. As previously stated in the summary of the report, changes to the routines and practices have been made to ensure that staffing levels are at their highest during key times of the day such as mealtimes and when individual residents require assistance to eat and drink. The changes have also been made as a direct outcome of some of the comments made in the annual survey about the response time to call bells, especially at crucial times of the day. Residents were very positive about the input from the staff, but acknowledged that the response time to call bells differed widely and can be a problem. The initial changes to practice and routine are relatively recent and will be reassessed over the coming months. The manager is also continuing to look at ways in which the unpredictable demands of the transitional bed unit can continue to be safely met without detracting from the care needs of the long term residents in the home.( see recommendation). Mandatory training is in place and staff interviewed confirmed that they have attended sessions on moving and handling; basic food hygiene (22 staff); fire training procedures (42 staff) risk assessment (11staff); this course was held in house but verified by an external assessor. Study sessions on managing Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 19 continence, and all the domestic staff are currently undertaking NVQ1 whilst the housekeeper is undertaking NVQ2. The manager is also using the induction and foundation trainee handbook from TOPSS for newly appointed care staff. More recently the staff have also been shown a ‘customer care’ video to promote good relationships with visitors, relatives and other outside agencies. One of the company employees has recently become a first aid trainer and is undertaking sessions in each of the company’s homes, although the arrangements for each session have yet to be made. Two care staff are undertaking NVQ2 and one carer is currently undertaking the NVQ assessors course D32 33. One of the care staff confirmed that they hope to follow on their NVQ2 course with the NVQ3 training next year. As previously stated in the report ( standard 18) training opportunities relating to the protection of vulnerable adults and adult abuse awareness is being led by the manager who has completed trainer sessions and has produced a written guide and work book for all staff. However there is a need for staff to be offered training in the management of challenging behaviour and understanding dementia . During the discussions it was acknowledged that the nursing staff also need to update their knowledge in respect of new initiatives and clinical practice and should include : Wound care and pressure area management. Tissue viability. Nutritional screening and promotion Peg feeding – updates on management and care, including administration of medication. ( see requirement) Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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) 35,38 The policies and procedures in place ensure that resident’s financial interests are safeguarded and also promote the safety and protection of residents and staff. EVIDENCE: The annual customer survey for the home was carried out in September this year and the results and outcomes have been collated and an action plan is being implemented. Sixteen of the forty three sent out were returned. The overall results are positive. Negative comments have been addressed and incorporated into the action plan. The results have been displayed and the action plan is available to residents and staff and visitors on request. Consideration is being given to the outcome of the survey being made available to other healthcare professionals and placing agencies. The manager has responsibility for a small number of resident’s personal allowances. A separate ledger is kept and each person’s financial monies and details are maintained separately. A record is kept of income, expenditure and Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 21 receipts obtained for any purchases made on resident’s behalf. The accounts held are audited by the nurse care manager as part of the regulation 26 visits and report on the home. The inspector randomly inspected a sample of the accounts, the information held was up to date and reconciled with the cash held. Three of the accounts are also audited by representatives of the SSD for Norfolk County Council. A sample of maintenance records were seen on the day and all were up to date and well kept and included ; Water management certificates. Fire prevention equipment maintenance certificates. Hoists and lift maintenance. Fire alarm service. Electrical testing. Insurance policy. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x 3 2 x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x 3 x x 3 Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 22(8) Regulation 23 Requirement The registered providers should continue to review the accessibility of the call bell in the communal areas and find ways in which residents can use the system independently. The registered providers should continue to promote and provide NVQ opportunities for all care staff. The registered providers should implement a training programme for the staff and should include specialist training for both care and nursing staff Timescale for action immediate and by 31 December 2005 immediate and ongoing immediate and by March 31st 2005. 2. 28 18 3. 30 18 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 21 Good Practice Recommendations It is recommended that the registered providers continue with the plan to acquire another suitable bath aid or chair to extend the choice and range of bathing facilities to residents. It is recommended that the management continue to review the care planning process and recording systems to I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 24 2. 7 Woodland Care Home 3. 27 achieve a robust process that will provide clear direction and information about the health and welfare of residents. It is recommended that the management continue to monitor the recent changes in care practice and routines to ensure that there are sufficient numbers of staff on duty at key times of the day and are avialable to supervisie and support staff with designated care tasks and meals. Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).doc Version 1.40 Page 25 Commission for Social Care Inspection 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 Woodland Care Home I55 s44375 Woodland v248135 UN 271005(4).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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!