Care Home: Clara House

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What the care home does well The people I spoke to said they are happy with the care and support they receive. One person said `I am very happy living here, the staff are friendly, it`s very comfortable. Another said that the staff are `lovely and very hard working`. People looked comfortable clean and well cared for. There was a really good range of activities to keep people occupied. They included craft sessions, card making and quizzes. At the last residents meeting people requested that the home should have a dog, the management are looking into this. People said they enjoyed the activities that now take place at Hollyacre and really appreciate the time staff are now spending with them. Everyone said they enjoyed the food they were given and said that there was a good choice. One person said `the meals are great, I really enjoy my breakfast, I had cornflakes and a bacon sandwich today`. Another person said ` the food has really improved since the new people arrived. We get a nice choice, the sausage casserole for lunch today was champion`. The pre-admission assessments have been reviewed and are thorough. The majority of people who I spoke to said they had been given enough information about the home before moving in. One person commented `my family sorted this place out for me; they came to look around and thought it was okay. My wife wants me to go back home, but I am really settled here, she`ll never get me home now`. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said `I would tell the staff if I have a problem, they would sort it out for me`. The staff are aware of their responsibilities if they believe that neglect or poorcare practice is taking place and were confidant that if they raised any issues the manager would investigate. There are now thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All new staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. What has improved since the last inspection? This is the first inspection of the home since the new owners have taken over. They have done a considerable amount of work both with the fabric of the building and with the management arrangements of the home. The new owners recognise that living in a nice environment is an important part of people`s lives. They also believe that the people who live at the home should have a `voice` in what happens at the home. A bathroom was totally refitted to make it more accessible and suitable for people to use following consultation with people living at the home. The upper floor has been closed whilst total refurbishment of this area takes place. The conservatory has been refurbished along with the adjacent sitting room to accommodate a newly formed day care centre, which will run independently from the home. The fire and rescue services asked for work to be done to make the building safer for people and this work is now complete. The home has joined an organisation called NAPA (national association for providing activities) and have introduced activity session in the home such as art and crafts, quizzes and reminiscence. A part time activities coordinator has also been appointed. Staffing restructure is underway and some new staff have been employed at the home. What the care home could do better: This service has the potential to be very good. The new owners have achieved a considerable amount of work in a short time. New policies, procedures and staffing structures now need time to `bed in`. Staffing the home has been problematic for the new owners, and they have worked hard to improve standards and met people`s needs with a limited staff number. Recruitment of suitable staff must continue and staffing levels must be maintained. It is essential that staff training continues and that all mandatory training is under taken by staff. The providers need to make application for the manager to be registered with the Commission for social Care Inspection, to ensure that someone is accountable for the management of the home and to make sure things are done properly. Unless risk assessment suggests otherwise all radiators should be guarded. The radiators that are fitted with a guard also need to be risk assessed to make sure that the guard is suitable for the radiator. The manager must take action regarding this so that people who live at the home are kept safe. CARE HOMES FOR OLDER PEOPLE Hollyacre Care Home Front Street Sacriston Durham DH7 6AF Lead Inspector Bridgit Stockton Unannounced Inspection 19th November 2007 09:30 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 Hollyacre Care Home DS0000069480.V351047.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. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollyacre Care Home Address Front Street Sacriston Durham DH7 6AF 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 3719777 0191 3718947 Akenam@aol.com Florence Ann Akena Position Vacant Care Home 37 Category(ies) of Dementia (35), Old age, not falling within any registration, with number other category (36), Physical disability (1) of places Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories. Dementia, - Code DE, maximum number of places: 35 Old age, not falling within any other category - Code OP, maximum number of places: 36 2. Physical Disability - Code PD, maximum number of places: 1 The maximum number of service users who may be accommodated is 37. New Registration. Date of last inspection Brief Description of the Service: Hollyacre Care Home is registered for 36 persons in the category of older persons with or without dementia, and for 1 person in the category of physical disability. The building is situated within its own grounds, in a quiet part of Sacriston. 2 of the homes bedrooms are double rooms, the rest are singles, and only 2 bedrooms in the home have en suite facilities. The home extends to 3 storeys, with the benefit of a shaft lift between them. This enables residents to access the communal rooms, as well as the bathrooms and toilets on each floor. The home’s monthly fees range from £1448.78p to £1657.99p. Additional charges are made for chiropody, hairdressing, newspapers, and magazines, if required. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of this service since the new owners took over the home. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Hollyacre Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of three people, examined other records and looked around the home. I spent five hours at the home. The manager also completed the home’s Annual Quality Assurance Assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home. What the service does well: The people I spoke to said they are happy with the care and support they receive. One person said ‘I am very happy living here, the staff are friendly, it’s very comfortable. Another said that the staff are ‘lovely and very hard working’. People looked comfortable clean and well cared for. There was a really good range of activities to keep people occupied. They included craft sessions, card making and quizzes. At the last residents meeting people requested that the home should have a dog, the management are looking into this. People said they enjoyed the activities that now take place at Hollyacre and really appreciate the time staff are now spending with them. Everyone said they enjoyed the food they were given and said that there was a good choice. One person said ‘the meals are great, I really enjoy my breakfast, I had cornflakes and a bacon sandwich today’. Another person said ‘ the food has really improved since the new people arrived. We get a nice choice, the sausage casserole for lunch today was champion’. The pre-admission assessments have been reviewed and are thorough. The majority of people who I spoke to said they had been given enough information about the home before moving in. One person commented ‘my family sorted this place out for me; they came to look around and thought it was okay. My wife wants me to go back home, but I am really settled here, she’ll never get me home now’. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff if I have a problem, they would sort it out for me’. The staff are aware of their responsibilities if they believe that neglect or poor Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 6 care practice is taking place and were confidant that if they raised any issues the manager would investigate. There are now thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All new staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. What has improved since the last inspection? What they could do better: This service has the potential to be very good. The new owners have achieved a considerable amount of work in a short time. New policies, procedures and staffing structures now need time to ‘bed in’. Staffing the home has been problematic for the new owners, and they have worked hard to improve standards and met people’s needs with a limited staff number. Recruitment of suitable staff must continue and staffing levels must be maintained. It is essential that staff training continues and that all mandatory training is under taken by staff. The providers need to make application for the manager to be registered with the Commission for social Care Inspection, to ensure that someone is accountable for the management of the home and to make sure things are done properly. Unless risk assessment suggests otherwise all radiators should be guarded. The radiators that are fitted with a guard also need to be risk assessed to make sure that the guard is suitable for the radiator. The manager must take action regarding this so that people who live at the home are kept safe. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 7 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. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose has been updated to include all the changes that have occurred at the home since the new owners took over. I also looked at contracts people have with the home. These were detailed and included a breakdown of the fees and who was responsible for paying for the care provided. New contracts will be issued to all the people who live at the home when they have their annual review. I looked at the pre-admission assessments paperwork that will be used before offering someone a place. It was comprehensive. The manager explained that a senior member of staff will visit the person at home or in hospital to discuss their care needs. Social Services assessments will also be used to determine if the placement is suitable and the persons needs can be met. People are welcome to visit the home before reaching a decision. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 10 The home does not provide intermediate care. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 People who use the service experience good quality outcomes in this area. Good systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: I looked at three care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers and to help them maintain their health and well-being. The care plans that I looked at had been reviewed by the new owners, and some new documents added. The plans demonstrated that people are in receipt of individual planned care and support. Careful and thoughtful strategies to address particular needs or problems were well documented and sensitively written. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 12 There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. The plans cover each area of the individual’s health and care needs in detail. There are risk assessments in place, where needed, and these show how potential risks can be minimised. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. One person said that the ‘girls are nice’, another said ‘they will get the Doctor to look at me when I ask, I always see him in my own room’. During my visit I looked at how peoples medication was looked after by the staff at the home. Administration of medication is carried out properly. The system has been rearranged and overhauled by the new owners. A new clinical room has been developed on the ground floor with the expectation is that eventually each floor will have it’s own clinical room. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,&15 Quality in this outcome area is good. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming. Some people were enjoying chatting with each other; some were listing to music or else watching television. A part time activities coordinator has been appointed to the home. Appropriate life long skills are promoted, such as baking and reminiscence. Some people have expressed a wish to clean there own bedrooms. At a recent resident meeting, people asked if the home could have a dog. The new owners are looking into this. Church services are held and people could attend if they wanted to. Plans are in place for the residents to get more involved within the local community for shopping trips and outings to the local area. People told me they had a choice in how they spent their days, one person said ‘I am well fed, looked after and comfortable. I get my tablets when I ask for them and I get up and go to bed when I want. What more could I ask for’. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 14 Everyone said the food was good, and a choice of meals is now offered. The cook was knowledgeable about peoples diet requirements and knew what people liked to eat and what portion sizes they preferred. She said she now goes and asks people about what they really like to eat. She said that most of the meat fruit and vegetables are locally sourced. If anyone needed supplements during the day, milkshakes and fruit smoothies were some of the things offered. A selection of fresh fruit is always available. The lunchtime meal looked really nice and everyone said it was really tasty. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the staff spoken to confirmed they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Since the new owners have taken over there are no complaints recorded. The complaints procedure has been issued to all of the people who live at the home, and is also contained in the statement of purpose and service user guide. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19& 21,26 Quality in this outcome area is adequate Whilst major improvements have been made in the environment, there are still areas of the home that require work in order to meet with standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the new owners have taken over the home they have made lots of improvements to the environment. They have listened to what people who use the service have said about the environment. A bathroom was totally refitted to make it more accessible and suitable for people to use following consultation with people living at the home. The upper floor has been closed whilst total refurbishment of this area takes place. The conservatory has been refurbished along with the adjacent sitting room to accommodate a newly formed day care centre, which will run independently from the home. The fire and rescue services asked for work to be done to make the building safer for people and this work is now complete. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 17 The owners believe that the environment is an important part of people’s lives, and that Hollyacre should be a nice comfortable place to live. Soft furnishings have been replaced in some areas and some bedrooms have been re-carpeted. When I looked around the home some of the radiators in the corridors were not guarded and were very hot. People could burn themselves. Some radiators had guards but these where not properly fitting and had big gaps in them that you could easily get your hand through and burn yourself. The manager said she would get the maintenance person to check the guards and replace them where necessary. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 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 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. The people who live at Hollyacre are protected by thorough recruitment procedures, which ensure that staff are suitable to work with older people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing the home has been problematic, and some existing staff have been unreliable, not turning up for duty or else not working a period of notice, resulting in the owners covering a lot of the shifts themselves. At the inspection there was only one member of care staff, a cook and the maintenance man on duty who were not management in the home. People’s needs were being met, however the amount of hours worked by the management team is not sustainable. The manager said that the home was staffed with regular agency workers for the continuity of peoples care, however someone had not turned up for duty at short notice and the agency was unable to provide a carer today. Whilst I was at the home three new members of permanent staff were undergoing induction. The manager said that once the three care assistants had completed induction they would be deployed in the home and this would free up management time. Other new members of staff had been recruited but the manager was still awaiting references and other checks before they could start working at the home. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 19 I looked at a selection of staff files. Some of these files were the ones used by the previous owners. They all included completed application forms and written references. All files had at least one reference; the manager needs to check all of the staff files to make sure that there are two references in place. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The management hope to create an individualised training program for each member of staff and regular supervision all grades of staff is about to commence. The manager needs to check that everyone is up to date with mandatory training. Some people who work at the home had not attended fire and rescue training. Although everyone had received annual training, the fire and rescue service ask that staff that work in care home are trained more regularly. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 good. The home is well managed. People who live and work at the home can contribute to the decision-making processes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well managed. During my visit the people who live at the home said the ‘new managers’ were ‘great’. One person said ‘they listen to what we want’. Resident meetings have commenced and minutes were available. I read some of the minutes and it was clear that people’s opinions were valued and considered. A ‘stakeholders’ questionnaire is currently being devised to gain external views about the home. Staff meetings have also taken place, but have been poorly attended. Minutes of these meeting were also available for me to read. I spoke with a member of staff who said ‘all the changes here were Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 21 difficult at first to deal with, but now if I have a problem I would go to the manager, and I have done, she is very fair’ The home does not look after anyone’s personal allowance, however an advocacy service is available should people need any help. Most Policies and procedures have been reviewed and revised; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. I looked at some certificates to make sure that equipment was safe and had been maintained. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 x 3 x x 3 Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP19 Regulation 13 Requirement Timescale for action 19/11/07 2 OP19 24 To avoid risk of harm all radiators should be risk assessed, and unless this assessment suggests otherwise the radiators should be fitted with appropriate guards. All staff must received fire 19/02/08 training at regular intervals as directed by the fire and rescue service. This is to make sure that people are safe. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations It is important that the recruitment and retention of staff continues and the manager achieves a full complement of staff who can be deployed at the home, freeing up valuable management time which is currently spent covering care staff duties. It is recommended that the manager submits an DS0000069480.V351047.R01.S.doc Version 5.2 Page 24 2 OP31 Hollyacre Care Home application to the Commission to become registered, as soon as practicable. Hollyacre Care Home DS0000069480.V351047.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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