Care Home: Bewick Lodge

What the care home does well The home has a number of staff that have worked at the home for some time and they are keen to improve the quality of the lives of the residents. Care assistants were attentive to the needs of the residents. They worked hard at lunchtime to ensure that people got the food that they wanted and they provided sensitive and professional care when residents required help or reassurance. The atmosphere in the home was calm and organised. The residents spoken with made the following comments: "the staff are lovely" and "I like the food, you can have what you want". What has improved since the last inspection? There were two requirements identified at the last inspection. One was to ensure that the residents whose personal allowances were being managed by the home would receive interest on their money. This issue was dealt with at a national level with Commission for Social Care Inspection and has now been resolved. What the care home could do better: The care plans are adequate but must be improved to reflect more fully the care needs of the residents. The management of medicines must be reviewed and action taken to ensure that the systems are robust and protect the residents. There is a social activities programme in place, however the way that they are organised and provided must be developed further so that they are provided to individual residents in line with their taste, abilities and needs. The complaints management must be improved in line with the company policies and procedures. The decoration programme must be completed. The hoist in the bathroom on the ground floor needs to be moved so that people can use it. There must be enough numbers of staff on duty at all times to safely care for the residents. NVQ training must be given as planned to ensure 50% of care staff are trained and statutory training updates must be given to sure that they can continue to carry out their role in a safely and competently. There must be an appropriate manager appointed who will apply for to be registered by the Commission for Social Care Inspection. CARE HOMES FOR OLDER PEOPLE Bewick Lodge Waverly Crescent Lemington Newcastle Upon Tyne NE15 8AN Lead Inspector Suzanne McKean Key Unannounced Inspection 12th March 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bewick Lodge Address Waverly Crescent Lemington Newcastle Upon Tyne NE15 8AN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 264 7267 0191 264 7296 bewick.lodge@fshc.co.uk Bewick Waverley Ltd Vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 8 beds can be used for service users who do not require nursing care, category DE(E). 15th January 2007 Date of last inspection Brief Description of the Service: Bewick Lodge is a 45-bedded care for older people with enduring mental health problems. The home provides nursing care to those residents who have been assessed as requiring it and social care to the residents not needing nursing care. The home is purpose built and is physically attached to another home on the same site. The home is set in large landscaped gardens, close to local amenities and has good local transport links. The home has 45 single bedrooms 18 of which have en-suite facilities. There are two floors with lounges and dining rooms on each floor. There are sufficient bathing and toilet facilities in all areas. Stairs and a passenger lift access the first floor. The home charges fees of between £376 and £477 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 15th January 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals, including surveys. The Visit: An unannounced visit was made on 12th March 2008. During the visit we: • Talked with people who use the service, relatives, staff, the new manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. • Spoke to the Regional Manager of the company. We told the manager and the regional manager what we found. What the service does well: The home has a number of staff that have worked at the home for some time and they are keen to improve the quality of the lives of the residents. Care assistants were attentive to the needs of the residents. They worked hard at lunchtime to ensure that people got the food that they wanted and they provided sensitive and professional care when residents required help or reassurance. The atmosphere in the home was calm and organised. The residents spoken with made the following comments: “the staff are lovely” and “I like the food, you can have what you want”. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 (the home does not provide intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of needs are comprehensive and help to identify the level and type of care people need before admission. This ensures that people’s needs can be met by the home. EVIDENCE: Individual residents’ files contained a copy of a needs assessment carried out by the referring care manager as well as a detailed assessment completed by the home staff. The pre-admission assessments contained a range of appropriate information about people’s diverse needs. These are used to draw up both these initial assessments and the home’s subsequent service user plans. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 9 All prospective service users and their representatives are invited to visit the home prior to admission to the home. Relatives who were in the home during the visit said that they had been given sufficient information prior to their relative’s admission and that it proved to be accurate. Care plans show that a range of specialist services was provided to service users and staff confirmed that this was so. Staff also demonstrated they had a range of relevant training and experience. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, good systems ensure that health and social care needs are delivered in a respectful way. However, the care plan documentation is not developed to a sufficient standard to show that the resident’s needs are being fully met. EVIDENCE: The Company have an extensive range of documentation and each resident has an individual plan of care. The documentation available is varied and includes, a variety of assessment tools including those for a dependency, skin integrity, falls, nutrition, and general risk assessments. The home is using the company documentation and as a result the care plans contain a large amount of information and are detailed in many of the areas and describe the care being given. However they do not all fully reflect the changing needs of the residents and are not person centred. The care plans vary in the standard to which they are being maintained. Two care plans had not been reviewed to Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 11 the necessary frequency (no review carried out in February), which is not in line with the company policies and procedures. It was therefore not possible to assess from the plans if the residents psychological, health and personal care needs are being monitored and met with preventative care being delivered. Although the home is registered to provide nursing care for residents with dementia and the home also has some residents who also have general nursing needs. The home has the necessary equipment to provide for the needs of these residents including intermittent pressure-relieving mattresses and patient lifting hoists. Residents are provided with services available to the wider community for example chiropody, dentistry and other therapeutic services according to assessed need. The staff obtain advice from specialists from the local Primary Health Care team as necessary and the Tissue Viability Nurse (TV nurse) is currently attending the home to provide advice to support the staff to care for an individual resident. Residents are weighed regularly and staff make changes in the care provided to take into account any changes. Although some weight loss was noted in the care plans action had been taken to address it. Dietary needs are identified and met for those residents who have specific religious, and cultural needs. Other choices and preferences are accommodated. Care plans include information about the individual cultural and religious needs of residents and this is considered when care is being provided. Staff knocked on bedroom doors before they entered but residents could not say if this was usual practice. Two relatives said that they felt that their relatives were offered privacy when receiving personal care. Any examinations by medical or nursing staff are carried on in the resident’s own room. The record of the administration of medicines including the way the home orders, manages and stores it is appropriate. Residents are receiving there prescribed medication in line with the relevant legislation and good practice guidelines. However, although generally there are adequate recording of medicines given, there are some inconsistencies and there is no regularly auditing to ensure that they are being handled in line with best practice or the homes policies and procedures. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are generally well supported to have choice in the way they spend their time so that they can live satisfied and fulfilled lives but record does not adequately show how staff achieve this. Residents receive a nutritious and varied diet that helps ensure they stay healthy. EVIDENCE: Residents are offered a selection of social activities. There is an activities coordinator employed for 21½ hours per week. These activities are recorded on an individual basis and the variety offered to individual residents depends upon their dependency level, needs and interests. They do offer some choice and there is a programme available to give information about what is planned. The schedule of activities does not specify the time or duration of the activity and there is little evidence of the residents being given the information as part of their day-to-day conversations. It is acknowledged that engaging people with dementia can be challenging but the home should seek creative ways of achieving this. During the visit care staff confirmed that there was usually something planned to occupy the residents during the day. However they could Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 13 not organise it, as they could not get the equipment/resources required because the cupboard was locked. This was due to the activities co-ordinator being on holiday. Although the manager confirmed that the key could be obtained the staff obviously did not know this. The care plans do not always contain sufficient information to show the preferences and abilities of the residents were included in the social activity planning. Plans to improve the care planning would improve this and would assist in ensuring that activities are more specific to the individual residents. Records in the home including the care plans show that residents are making decisions about their daily lives. Although this can be in small ways it includes issues such as what time they get up and go to bed and what they eat and wear as well as taking part in social activities. All residents are supported to maintain links with their families. During the visit some relatives were visiting the home and those spoken to were positive about the way they are welcomed and made to feel comfortable. The staff were helping the residents in a sensitive and respectful manner with service users and although the residents were not able to verbally confirm if the staff respect their dignity they were comfortable with staff. The menus are developed by the company and operate around a four-week programme. The menus are varied and nutritional, special diets are provided as needed. One resident said that the food “is always really nice” and another that “if they don’t like what is on the menu they could have something else”. During the lunchtime meal all of the residents were asked for their choice at the time of serving and some were offered an alternative when they did not appear to be eating the food they were served. The kitchen was well organised, clean, and tidy with ample stock level including fresh vegetables and a good selection of fruit. The catering staff maintain appropriate checks as required. There was an extensive supply of good quality food available. The chef was knowledgeable about fortifying the food for those residents who are at risk of loosing weight and there was a good supply of butter and full fat cream to assist in achieving this. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While complaints and safeguarding procedures are clear, recording and handling of complaints is not sufficiently robust to ensure that issues are properly addressed. EVIDENCE: The complaints policy is in the service user guide and is displayed in the home. Two relatives said the complaints procedure and added that they would not be worried about speaking to a member of staff if they had any concerns and said that they would be happy to approach the new Manager. It was difficult to determine from the records the way that complaints were being managed, as they were not in order and did not have all of the correspondence and investigation notes in the file. There was little evidence of the way the complainant was being communicated with, particularly to inform them of the outcome of the complaint or if any improvements were planned as a result of the investigation. The home has policies and procedures in relation to the prevention of abuse and whistle blowing; the staff are trained in these areas of practice, which is included in the induction programme and the ongoing in house training programmes. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although there has been a lot of redecoration and refurbishment there are still areas of the home that are in need of work. EVIDENCE: The home is purpose built over two floors and it is set in extensive wellmaintained gardens which residents can only access when supervised by staff. There is no free access to a safe, secure area for residents who have mental health problems. The improvements to the decoration noted at the last inspection have continued and the decoration is better, however there are still areas of the home that need further improvement. The lounge carpet and the corridor carpet on the first floor are stained and this resulted in there being a distinct Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 16 and unpleasant odour on the corridor. The dining room on this floor is now in need of redecoration to bring it up to the standard of the one of the ground floor. A random inspection of the bedrooms found that improvements continue to be made. The bedrooms are clean and there is a redecoration programme. The new furniture and bedding make the rooms look homely in style. There are bathrooms and toilets close to all communal areas and bedrooms. Eighteen of the bedrooms have en-suite facilities. There are three bathrooms on each floor, but only two can be used as assisted facilities. The bath on the ground floor has a fixed patient lift but cannot be used as it is badly positioned resulting in only a very few (small) residents being able to use it safely. A freestanding hoist cannot be used in this bathroom. This means that only one bath can be used for all of the residents. There are also no showering facilities in the home. The sluices were tidy and generally clean. The sluices were locked and the disinfector was working. A cleaning schedule is in place and all areas of the home were clean. The clinical waste is securely stored outside the building. Liquid soap and paper towels are available in resident areas and in all resident’s bedrooms allowing staff, visitors and residents to wash their hands without leaving the room. The laundry is separate from resident areas and was clean and free from odours. Lighting levels were sufficient and there was emergency lighting throughout the home. Water is stored at over 60°C. Valves are in place at water outlets to ensure water is provided close to 43°C to prevent scalding. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ needs are supported by competent staff that have undergone robust recruitment. However, staff are not currently receiving regular updates to ensure their skills are maintained, and more must be done to ensure that adequate numbers of staff are always available. EVIDENCE: Although there was records of the staff having had statutory training during their employment, during their induction period or as part of the updating programme this is currently not up to date. This includes moving and handling, fire training and food handling and hygiene. Staff are being given some clinical training both formally through training sessions and informally during the delivery of care. Specialist advisors are asked to see individual residents and the home is using the advice to plan the care they give. There has been a problem with the home achieving a minimum of 50 of the carers with a National Vocational Qualification (or equivalent) at level 2, as the training provider has had to be changed. The new manager now feels that the training is back on track to achieving this by the end of 2008. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 18 There has been a number of staff changes since the last inspection visit including the manager and some care staff. However there are some staff that have worked in the home for a long time. Staff that were spoken to were positive about the recent changes to the management arrangements and felt that they were being listened to. Staff interviewed were knowledgeable about the residents needs. Staff records are completed in line with the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. On the day of the visit there were the following staff in the home:The manager One qualified nurse Five care staff Two domestics & one laundry assistant The administrator The handyman It was noted that when sickness and staff holidays occur home staff usually covers it. Late reporting of sickness particularly at holiday times and weekends does result in fewer staff being on duty for shift periods. The Manager was on duty from nine till five but by his own admission, confirmed by the rota, he is currently working over his contractual hours. Relatives had some concerns that he was working for long periods and was covering a number of shifts as the nurse and that this was leaving him less time to manage the home. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A change of personnel has created some inconsistencies in the management of the home, and although the residents are protected by the companies systems there are areas in which the home has not been well managed. EVIDENCE: There has been a change in the management of the home since the last inspection. The registered manager is no longer working at the home and there is a new Manager Mr John Logan currently managing it. This created a period of time when the residents, relatives and staff were not sure what was happing with respect to the manager’s post. The company has put a manager in post Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 20 and there are plans in place to appoint a permanent manager. They will then need to be registered with Commission for Social Care Inspection. During the inspection visit the Regional Manager for the Company was present. She was aware that there had been a recent fall in the standards and was putting in place an action plan to address the issues as necessary. She was confident about the lines of accountability both within the home and with the senior managers of the company. Staff interviewed were clear about the their responsibilities. Those spoken to were positive about the new management systems saying they were encouraged to contribute to the development of the service. Reviewing of the care and service delivered takes place through a process of regular audit but some of these are now overdue and will need to be recommenced. The records of the residents personal finances were examined and were being kept in detail with records of money spent being signed by either the resident their representative or by two staff. The receipts and the recordings were in order. The home follows good fire detection and prevention practices, regular maintenance checks are carried out and recorded. However, although the staff have received their initial statutory training their regular updates are not up to date and the fire practices have not been held in frequent enough intervals (see requirement in training section). There was information, which verified that appropriate maintenance contracts for the home are in place. Water storage tanks, gas and electrics are checked annually. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X 1 X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. 2. Standard OP7 OP9 Regulation 15 13 Requirement The care plans must be up to date and adequately reflect the care needs of the residents. The management of medicines must be reviewed and action taken to ensure that the systems are robust and protect the residents. The complaints management must be improved in line with the company policies and procedures. The decoration programme must be completed including the replacement of carpets to the first floor lounge and corridor. There must be adequate numbers of staff on duty at such times necessary to safely care for the residents. The registered persons must ensure staff progress with NVQ level 2 or equivalent training to ensure 50 of care staff are trained to meet residents needs. Timescale of 30/09/06 not met. The staff must be given adequate training to ensure they DS0000000419.V360902.R01.S.doc Timescale for action 01/09/08 01/07/08 3. OP16 22 01/09/08 4. OP19 16 01/10/08 5. OP27 18 01/05/08 6. OP28 18 01/08/08 7. OP30 18 01/07/08 Bewick Lodge Version 5.2 Page 23 8. OP31 8 can carry out their role safely and competently. There must be an appropriate manager appointed who will apply for to be registered by the Commission for Social Care Inspection. 01/08/08 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. 2 3 Refer to Standard OP19 OP12 OP24 Good Practice Recommendations The home should provide a safe; secure garden area for residents to freely use. Social activities must be developed further so that they are provided to individual residents in line with their preferences, abilities and needs. The residents must have sufficient bathing facilities available to meet their number and needs. Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bewick Lodge DS0000000419.V360902.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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