Inspection on 04/04/05 for Woodside

This inspection was carried out on 4th April 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodside 10/04/07

Woodside 02/11/06

Woodside 18/07/06

Woodside 16/09/05

Woodside 14/09/04

Woodside 01/06/04

Woodside 15/03/04

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 Woodside The Old Vicarage Slip End Nr Luton LU1 4BJ Lead Inspector Leonorah Milton Unannounced 4th April 2005 09:00 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. Woodside Version 1.10 Page 3 SERVICE INFORMATION Name of service Woodside Address The Old Vicarage Slip End Nr Luton Beds LU1 4BJ 01582 423646 01582 423646 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) Shires Healthcare (Woodside) Ltd Janet Mary Cox Care Home 28 Category(ies) of OP Old Age - 28 registration, with number PD(E) Physical Disability - 28 of places DE(E) Dementa over 65 - 28 Woodside Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/16.09.04 Brief Description of the Service: Woodside was a privately owned care home. It was registered to provide for twenty-eight older people who may also have physical disabilities and/or dementia. The registered providers were Shires Healthcare (Woodside)Ltd. Mrs V Khan was the sole director and the responsible person. Mr Peter Hodges had managed the home since December 2004. His application to register as the manager was being processed by the CSCI as this inspection progressed. The home was located in a rural area at the edge of a village. Public transport was limited but access to the M1 and Luton were nearby. The premises had been suitably adapted to meet the service users’ assessed needs at this inspection with the exception of access to ensuite toilet facilities, which was limited in most instances and suitable only for those without mobility problems. Single room accommodation was provided. Twenty-one of these had en-suite toilet facilities. A lift enabled service users to access the second floor. The third floor was used as a laundry and storage area and was not accessible to service users. It had also been used for staff accomodation. This arrangement had not been agreed with the regulating authority. There was a large garden to the front of the house. This inspection identified significant shortfalls in the staffing arrangements and the documentation to evidence practice. Woodside Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days and took 14.5 hours in total. The manager was present for some of the first day of the inspection and throughout the second day. Feedback was given as the inspection progressed and in a summary at the end of both days. The inspection comprised a tour of the premises, which included a random selection of bedrooms on all floors, a random selection of toilet and bathing facilities, the two offices, the laundry facilities and the communal sitting and dining rooms; conversations with five service users, three relatives of service users, a district nurse, the manager and a telephone conversation with a social worker who had placed two service users in the home. Documents reviewed at this inspection included the case files of three service users and two others in relation to recent complaints. Records to evidence the care of these five individuals and in relation to staffing arrangements were also assessed. The inspection showed that whilst the new manager had instigated change for the better through the introduction of improved systems to consult with service users and to record their needs, there were examples where service users and their families had not received an acceptable level of service. What the service does well: What has improved since the last inspection? A visiting healthcare professional stated that there had been a recent improvement in the organisation of the home. The introduction of a scheduled and organised programme for activities for diversion and entertainment had increased the opportunities for service users to take part in stimulating exercises. However, a service user and a visitor commented that at other times there was little to do and that it was not possible to engage the staff in an interesting conversation. A service user and staff commented that maintenance issues had been dealt with more speedily. Woodside Version 1.10 Page 6 What they could do better: The overriding concerns arising from this inspection were about the ability of the care staff to carry out their roles and the attitude of some members of the team towards their responsibilities. The commitment of the manager was without doubt, but it was evident that he had been hindered in his aims to improve the service by the lack of a skilled senior team to support him and the lack of awareness amongst the care team about their responsibilities and accountability. The manager’s efforts and also those of some staff were commendable but the inconsistency in the team was illustrated by the varying comments from those who contributed to this inspection. Remarks about the staff included, “Good, helpful, unhelpful, kind, lazy, abrupt, caring, uncaring, unconcerned, poor listeners, poor communicators”. The contributions of visitors and service users indicated that there was insufficient leadership for the staff during the manager’s absence. This was summed up by the comment, “When the cat’s away…” Concerns were also expressed about the ability of a few members of the team to converse in English. The lack of skill and awareness of staff had meant that records to show how service users had been cared for had been poorly maintained and did not accurately shown significant changes to service users’ welfare including bereavement, terminal illness and the circumstances preceding a service user’s death. The administration of medicines at the first visit was unsafe and poorly recorded at the second. The failure to carry out sufficient checks required for the protection of vulnerable service users about temporary staff who had lived and worked at the home raised concerns about the fitness of the organisation to operate a care home. The prolonged inconsistency of the management of the home noted at previous inspections, was still evident at this inspection. The manager had resigned his post by the second visit. His resignation was the third by a manager in under a year. This, when coupled with the loss of several experienced members of the senior team during the previous year, showed that there were problems with the retention of staff. The future leadership of the home was uncertain. The concerns about so many aspects of the service were such that the proprietor and the manager were asked to attend a meeting with the CSCI to explain how the staff would be given sufficient guidance, support and if Woodside Version 1.10 Page 7 necessary subject to disciplinary action to enable the team to properly care for service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodside Version 1.10 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 Woodside Version 1.10 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) 1,2,3,4. Information available in the home to service users and their representatives, but did not present a complete and accurate picture to enable them to make an informed choice about their admission to the home. Recent contractual arrangements did not provide service users with sufficient information about the service and their individual fees. The ability of the team to properly care for service users was questionable. EVIDENCE: The statement of purpose and other guidance advertised on the notice board provided a detailed description of the service provision. However,it was noted that it did not include a copy of the last inspection report to enable service users , their representatives and other stake holders to be informed about the regulators most recent opinion. Contractual arrangements in some instances were only with funding authorities. Whilst there was evidence that service users’ representaives had agreed these contracts, the documents were insufficiently detailed and did not include information in relation to fees or rooms to be occupied. A revised pre-admission document that included the details specified by the standard had been introduced. Records assessed showed that notes made on Woodside Version 1.10 Page 10 this document were a little brief and several sections had been omitted. Conversation with a service user showed that some aspects of his personal needs had not been fully documented but that staff had taken these into account during the delivery of care. There was no assessment in place for a service user admitted with a terminal illness. The ability of the team to understand and meet service users’ needs remained questionable. Poor record keeping, the opinions of three visitors and two service users about the language difficulties of some staff and the lack of understanding about safe medication procedures demonstrated a shortfall in the overall skill in the team. Woodside Version 1.10 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9. It was difficult to assess the overall arrangements to meet health, personal and social because the care planning documentation was under review and inconsistent in some areas. Medication procedures observed at this inspection were hazardous and had placed the service users at considerable risk of overdose. EVIDENCE: Although the new care planning documentation had provided a clearer guide to how service users’ assessed needs would be met, it had only been introduced for a few service users. The plans were an improvement on previous documents. However at this inspection because plans in place before the appointment of the current manager had not been reviewed and updated as required in all instances, there was some reliance on staff’s knowledge of service users’ needs rather than comprehensive updated written records. It was also evident that the new manager had encouraged the participation of service users’ families in the review processes to re-establish updated care plans. Woodside Version 1.10 Page 12 Although daily progress records had noted interventions in relation to healthcare needs, there were no sequential records for audit purposes on the case files assessed, to identify that routine treatments, such as chiropody and optical care, had been arranged. Whilst it was evident from records of charges that chiropody appointments had been arranged, there must be an individual record of such appointments on each service user’s file. Assessments and consequent care plans assessed at this inspection did not fully document service users’ needs as detailed by the standard and the arrangements to meet them. There was evident inconsistency between the manager’s opinion about care needs and the actions of staff to meet them. An example of this was the provision of continence materials at night for a service user who was described by the manager as not in need of such products. This was concerning because the introduction of continence pads rather than assistance to access the toilet could lead to the loss of usual continence. The behaviours of one service user were concerning as records noted nocturnal wanderings, the development of aggressive behaviours and a pattern of sleeping all day. The manager was advised to consult with appropriate healthcare professionals in relation to dementia related behaviours and to seek support for a programme to introduce a more usual day-to-day lifestyle. There were failures to accurately record the decline in a service user’s health and to record the events during the night when a service user had died. There was considerable delay during the manager’s absence on the first day of this inspection to administer the morning medication within prescribed timescales. The administration eventually finished at 11.30 hours. Given that some medicines were scheduled for a second dose with lunch there was insufficient evidence to show that there had been a safe interval between doses. It was not possible to assess how the delay in receiving medicines had affected those who required medication for pain relief, treatment for Parkinsons Disease and other medical conditions. The records did not indicate the delay in the administration of the medication. Records for the administration of medicines that had been handwritten rather than pre-printed had not included the date, so that it was not possible to assess current and previous records for accuracy. Whilst there were some improvements at the second visit, several records for the administration of medicines had not been signed as given during the preceding 24 hour period. Woodside Version 1.10 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 There had been an improvement in the arrangements to provide activities for diversion and stimulation. It was unfortunate at this inspection, as had been seen at the previous inspection, that unexpected staffing shortages had lead to an upset in the daily routines. EVIDENCE: A programme of daily activities was advertised and established as part of the routine on most days. Service users spoken to stated that activities were available and had provided enjoyable and interesting pastimes. Three service users stated that they did not wish to participate. A smaller lounge was available to those who preferred a quieter lifestyle. Two visitors remarked that they had rarely witnessed any activities. It was concerning that two service users commented on the lack of stimulating conversation with staff. It was unclear whether this was due to the pressure of work or because of communication problems between service users and staff. Some service users had some hearing loss and had difficulty in understanding the pronounced accents of several members of staff from overseas. A visitor stated that she had been unable to make herself understood by the foreign national who had shown her to her relative’s bedroom. Woodside Version 1.10 Page 14 A notice advertised that information was available in relation to advocacy services. Individual belongings created a personal and unique appearance to many bedrooms. Restrictions to liberty such as the ability to hold keys to bedrooms, manage personal monies or to hold cigarettes had not been subject to risk assessment or noted on care plans. Woodside Version 1.10 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staff turnover had resulted in a lessening in the awareness amongst the team about situations that could lead to the development of abusive practice. A lack of awareness about concerns that should be treated as complaints had resulted in a failure to properly address issues. EVIDENCE: Several members of staff had left since the previous inspection. More recent employees had not received training to recognise and prevent the development of institutional abuse. Recruitment records assessed at this inspection showed that insufficient checks had been carried out to establish identity or to verify reasons for gaps in employment history. It was most concerning that there were no personnel records on site in relation to agency personnel who until recently had lived and worked at the home. There had been a failure to recognise that concerns expressed by relatives recently about the care of two service users were of a serious nature and must be reviewed in accordance with the home’s complaints procedure. Allegations investigated as this inspection progressed, substantiated that the wishes of a service users’ family had not been followed at her death. Woodside Version 1.10 Page 16 The records of an internal investigation about allegations that staff had shouted and refused to help a service user during the night had not been properly carried out or recorded as a complaint. The proprietor must ensure that the home’s complaints and protection procedures, including robust recruitment procedures are followed. Woodside Version 1.10 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24,25,26. The environment was in the main suitable to provide for frail older people. EVIDENCE: Two service users stated that they were satisfied with the comfort of their bedrooms. Two service users had been enabled to keep pets in their rooms. Appropriate measures were in place to prevent the spread of infection in the kitchen where a new dishwasher had been installed and in the laundry where a new washing machine with sluicing facility had been fitted. The home had previously had a prolonged history of heating problems and unregulated hot water supplies. The proprietor had reported that these problems had been actioned. No further problems with these systems were detected at this inspection although the manager stated that there had been a need to use freestanding heaters during the winter. Even though risk assessments had been carried out on the use of the heaters, the proprietor Woodside Version 1.10 Page 18 must ensure that the integral heating systems are sufficient before the onset of colder weather. The shaft lift had broken down twice in the last two months. The replacement of the door of this lift must be authorised to ensure that it remains fit for purpose. Woodside Version 1.10 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. The attitude and the skills of some members of the team had let down others who had worked well. Insufficient contingency planning to overcome staff shortages at short notice had resulted in inadequate numbers of personnel on the day of the inspection to properly care for service users. Recruitment practices as illustrated in a previous section of this report were not sufficiently robust to offer protection to people living in the home. EVIDENCE: The morning routines as the first day of this inspection commenced were somewhat chaotic during the absence of the manager, who was at college. There was no provision for the duty senior to call on additional personnel when others on the payroll were unavailable. A notice on the rota prohibited the use of agency personnel. A health care professional commented on the improvement in the organisation of the home since the appointment of the manager but stated that service users continued to complain for overlong waits for attention from personnel. One service user commented that some staff were reluctant to answer call bells and worked less readily during the absence of the manager. Another commented that night staff responded quickly to calls for assistance and described all staff as helpful and kind. Two other service users also remarked on the kindness and attention of staff. Woodside Version 1.10 Page 20 The turnover and relative inexperience of the team was reflected in their nervousness and lack of confidence during the inspection process even though the manager had posted a note about the need to co-operate with inspectors. There was an evident need for the appointment of a deputy to support the manager and oversee the direction of the care team. An appointment to this position was long overdue. The manager stated that recruitment procedures were almost complete for a candidate for this role. Direction of staff was heavily reliant on written communication and instruction including a bathing list to ensure that service users’ hygiene needs were met. Communication difficulties have been mentioned elsewhere in this report. A carer was overheard to be quite abrupt with two service users. The manager explained that this was an aspect of the carer’s accent and speech patterns that were not unusual in people of her nationality. The service users could not be expected to be familiar with the customs of others’ cultures or indeed to tolerate them in this guise. Staff must receive instruction on conduct including mode of speech. The proprietor must ensure that previous requirements in relation to staffing arrangements are actioned and continue to be met by the new manager. Woodside Version 1.10 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37,38 The management of the home was inadequate because the manager had not received sufficient guidance from the proprietor or the full support of staff. As a consequence some of the measures he had introduced to improve the service had not been effective. This resulted in failures to ensure that each service user had been properly cared for. EVIDENCE: Documentation and systems for consultation had improved under the new manager but the sheer volume of work required to improve the service as illustrated throughout this report was more than one person could be expected to tackle without the assistance of an experienced senior team. Woodside Version 1.10 Page 22 Regulation 26 records did not identify that the proprietor had many concerns about the conduct of the home. Inaccurate record keeping was most concerning. There had been a failure to record anything about the death of a service user. Another record showed a service user to be “very weak” and also “fine” in the same entry. Poor record keeping had resulted in considerable distress to a family in relation to a delay to inform them about the death of their Mother. Requirements outstanding from the previous report have been carried forward to give the proprietor the opportunity of providing the CSCI with an action plan. The CSCI’s concerns about the continuing deterioration in the service provision were such that any further failure to take action on requirements will result in a review of the organisation’s fitness to operate a care home. Woodside Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 1 1 N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 N/A 14 2 15 N/A COMPLAINTS AND PROTECTION 3 3 3 N/A 3 2 2 N/A STAFFING Standard No Score 27 1 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 N/A 1 2 2 1 N/A 3 2 1 2 Woodside Version 1.10 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1,2 Regulation 4(1)(2) Schedule 1, 5(1)(2)(3) 6(a)(b). 14(2)(a) (b) Requirement Service users must be provided with accurate information as specified by these standards and the legislation to enable them to make an informed choice about their decision to move into the home. Service users must not be accomodated in the home unless an assessment of need has been carried out by a suitablely qualified person. Assessments must take account of the details specified by this standard. Formal review procedures after trial periods must be introduced for all service users. (previous timescales of31.07.04 and 31.12.04 had not been met). More specific detail about capabilities and personal preferences must be included in plans of care and record service users’ agreements to their plans of care. This must include wishes for last rites (Previous timescales of 31.08.04 and 30.11.04 had not been met). Care plans must be updated as needs change. Consultations with appropriate Version 1.10 Timescale for action 30.06.05 2. 3 25.05.05 3. 5 14(2)(a) (b) 30.07.05 4. 7 15(1)(2) 31.07.05. 5. 6. 7 8 15(2)(b) 13(1)(b) 25.05.05. 30.06.05 Page 25 Woodside 7. 9 13(2) 8. 16 22(3)(4) 9. 18 19(1)(a)( b) Schedule 2 10. 25 23(2)(p) 11. 27 18(1)(a) 12. 27 18(1)(a) healthcare professionals must be arranged for assessment of service users with continence or behavoural problems. Medicines must be stored safely, administrated as prescribed and accurately recorded on receipt, disposal and at the time of administration. Issues of concern must be investigated under the homes complaints procedures. Those expressing concerns must be informed about the homes complaints procedures. New personnel must not commence duties until recruitment procedures including all of the statutory checks have been completed ( Previous timescale of 30.10.04 had not been met). The integral heating system throughout the home must be sufficient so that there is no need to use freestanding heaters and increase the risk of accidental burn. Ensure that any members of the care team who are included in the minimum staffing ratios are sufficiently fluent in spoken English to communicate with service users. Staff members of the care team with verbal communication difficulties must not be included in the minimum staffing arrangements.(Previous timescale of 01.10.04 had not been met). There must be contingency planning to ensure that staff shortages are covered by others. Staff in the home must be able to authorise the cover so that gaps in the rota are covered without delay. Version 1.10 25.05.05. 25.05.05. 25.05.05. 01.09.05. 31.05.05. 31.05.05. Woodside Page 26 13. 27 18(1)(a) (c) 14. 27 18(4) 15. 33 37(1)(2) 16. 17. 37 37 17(2) Schedule 4.6(a) 17(1)(a) Schedule 3 23(4) Members of the senior team must receive sufficent guidance to enable them to carry on the home during the managers absence. This must include instruction about record keeping, communication skills including receiving and passing on information by telephone and the direction of staff. Staff must receive instruction about their conduct and the responsibilities of their role as indicated under Section 62 of the Care Standards Act 2000. The CSCI must be notified about complaints/concerns of a serious nature that adverseley affects the well being of any service user. Staffing rosters must include staff surnames. Records must be maintained accurately: Daily records of individual service users progress must reflect their actual condition. All staff must have taken part in a fire drill by the stated timescale. 30.06.05. 30.06.05. 30.05.05 31.05.05. 31.05.05. 18. 38 30.06.05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 10 Good Practice Recommendations Staff in the home should ensure that service users are not dressed in clothing that belongs to others. Woodside Version 1.10 Page 27 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 Woodside Version 1.10 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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