Care Home: Beyer Lodge Nursing Home

What the care home does well The management makes sure that before people come to live at the home they had gathered enough information themselves and from other sources, such as health and social services, about people`s needs and support. This helped to make the move to the home less stressful for the person and so that staff know how to support them in the right way. Each person has a care plan that was very detailed and contained lots of personal and useful information about the person. This included areas such as their life history, family and friends, previous employment and their own interests. This gave staff a good understanding of the person and their life before they came to live at the home. The service supported people with long term emotional and mental health needs who may also have other general health needs. The management and staff team supported people to maintain their general health through accessing health services such as G.P`s, dentists, District Nurses and other specialists. They also supported people`s emotional health by accessing specialist community and hospital based mental health services such as Psychiatrists and Community Psychiatric Nurses. People live in a home that was very well maintained, nicely decorated with colourful and modern fixtures and fittings. Over the course of the past 12 months most of the building had been redecorated and a lot of new furniture and carpets provided. The layout of the building also allowed people to choose where and with whom they want to spend their time. In addition to the spacious bedrooms, there was a separate smoking lounge, two other lounge areas and two dining rooms. What has improved since the last inspection? The management had acted on the recommendations made at the last inspection to improve the medication administration system to make sure that people got the right medication to stay healthy. What the care home could do better: No requirements were made during this inspection. Key inspection report Care homes for older people Name: Address: Beyer Lodge Nursing Home 65 Taylor Street Gorton Manchester M18 8DF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Steve OConnor     Date: 2 7 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Beyer Lodge Nursing Home 65 Taylor Street Gorton Manchester M18 8DF 01612237785 01612239927 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.anchor.org.uk Anchor Trust care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: All service users shall be above pensionable age and require care by reason of mental disorder (excluding learning disability) or dementia. Minimum nursing staffing levels indicated in the Notice served in accordance with Section 13 (5) of the Care Standards Act 2000 issued on 29 October 2003 must be maintained. The maximum number of service users, who all require nursing care , will be 16. Date of last inspection Brief description of the care home Beyer Lodge Nursing Home is registered to provide accommodation with nursing care for a maximum of 16 older people aged 65 years and above assessed as requiring nursing care for mental health needs. The home was purpose built all on one level, and is totally wheelchair accessible. There are 16 single bedrooms, all with en-suite bathrooms. There are three lounges and two dining rooms; one is designated as a smoking area. The home is set in its own small grounds with a secure, wellCare Homes for Older People Page 4 of 27 Over 65 0 0 16 16 Brief description of the care home maintained garden. It has its own car park. The home is situated on Taylor Street in the Gorton area of Manchester. Shops, public houses and other social areas and amenities are within a short walk of the home, which is close to public transport services. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection report is based on information and evidence gathered by the Care Quality Commission (CQC) since the last key inspection of May 2007 and annual service review in May 2008. This information included the manager completing a self-assessment form called an Annual Quality Assurance and Assessment (AQAA) describing how they feel they have met the National Minimum Standards (NMS). Additional information that would be used included any incidents notified to us and information provided through other people and agencies, including any concerns and complaints. During the visit time was spent talking to people who live at the home, the nurse in charge and members of staff. Documents and files relating to how the service was run were also seen. In addition, staff on duty were asked to complete a survey to seek their views of the service. Care Homes for Older People Page 6 of 27 We spoke to the manager and care manager, via the telephone, on the Friday and Monday after the visit. Fees were charged at 789 pounds per week. Information about the service can be gained direct from the manager. The inspection was an opportunity to look at all the core standards of the NMS and was used to make a judgement on the quality of the service provided and to decide how much work we needed to do in the future. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and support were identified before they came to live at the home so that staff knew about and were able to support their needs in the way required to keep them well and safe. Evidence: Before people come to live at the home their needs and support had been identified through a range of information that was gathered from relevant agencies such as the local authority or health service. Examples were seen of multi-disciplinary needs assessments and care plans that were detailed and comprehensive. The manager or a senior nurse visited prospective people to carry out a pre-admission assessment and to get to know the person. Examples of these pre-admission assessments were seen and found to contain an in-depth record of peoples needs and social history. Care Homes for Older People Page 10 of 27 Evidence: People would be invited to visit the home on a number of occasions before making a decision about living at the home and usually stayed for a meal and progressed to an overnight stay. This was to make sure that the staff was able to meet the persons needs and that they were happy to move in. The home did not provide intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples general, emotional health and personal care needs were identified through person focused care plans that supported and maintained their health and wellbeing. Evidence: Within 24 hours of a persons arrival at the home a base-line assessment was completed that described a persons lifestyle choices, likes and dislikes and social interests. It also detailed the persons primary general and emotional health and personal care needs for staff to follow and so give the support the person needs. From the various assessments and after getting to know a person an individual care plan was developed. This clearly set out a range of peoples needs and goals and included their general and emotional health needs, personal care, risk assessments to keep people safe and specific goals that related to the individual. The care plans also included in-depth information about a persons life, family, employment and medical history that gave a good understanding about the person as an individual with their own history. The care plans contained detailed information of peoples health needs and support. Several people were being supported by district nurses and a nurse was Care Homes for Older People Page 12 of 27 Evidence: visiting at the time of the inspection. People were supported to access specialist health services such as psychiatrists and mental health services. Each person had a named nurse and group of care staff who were responsible for making sure that care plans and documentation was up-to-date. Care plans were reviewed on a monthly basis and changes in peoples needs were clearly recorded. An example of this was seen where staff had concerns that a person was not eating properly and losing weight. The care plan reflected these concerns and the actions taken by the staff to support the person to eat well and remain healthy. Medication is dispensed in a monitored dosage system. People were registered with a General Practitioner and visits from other health care professionals, including dentists and chiropodists, were arranged as required. At the time of the visit a person told staff about a pain with their teeth. An appointment was made with their own dentist straight away. The medication was stored in a metal trolley, which was stored securely in a treatment locked room. The medication administration record (MAR) sheets were examined and were up to date with no gaps in recording. The previous key inspection had raised the issue of the coding system not being used correctly. There were no examples of this in the MAR sheets examined and all missed medication had been recorded with the explanation of why missed. The recommendations made in the previous key inspection report for staff signatures to be recorded and to have photographs of people on file, to make sure the right person got the right medication, had been followed. The medication policy was available for all administering staff to read. There was evidence that temperatures were recorded for the fridge used to store medication requiring cold storage. Through observing how staff worked with people it was seen that they addressed them with respect and spent time talking to people and explaining to them how they were being supported. Staff were seen knocking on peoples bedroom door before going in and training records showed that the majority of staff had attended training courses in supporting people with dignity. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were being supported to follow their chosen daily routines and to be able to take part in a range of leisure activities if they wished. Evidence: Peoples care plans described how they liked their daily routines and could decide when they got up and went to bed. No restrictions were placed on people unless these had been agreed fully with the person. One person explained how they could have a lie in when they felt like it and could take their meals in their room if they wanted. At the time of the visit people was spending time in the different lounges talking to each other, following a hobby, watching television or listening to music. At the time of the visit the manager had appointed two existing members of staff as activity coordinators to work with people to find out what social and leisure activities they would enjoy. One of the staff members explained how they had purchased a range of items for people to use such as jigsaws, a darts board, jewellery kits and arts and craft equipment. They had also recently bought a Wii games console and one Care Homes for Older People Page 14 of 27 Evidence: person described how they enjoyed playing a bowls game. This is an imaginative use of activity equipment and is commended. Some people were able to go out into the community independently and described how they visited local shops and cafes. Most required support from staff members to access the community and a few people did mention that this was not always possible especially if this was at short notice rather than organised trips. A few people had control of their own finances with some support from the staff team. For other people their relatives or the local authority assisted with managing their personal finances. Where this is not possible people have access to an advocacy service run by Age Concern to manage money on their behalf. Visitors were welcomed at any reasonable time and one person described how they still went back to their home town to spend the weekend with her family. Other people also mentioned the family members who visited them. Meals were served in two separate dining rooms to give people a choice of where and who they wished to sit with. The main meals of the day were at set times with hot or cold drinks and snacks available throughout the day. People were asked at mealtime what they would like to eat from the choices available. Their likes and dislikes had been recorded and, where required, peoples care plans made it clear how they needed to be offered choices if they did not like the menu of the day. Cooked breakfasts were provided on request and residents have a hot drink and snack in the evening. Several people described the meals as very good and gave examples of the foods that they liked and that were well made. When residents meetings were held the standard of meals was always a topic for discussion and the manager kept a record of when ever someone was not happy with the meals and this would be fed back to the chef. The chef explained how they developed a four week menu through talking to people and finding their likes and dislikes. They were able to describe how certain people needed special diets and was aware of the cultural needs of people with the use of specific Afro Caribbean and Nigerian meals Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The policies, procedures and staff awareness was in place to safeguard people from harm and there is an ongoing programme of staff training. Evidence: The complaint procedure was included in the service users guide and displayed in the home. Several people were asked about making complaints and they were all aware that they had the right to speak to the manager or any member of staff about their concerns. The manager maintained a complaints log of all formal complaints. Although they had not received any formal complaints in the past year the manager was maintaining a record of any concerns or worries that people had raised and these had been acted on to make things better for the person. The home had a policy on protection of vulnerable adults from abuse in line with the Manchester Multi Agency policy and procedures. Staff spoken to were aware of the procedure and of the actions to be taken in the event of an incident or allegation being made. They were able to describe the training they had attended and training records showed that the majority of staff had taken part in specific training or as part of their induction. At the time of the visit there had been no safeguarding issues notified to us since the Care Homes for Older People Page 16 of 27 Evidence: last key inspection. Where people were helped by staff to manage their personal finances there were clear and robust systems in place for recording how peoples money was being used and this was monitored on a regular basis. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a well maintained, modern looking and homely environment that was clean and of a good standard of decoration. Evidence: The home felt comfortable and homely. All areas were tastefully decorated and furniture was of a domestic nature and of a good standard. Since the last key inspection most of the building had been redecorated with several of the toilets/bathrooms having been refurbished and updated. Since the last key inspection in May 2007 the layout of the home had been changed to give more flexibility to the space. There was a separate smoking lounge with its own ventilation and a main lounge where most people spent their time. The dining room had been divided into two separate areas that gave people the choice of where and with whom they sat with during mealtimes. Both dining rooms had access to a conservatory which led directly to the enclosed garden. Privacy locks were fitted to bathroom and toilet doors and an emergency call system was available. Laundry facilities were suitable for the demands made and the systems were in place to return clothing as soon as possible. Care Homes for Older People Page 18 of 27 Evidence: All toilets and bathrooms had instructions for effective hand washing and appropriate equipment was available for staff to maintain good infection control. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of staff was sufficient to meet peoples support needs and to maintain their health and wellbeing. Evidence: At the time of the visit the registered manager was on leave and the care (deputy) manager was at a training event. An agency nurse who regularly works at the home was the nurse in charge. The staff team was made up of registered mental health nurses, care workers, a chef, kitchen and domestic staff, a handyman and administration worker. The minimum staffing levels were 4 staff (including the nurse in charge) working in the morning up to 2:00 pm with 3 staff in the late afternoon and evenings and two waking staff were on duty overnight. The manager and care manager were usually supernumerary to the rota and worked across office hours and some weekends. At the time of the visit staff were observed talking and joking with people and helping them with their routines and personal care. It was noticed that staff responded quickly to peoples requests and were given the attention they needed. Information provided by the manager stated that five of the 12 permanent care staff Care Homes for Older People Page 20 of 27 Evidence: had achieved the National Vocational Qualification in Care Level 2. This below the levels recommended that 50 of staff who should have this qualification and so it is recommended that the manager develop a plan of action to achieve the recommended targets for vocational qualifications. A sample of staff files were checked to make sure that all the right checks had been made before the staff member started working with vulnerable people. Evidence was seen of completed application forms, interview notes and offers of employment. All the files checked held a current Criminal Records Bureau (CRB) certificate and a Protection of Vulnerable Adults (POVA) First check that allowed the staff member to start work before a full CRB certificate was available. The nursing staff Nursing and Midwifery Council PIN numbers were checked by the administrator to make sure they were up-to-date. Even agency nursing staff PIN numbers were checked. It was found that this information had not always been placed in a staff members file and so it is recommended that evidence of nursing staff current registration status and PIN number be kept in their personnel file. The majority of the staff files contained at least two references. One example was found where only one reference was available but the second had been gained over the phone. There was a record of this but it was not dated or signed. It is recommended that all documentation relating to recruitment was clearly signed and dated. The staff spoken to during the visit were able to describe the training they had received over the past 12 months. This included an Induction where the staff member keeps a running record of their learning and covered the Skills for care Induction Modules Common Induction Standards. The majority of core training was provided in-house or through the Anchor organisation. Occasionally training from other providers, such as the local authority, was used. The manager was responsible for identifying training needs and arranging the training events. They stated that they had identified specific training needs for care staff including mental health awareness and these training events were ongoing. All staff had a record of training events that they had undertaken including Moving and Handling, Fire Safety, Health and Safety and Protection of Vulnerable Adults over the last two years. There was no formal system for assessing that the staff had understood the training provided and were competent in applying that knowledge and skills. It is recommended that a formal system be developed that clearly records that Care Homes for Older People Page 21 of 27 Evidence: staff were competent in the application of the training they had recieved. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was managed well with the systems and procedures were in place which safeguard peoples health and wellbeing and protects their financial interests. Evidence: The manager had been in post since November 2007 and registered with us since July 2008. They had over six years of management and supervisory experience in the care sector. They had fully operational responsibility for running the home and for maintaining budgets and costs. they were supported by their line manager and at the home by the care manager who deputised in their absence. They received regular supervision and had a training and development plan to maintian their skills and knowledge. the manager follows a quality monitoring system where they record and report on key operational targets every month. The service was also visited every month by the area manager of Anchor who own and run the home. This was part of the system of Care Homes for Older People Page 23 of 27 Evidence: monitoring the quality of the service people receive. In addition to this, managers from the organisations other care homes also visit and carry out mini inspections. The care manager and nurses also monitor the quality of the care planning, medication and recording and the manager also spots checks the quality of the work. Resident and relative meetings had been organised in August 2008 and April 2009 but no one had attended. It is recommended that alternative ways of seeking peoples views and passing on information be considered. At the time of the visit around three people managed their own personal finances with some support from staff. For the majority of people either relatives or the local authority acted as appointee. For some people Age Concern were advocates for people acting on their behalf in managing financial affairs. To make sure that people had access to their own money to buy personal items a financial management system is used to keep clear records of all monies and spending. This is a standard system for the Anchor organisation and there was a set monitoring and auditing procedure to make sure that peoples money is safe. Staff spoken to during the visit all confirmed that they received one to one supervision to talk about their work, performance and training needs. Examples of supervision records were seen. Staff who commented on the surveys all confirmed that they received good support from the management team and some staff said that they could speak to the management at any time if they had any concerns. The AQAA completed by the manager confirmed that they had health and safety policies and practices to keep people and staff safe. Regular health and safety audits were carried out to make sure that the environment was safe and well maintained. Checks on fire equipment, alarms, lighting and means of escape were all visually checked on a regular basis. Fire drills and fire training was ongoing. There was a fire/emergency action plan for every person and an annual fire risk assessment. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 28 It is recommended that the manager develop a plan of action to achieve the recommended targets for staff to gian the national vocational qualifications. It is recommended that all relevant records and documentation relating to recruitment, such as telephone references, was clearly signed and dated. It is recommended that evidence of nursing staff current registration status and PIN number be kept in their personnel file so that the information was readily avaiable to anyone who requires it. It is recommended that a formal system be developed that clearly records that staff were competent in the application of the training they had recieved. It is recommended that alternative ways of seeking peoples views and passing on information be considered to be able to establish the quality of the service that people receive. 2 29 3 29 4 30 5 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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