Inspection on 18/08/05 for Worsley Lodge

This inspection was carried out on 18th August 2005.

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

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

Other inspections for this house

Worsley Lodge 10/11/08

Worsley Lodge 01/07/08

Worsley Lodge 15/02/08

Worsley Lodge 08/11/07

Worsley Lodge 06/08/07

Worsley Lodge 11/05/06

Worsley Lodge 16/02/06

Worsley Lodge 13/10/04

Worsley Lodge 20/04/04

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 Worsley Lodge 119 Worsley Road Worsley Manchester M28 2WG Lead Inspector Elizabeth Holt Unannounced 18 August 2005 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. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Worsley Lodge Address 119 Worsley Road Worsley M28 2WG 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) 0161 794 0706 0161 794 7715 Highfield Home Properties Ltd Karen Johnson CRH Care home N Care home with nursing 48 Old age 47 Physical disability 1 Category(ies) of OP registration, with number PD of places Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 47 service users aged 65 years and over may be accommodated. A maximum of 20 service users requiring personal care only may be accommodated on the ground floor. A maximum of 28 service users requiring nursing care may be accommodated on the first floor. Minimum Nurse staffing levels will be maintained as specified in the Staffing Notice of 5th February 2003 issued in accordance with section 13 of the Care Standards Act 2000 with regards to the service users accommodated on the first floor. Dependency levels of service users on the ground floor are continually assessed and staffing levels adjusted in order that care staffing levels will be maintained in accordance with the minimum levels specified in the Residential Forum Guidance for staffing in Care Homes for Older People. One named individual who is below the age of 65 years and requires nursing care by reason of physical disability may be accommodated on the nursing loor and included in the maximum numbers receiving nursing care. Should this service user leave, the category will revert to OP. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 13 October 2004 Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Worsley Lodge is a detached ,purpose built property set in its own grounds. The home is registered to accommodate up to 48 older people on two floors. A maximum of 20 residents requiring personal care only can be accommodated on the ground floor and up to 28 residents requiring nursing care can be accommodated on the first floor. Forty eight of the bedrooms are single, with 33 of them having an en suite facility 16 with shower en-suites and 17 toliet en suites. A passenger lift is available to both floors. A variety of aids and adaptations are around the building to allow residents to move about independently. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection, conducted by two inspectors, which took place over the course of four and a half hours on the 18 August 2005. During the course of the inspection time was spent talking to the deputy manager, residents, relatives and members of staff to find out their views of the home. Time was spent examining records, documents and residents files. A tour of the building was also conducted. All residential residents are accommodated on the ground floor and residents in receipt of nursing care are on the first floor. Since the last inspection the Commission for Social Care Inspection has received three complaints which were upheld. Requirements were made and action has been taken by the home to address these. During this inspection only a selection of the key National Minimum standards were assessed, therefore in order to gain a full picture of how the home meets the needs of residents this report should be read with the previous and any future reports. What the service does well: What has improved since the last inspection? Care plans were examined and there was evidence of improvement since the last inspection however a requirement was made to ensure the recordings are clear to fully record the changing needs of the residents. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 7 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. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 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 Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 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 and 6 Prospective resident’s needs were assessed before they were admitted to the home. Relatives and friends can visit the home before making the decision to stay. EVIDENCE: A requirement was made at the previous inspection that all residents must be provided with an up to date copy of the Service User Guide. This requirement had been met. The manager or deputy manager undertakes a pre-admission assessment of prospective residents to ensure the home can fully meet their assessed needs. Copies of care management assessments were held within the residents care plans for those referred through care management arrangements Where possible, prospective residents and their family/representatives were encouraged to view the home prior to making a decision about admission. The home does not provide Intermediate care. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Improvements were noted in the care plans however some areas required further development to ensure the healthcare needs of the residents are fully met. Some shortfalls in medication practice have the potential to place residents at risk. EVIDENCE: A sample of resident’s care plans were seen. Improvements were noted in including social and religious needs in the care plans however limited progress had been made on the requirement to write clear and ordered daily statements linking these to previous entries made in respect of the residents. Phrases such as “good day”, ”full assistance given”, “all care as plan” were regularly used. Care plans had been reviewed and evaluated. One resident was noted to have been assessed as very high risk on the “Waterlow” pressure assessment however the care plan did not record the type of pressure relieving mattress to be in place and provide a specific care plan for this risk. The wound care plan for a resident showed that the staff were using the record from the tissue viability nurse instead of generating a separate plan of care to accurately record the care required to treat the sore including wound mapping. Care staff spoken to said they would always alert the registered nurse to any Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 11 changes in a residents skin condition. One carer said she had not received training on pressure relief and did think she would find this useful. A list of pressure relieving equipment in use was available however this was not up to date. Five care plans were examined on the residential unit. Information was found to be inconsistent. An example of this was the care plan stated that the resident was at ‘low risk’ from pressure sores, however, the ‘Waterlow’ assessment stated that the resident was at risk. Daily records were made of what care and support residents had received and been offered by staff. However, some records were written inappropriately, describing residents and “she” and “he”. Some records were written in a style that made them illegible. Care staff were observed talking to residents in a kind and respectful way and it was evident they enjoyed their job. It was pleasing to see there was evidence of a risk assessment put in place for a resident who refused medication on a regular basis. Records of weekly weights of residents were included in the care plan and action to be taken in the event of any significant weight loss. A relative spoken to discussed how the senior care staff communicated well with them and they discussed their relatives care plan on a regular basis with them. It was pleasing to see that some plans of care showed that residents and or relatives were involved in the care planning process. Records included evidence of involvement from other healthcare professionals for example, opticians, tissue viability nurses and chiropodists. It was pleasing to see that a resident who was presenting with “challenging behaviour “ had the appropriate risk assessments in place and communication with appropriate health professionals had been made. The accident record book was examined and a total of 27 falls were recorded in a period of 5 months. The majority of these falls were recorded as taking place during the late evening, through the night or early morning and all were un-witnessed. Records demonstrated that several residents had experienced numerous falls and this was not reflected in their care plan/risk assessment. Medication administration practices on the nursing floor were found to be appropriate however on the residential floor the senior carer had administered the medications and failed to sign each resident’s medication administration chart (MAR) following this. A requirement has been made that as soon as medication is administered the carer must sign the resident’s chart. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 12 Photographs were available on residents MAR sheets. There was no evidence that there was a specimen signature sheet available for use with the MAR sheets. A system was in place for the accurate storage and recording for Controlled drugs. Carer diaries are used to record entries in relation to personal hygiene and care carried out and records of fluid intake. A recommendation made at the last inspection was that the “carer diaries” should be reviewed on the nursing floor, there was no clear evidence that these had been fully reviewed however the deputy manager said she was in the process of this.. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 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) 13, 14 and 15 Social activities and meals are managed well and provide variety for the residents. EVIDENCE: The staff member responsible for activities was on holiday on the day of the inspection. Care plans included social assessments on admission to the home. Residents discussed how they participated in singing which was led by the staff and photographs of residents on trips/excursions were displayed in the lounge areas. Music was playing in the entrance hallway and residents were offered a drink of their choice in the afternoon. One resident said he enjoyed a trip to the local pub on a Friday and had recently been on a trip to Southport. A religious minister had visited the home prior to the inspection and residents said they valued these visits. Residents said their relatives could visit the home as they wished and they could enjoy their company in the privacy of their bedroom. Minimal activity apart from watching the television appeared to be carried out on the nursing floor on the day of the inspection however care staff said they Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 14 did try spending time chatting on a one to one basis with the residents when possible. The extent of activities provided on the nursing unit will be more fully addressed at the next inspection There was evidence of a good rapport between the staff and the residents. Lunchtime was observed to be relaxed and friendly with a high number of residents enjoying their meal in the dining room. The dining tables were pleasantly laid with flowers in the middle of each table. A choice of meal was available for residents at each mealtime and one resident said “The food is good, I am never hungry and I am always offered tea and toast at bedtime too.” Residents care plans included a nutritional screening risk assessment. Staff were observed to be sensitive when assisting individual residents at mealtime. A full time assistant cook was covering for the head chef at the time of the inspection. He had completed a Food Hygiene Induction course and a basic food course since commencing employment at the home. Freezer and refrigerator temperatures, core cooking temperatures and kitchen cleaning rotas were all available and up to date. The stores of food were satisfactory and the kitchen was clean and tidy. Some flooring tiles at the entrance to the kitchen must be replaced/repaired to minimise the risk of an accident. In the downstairs ‘sub’ kitchen, food was found to be unlabelled and undated. Food supplement drinks that were past their use by date by 3 months were also found in this kitchen. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 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 Procedures in Adult Protection protected residents from the risk of abuse however some staff require training in the Protection of Vulnerable Adults. EVIDENCE: The home has written adult protection procedures in place, however through discussion with staff it was evident that not all staff have received training in whistle blowing procedures and adult protection. Since the last inspection the home had received some training on the importance of “good record keeping” from a member of Greater Manchester Police’s Salford family support unit. Staff commented how useful they found this training. The home had a comprehensive complaints procedure. Copies of this procedure were available in the home. However, the complaints procedure that was displayed in the foyer of the home did not contain all the information required to inform people who they could make a complaint to. Since the last inspection three complaints had been received by the Commission. These were upheld regarding care issues and requirements made. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24 and 26 The home was fit for its stated purpose and generally provided clean and comfortable surroundings for the resident’s to live. Some areas required attention. EVIDENCE: A continuous programme of redecoration was evident. A tour of the home showed that the bathroom on the first floor required urgent attention, particularly in relation to cleanliness. The area contained mattresses and chairs. Soiled wipes were exposed from the waste bin which did not have a lid. The sink could not be accessed due to a trolley blocking its use. The toilet extractor fan and floor were noted to be dirty in this room. The nurse in charge requested immediate action from the staff at the time of the inspection to address these serious concerns and this area was cleaned up. Doors to the sub kitchens were ‘wedged’ open with chairs and the cupboard where DIY equipment was found open and accessible to all. The ceiling outside Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 17 room 4 required a panel replacing. The extractor fans in several bathroom and toilets were not in working order and required cleaning. Outside furniture was available at the front and rear of the property. The patio to the rear had a raised ‘manhole’ cover that required attention and several flags needed to be sealed as they presented ‘tripping’ hazards. The patio door threshold in the downstairs lounge could also possibly present as a tripping hazard as it was uneven. None of the residents had a key to their own bedroom however the deputy manager stated the residents had been consulted on this. Care plans must include the risk assessment for the residents having a right to a key to their own bedrooms. A tour of the home highlighted that some of the paintwork around the bedroom doors was damaged from the use of wheelchairs. This must be included in the action plan to maintain the décor of the home. Communal areas were pleasantly decorated and maintained. The home was found to be free from odours on the day of the inspection. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Staffing levels were generally sufficient to meet the residents physical needs however attention must be paid to the social needs of the residents in receipt of nursing care. The home could not demonstrate that all the appropriate checks had been made prior to a member of staff commencing employment. EVIDENCE: At the time of the inspection the home accommodated 18 residents in receipt of nursing care plus 1 in hospital and 27 residents in receipt of personal care only. Residents and relatives spoken to praised the staff for their kindness and attention to detail. One relative was very pleased with how she had been kept up to date by the home’s staff with the treatment her relative was receiving from the dentist. During the tour of the home the call alarm was tested for a resident who was in urgent need of his personal needs being attended to. It was pleasing that a staff member responded promptly to answer this. Staff on the nursing floor said they were often “very busy attending to residents” and time was limited to spend time doing activities with them or having time to just sit and chat. The staffing levels must be reviewed on an ongoing basis in line with the dependency of the residents accommodated. Staff files were examined. Several, but not all files contained the required information to demonstrate that written reference requests had been completed and Criminal Record Bureau checks had been completed. For example, one staff file contained only a photograph and payment details. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 19 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) 38 The home is managed and run in the interests of the residents. Management arrangements were not always effective to ensure the best interests of the residents. EVIDENCE: In the absence of the registered manager, the deputy manager was in charge of the home. Observation of her role and her responsibilities during the inspection highlighted that she was accountable and overseeing the care throughout the home as well as being the nurse in charge on the first floor. A discussion highlighted that this responsibility potentially left the residents in receipt of nursing care at risk due to the demands on one individual of being available to all the residents accommodated. The responsible individual is requested to review how the nursing floor and the personal care only floor are managed. A record of accidents was available and included evidence that these were audited on a regular basis. However, accidents were being recorded in a Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 20 record book that did not meet the current requirements of the Data Protection Act. Several accident reports did not contain the full name of the staff member completing the report.. Some accident reports also contained very little information regarding the incident and information that also conflicted with the care plans. For example, one accident report stated that a resident “remained unsteady” however, there was no record of the resident being ‘unsteady’ in the care plan or risk assessment. A discussion was held around avoiding the use of speculation in the recording of information in the accident book and to ensure unexplained bruising for example is appropriately investigated. Uncovered and unlabelled food was in the downstairs ‘sub’ kitchen and several food supplement drinks were found to be out of date. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 3 3 2 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x 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 x x x 2 Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 22 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 OP7 Regulation 14 Requirement Daily entries must be clear and linked to the previous entries made in respect of residents. Entries must be consistent and legible. Residents who have a pressure sore must have a detailed corresponding care plan including wound mapping and an accurate record of treatment provided.Care plans must include the pressure relieving equipment provided. Staff must receive up to date training in pressure area care and management of pressure sores. The accident book must comply with the Data protection Act. Staff must sign the accident book following an entry. Accidents recorded must avoid speculation. Any falls recorded must have corresponding entries in the care plans and include risk assessments as appropriate. Medications must be signed for on the MAR chart immediately following administration. A list of staff specimen signatures must be available. F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Timescale for action 9.01.06 2. OP8 13 30.12.05 3. OP8 12 30.01.06 4. OP8 18 10.01.06 5. 6. OP9 OP9 13 13 10.12.05 10.12.05 Page 23 Worsley Lodge Version 1.30 7. OP15 12 8. 9. OP18 OP16 12 22 10. 11. 12. OP19 OP19 OP19 13 23 23 13. 27 18 14. OP29 19 15. OP32 10 Food stored must be appropriately labelled and dated. Out of date drinks must be discarded. Staff must receive training in whistle blowing procedures and protection procedures. The complaints procedure displayed must include details of who complainants can make a complaint to. The bathrooms and toilets must be maintained to an aceeptable level of cleanliness. Fire doors must not be wedged open with chairs for any reason. The raised manhole must be addressed. Flagstones must be fixed in place and the patio door threshold reviewed. The staffing levels must be monitored in line with a dependency tool to ensure the numbers are appropriate for the health and welfare of the residents. A full audit of all staff files must be carried out to ensure they contain all the information and documents listed in Schedule 2 of the Care Homes Regulations 2001. The registered provider must ensure the deployment of the management of the home is satisfactory. 10.12.05 27.01.06 30.12.05 30.12.05 16.12.05 30.01.06 30.12.05 20.01.06 30.01.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 24 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Worsley Lodge F55 F05 s6733 worsley lodge v229925 110605 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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