Inspection on 05/01/06 for Argyles Nursing Home

This inspection was carried out on 5th January 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Argyles Nursing Home 06/06/07

Argyles Nursing Home 16/05/06

Argyles Nursing Home 26/07/05

Argyles Nursing Home 08/03/05

Argyles Nursing Home 23/11/04

Argyles Nursing Home 03/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Argyles Nursing Home Pound Street Newbury Berkshire RG14 6AE Lead Inspector Mrs Rhian Williams-Flew Unannounced Inspection 5th January 2006 9.25 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 Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Argyles Nursing Home Address Pound Street Newbury Berkshire RG14 6AE 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) 01635 551166 smithsu@bupa.com BUPA Care Homes Limited Miss Susan Jayne Smith Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: The Argyles is a care home with nursing run by BUPA care homes. The home can accommodate 57 residents over the age of 65 years of age. It is not registered to provide care for people who were suffering from dementia as the primary diagnosis. The accommodation in the home is provided over two floors. Each floor has access to two lounge areas. There is a passenger lift between the two floors of the home. The home is very close to the centre of Newbury and is easily accessible by road and rail, as well as pedestrian access. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced occurring between 9.45 - 19.00 hours on a weekday. The Registered Manager was present for the majority of the inspection. The focus of the inspection was to review the requirements made at the previous inspection and to review the key standards that have not been inspected on previous occasion. 6 residents were spoken with and 7 members of staff, excluding the Registered Manager and the Deputy Matron. Documentation concerning the delivery of care to residents and, to ensure that the home is run to protect the health and safety of residents and members of staff were reviewed. Additionally, a short meeting was held with the training officer to review the training records for staff. What the service does well: What has improved since the last inspection? All of the previous requirements and recommendations have been met. The appointment of the Deputy Matron has certainly had an impact on the delivery of care to the residents. Members of staff spoke encouragingly about her support and the changes she has started to implement. Care plans have improved but it is recognised that this is only the start of the process. The Deputy Matron sees her priorities as promoting choice and ensuring that care is delivered in a dignified and respectful way. It was noticeable that these areas of care delivery had improved. She is also ensuring that the home has the correct equipment to meet the needs of the residents. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 6 The decoration of the downstairs corridor area has made a significant difference to the environment of a home. The upstairs corridor area is due for refurbishment at the beginning of February 2006. 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. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Since the previous inspection the quality and relevance of the information in residents care plans has improved. The process is not complete. However, the newly appointed Deputy Matron has enthusiasm and plans to continue the improvements. EVIDENCE: A previous recommendation has been met. All new residents who are admitted to the home do have a skeleton care plan based around their original admission assessment needs, whilst evidence for a more detailed care plan is being gathered. Three months ago the home appointed a Deputy Matron who has responsibility for the quality of care delivered to the residents. One of her main priorities has been to review and improve the care plans for the residents to ensure that they are relevant, clear and up-to-date. This process is not complete but on the evidence seen it was clear that changes are being made and it is her intention to continue this process of change. An initiative she has implemented includes having individualised documents, about the care Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 9 residents wish to receive and how to achieve this, within each persons room. These individualised records are not in place for all residents but it is acknowledged that this is the intention. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 The health care needs of the residents in the home are promoted and monitored. The ethos of the home is more centred on ensuring that residents are treated with respect and dignity. However, the employment of staff who are able speak and understand English clearly is also important if residents are to have confidence that their wishes regarding their personal care needs are being understood. EVIDENCE: A previous recommendation has been met. Evidence was also seen that individual records regarding weight records and bathing preferences are being included in the individual residents care plans, and not on separate task orientated lists as previously found. A previous immediate requirement to investigate matters of serious concern raised by a resident was satisfactorily concluded within the timescale set. The actions recommended following the investigation were followed through and all Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 11 members of staff have received the advised training. It was observed during the inspection that the staff and resident interactions were respectful. Some of the residents spoken with confirmed that they were treated respectfully. Some residents also commented that they found conversing and understanding some of the care workers difficult, as their first language was not English. This they found frustrating at times, as they could not make their personal needs known due to a lack of understanding on behalf of the care worker. This could be interpreted by residents as not showing them respect. Two residents advised the Inspector and the Deputy Matron that if a member of staff is not able to understand them then they send them away. This should not have to occur. When reviewing a random sample of the existing care plans with the Deputy Matron it was noted that one care plan had not been fully updated for three months and another contained errors in the risk assessment. The Deputy Matron acknowledged that these events should not have occurred and indicated that it was her intention to implement a regular audit of all documentation concerning care delivery in the near future. Since the arrival of the Deputy Matron the residents access to optical and dental services have improved. In addition the Deputy Matron is ensuring that the psychological needs as well as the physical health needs of the residents are recorded and monitored regularly. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 The opportunities for residents to make choices about how their care is delivered has improved however, continued emphasis and training on this aspect of care delivery is needed. The employment of staff who, can speak and understand English clearly is also important if residents are to have confidence that their wishes and choices are being understood and will be met. There is more emphasis being given in offering choice to residents with regard to food and drink. However, the presentation of the meal could also include confirmation from the care staff as to what the meal includes so that residents are reminded of the choices they made. EVIDENCE: A previous requirement has been met. The emphasis on resident choice has been promoted in the home and from the comments of the people who live in the home and observations during the inspection there was a marked improvement in this area of care delivery. There were some exceptions, which were observed by the Inspector and the Deputy Matron. It was accepted by the Deputy Matron that the promotion of choice for residents must be one of her ongoing priorities. The Training Officer for the home confirmed that further training was planned regarding the promotion of choice. BUPA as an Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 13 organisation have a training programme called Personal Best. During interviews with members of staff who had received this training programme they felt it had given them a valuable insight into how important it was to include the resident in all aspects of their care particularly, by communicating all that they did with the resident and always offering choice. As previously stated some residents did comment that they found conversing and understanding some of the care workers difficult, as their first language was not English. This they found frustrating at times, as they could not make their personal needs known. This was due to a lack of understanding on behalf of the care worker. This issue was discussed with the Registered Manager, as clearly this is an issue that needs to be explored during the recruitment of staff. Further comment on this issue will be made in the section of the report entitled staffing. The serving of the midday meal was observed and several of the residents were asked for their opinions on the quality of food and presentation. All were complimentary. It was noted that in the main dining room menus are now available on each table, advertising the food that is to be served. Residents make their choice of menu on the previous day. It was observed that members of staff did not always advise the residents (who were not in the main dining room and do not have ready access to the menu) of the content of the meal they are placing before them. Several of the residents commented that they were not sure what they were eating, as they could not remember what they had chosen. In spite of this they all said the meal was very good. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There are procedures in place to ensure that any complaints are investigated properly. All members of staff have received training in the protection of vulnerable adults (POVA). EVIDENCE: A previous requirement has been met. The Registered Manager has assured that all members of staff have been advised of the complaints procedure for the home and how they should access this when they receive complaints from residents, relatives or any other visitors to the home. It was confirmed by the Training Officer that all members of staff have received training in the protection of vulnerable adults (POVA). In addition, two members of staff have been on a “training for trainers” course so that they are able to provide POVA to all new staff and to ensure that all other members of staff receive regular refresher training. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The decoration and refurbishment of the downstairs corridors has been completed and it has significantly improved the quality of the environment that the residents live within. The upstairs corridor areas are due for refurbishment at the beginning of February. Whilst a previous requirement has been met with regard to appropriate door closing fitments for the fire doors it will be necessary to issue another requirement to ensure that when the fire doors close to form a complete seal. The home is clean and well presented. A recent winter virus that affected some residents and members of staff was managed appropriately and promptly. EVIDENCE: A previous requirement has been met as all of the downstairs corridor areas have been redecorated and have new carpets. This has made a significant difference to the ambience of the home and the quality of the environment the residents live within. The CSCI has received written confirmation from the Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 16 Registered Manager that the upstairs corridor areas will have similar refurbishments starting the week beginning 6 February 2006. A previous requirement has been met as all fire doors have been fitted with appropriate door closing fitments so that if residents wish to have their door open it can be done without compromising the fire safety requirements of the home. However, it was noted (under test conditions) that when these mechanisms are released, some of the doors were not closing properly into the doorframe. This means they are not making a complete seal. This should not occur and must be dealt with as a priority. The maintenance man and Deputy Matron witnessed the deficit. The maintenance man was spoken with regarding his work programme and the statutory checks he conducts to ensure the home is safe for the residents and staff. He is clearly committed to his task and it was observed that he is personable when conversing with the residents as he conducts repairs in their rooms. The home has recently experienced a winter virus that affected some of the residents and members of staff. From the evidence seen it was reassuring to note that the home responded promptly and appropriately, involving the public health protection nurses to give advice on the control of the virus. All staff received specific training from these nurses regarding safe hand washing and isolation of the virus in the home. Members of the domestic staff were very much involved in the management and containment of the virus. The home was clean and tidy. The laundry facilities in the home were inspected and comply with the standards required. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 There are sufficient members of staff in the home for the number of residents who require care. Whilst the home has not achieved the 50 ratio for care staff achieving NVQ level 2 by the end of 2005 the home does have a commitment to training and is always encouraging of staff if they wish to pursue their NVQ qualifications. The Training Officer ensures that members of staff do receive their statutory training when required. In a random sample of recruitment records significant deficits were found. Such deficits have the potential for exposing the residents in the home to risks. This should not occur. The Registered Manager has accepted responsibility for this. EVIDENCE: This home is registered for 57 residents. However, at the time of the inspection 42 residents were in the home. This is the average number of residents that this home usually has. This is because a number of the rooms in the home can be used for two people who have expressed a wish to share. Therefore, the numbers of staff allocated for this reduced number of residents is appropriate. Confirmation was sought from the Registered Manager and the Deputy Matron that they had adequate staffing to meet all the needs of the residents in the home and they confirmed that they did. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 18 Written confirmation has been received from the Registered Manager that she has 27 care staff and at the time of the inspection and 30 of them had achieved NVQ level 2 or above. This does not meet the standard required of 50 by the end of 2005. However, the Registered Manager has confirmed that within the next month at least 5 members of care staff will commence an NVQ qualification. If they complete the qualification this would increase the percentage of qualified care staff in the home to 48 . The recruitment records of 4 members of staff were reviewed in their entirety and 50 of these did not meet the requirements of the Care Standards Act. There were significant deficits in the documentation required for these 2 members of staff who have been in the home since September 2005. The records contained no references, particularly from their last employer. Their last period of employment appeared to have ended in 2001 and there was no evidence to suggest what employment they had been pursuing since that time. Only 1 police check could be evidenced for one of the employees but it was in the language of the employees home country and the employee had provided no translation. Only 1 health check could be evidenced for one of the employees. This had been translated. The Registered Manager accepted that the standard of recruitment practice was not acceptable. She was asked to review these 2 members of staff recruitment documentation and take appropriate immediate action. She was advised that it was imperative that she must ensure the protection of the residents in her care by employing staff as required by the regulations of the Care Standards Act. Subsequent to the inspection the Registered Manager has confirmed that she conducted a full audit of the recruitment records of all her staff and suspended 4 members of staff including the 2 identified at the inspection in order to ensure that all references and appropriate checks were in place. All these were in place within 48 hours and the Registered Manager has confirmed they were all satisfactory and the members of staff have returned to work. As previously indicated in this report residents had commented that some members of staff had not been able to converse and understand them, as they did not speak English well enough. It was revealed that one of the above mentioned member of staff was such a person. The Registered Manager was asked how this had occurred and she acknowledged that she did not speak with the person concerned before offering employment. She had conducted the interviews and negotiations of employment with his colleague (whilst they were still in their home country). This person was able to speak English and she made an assumption that the other person could speak English to a similar standard. Since arrival in this country the Registered Manager has facilitated access to various course in English speaking, writing and understanding. In conversations with members of staff they confirmed that the identified member of staff now speaks a level of English best defined as holiday English. The Registered Manager has accepted responsibility and has assured that she would never recruit members of staff in such a way again. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 With the notable exception of the errors that occurred in the recruitment of staff the Registered Manager does run and manage the home effectively. The resident’s views are sought with regard to the running of the home and the home does have a quality assurance monitoring system in place. There are robust procedures in place to ensure that the resident’s monies are safeguarded. With the exception of the proper closing of the fire doors the Registered Manager ensures that the home is a safe and well-maintained environment for the residents to live within. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 20 EVIDENCE: The Registered Manager is qualified and has significant experience in running the care home. However, she must remain vigilant to all aspects of her role in order to protect the residents who are in her care. She is respected by her staff and in conversations with a number of them they commented on how supportive she is. The appointment of the Deputy Matron is providing good leadership for the staff who provide the care to the residents. The home does have a quality assurance monitoring system to ensure that the home is run for the best interests of the residents. A recent survey of the residents and their relatives has been completed by the BUPA organisation was at the time of the inspection the results had not been fed back to the home. The Registered Manager conducts two resident/relative meetings a year and holds regular staff meetings. There is a system in place to ensure that resident’s monies are safeguarded by the home. An administrator oversees this. In a random sample of records and was noted that they are well kept and up-to-date. As previously referred to at standard 19 it is imperative to ensure that all fire doors do shut properly when they are released from their door closing mechanism. A random sample of the records kept in the home to ensure the health and safety of the residents and the members of staff were up-to-date. Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 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 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 2. OP10OP14 OP29 12, 18 & 19 3. OP19OP38 23(4) Residents care plans must be up 31/03/06 to date and accurately reflect the care to be delivered to the person. The recruitment of staff must 20/01/06 comply with the regulations of the Care Standards Act. The Registered Manager has this responsibility and must ensure that there are robust procedures in place. All staff recruited to the home should have personally applied and been interviewed for the post and all the relevant documentation detailed in schedule 2 should be in place. Staff must be able to speak English to a reasonably competent standard. It is the Registered Managers role to ensure that she has members of staff whom can meet the needs and choices of the residents this would include members of staff being able to speak and understand English. All fire doors must close to form 31/01/06 a seal between the door and the doorframe. This is particularly DS0000010969.V254427.R01.S.doc Version 5.1 Page 23 Argyles Nursing Home 4. OP31 9 relevant when door closure mechanisms have been used to hold the door open prior to their activation. The Responsible Individual should review the Registered Managers competence with regard to the errors that have occurred in the recruitment of staff and be satisfied that the Registered Manager is able offer robust protection to the residents who live in the home. 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The implementation of the changes and improvements already commenced to the care plans of residents should continue. Consideration should be given to ensuring these improvements are made within the next three months. The implementation of an audit tool to check the quality and relevance of the care plans should be followed through in the same timescale. Members of staff should continue to promote resident choice. This aspect of care delivery should be promoted at every opportunity. The Registered Manager continue to promote NVQ training to the care staff who work in the home to ensure the minimum ratio of 50 of the care staff team do achieve an NVQ qualification. 2. 3. OP14& OP15 OP28 Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Argyles Nursing Home DS0000010969.V254427.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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