Inspection on 09/08/06 for Ashton House

This inspection was carried out on 9th August 2006.

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

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

Other inspections for this house

Ashton House 02/02/06

Ashton House 16/08/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashton House Union Street Stow-on-the-wold Glos GL54 1BX Lead Inspector Ms Eleanor Fox Key Unannounced Inspection 09:30 9th August 2006 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 Ashton House DS0000064572.V304129.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. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashton House Address Union Street Stow-on-the-wold Glos GL54 1BX 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) 01451 830843 The Orders of St John Care Trust Mrs Maggie Keyte Care Home 45 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (35) of places Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under 65 years to be accommodated for respite care. This condition will be removed when the service user reaches 65 years of age or no longer wishes to receive respite at the home. One named service user under 65 years to be accommodated for respite care (DE). This condition will be removed when the service user reaches 65 years of age or no longer wishes to receive respite at the home. 2nd February 2006 2. Date of last inspection Brief Description of the Service: Ashton House is a purpose built well-appointed Care Home, situated within easy reach of the town centre of Stow-on-the-Wold. The Home offers personal and nursing care to the elderly residents; it is managed by The Orders of St John Care Trust. Ashton House has 42 single rooms and a double room, which is currently accommodating one resident, and has homely communal accommodation on both floors. A shaft lift has been installed for easy access to the upper floor; the Home is also well equipped with a variety of disability aids. Part of the ground floor has been converted to provide secure accommodation for ten elderly people who suffer from dementia. Consideration is being given to extending this facility. The residents have secure access to the extensive attractive private gardens that surround the property. The provider supplies information about the home, including the most recent CSCI report in a file at the entrance of Ashton House. Current fees range from £368.25 to £693. Hairdressing, chiropody and any personal items are charged extra. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection of the home over two days in August. During the visit, she chose four of the residents for particular scrutiny. She met each of these people, read their care records, visited their bedrooms and observed their interaction with the staff who were caring for them. One person had just been admitted to the home and another was seriously unwell at this time. The inspector read selected personnel and recruitment records, walked around the property and observed the service of two meals during her visit. She also spoke with some of the staff who were on duty on these two days. Finally, she talked with the Manager, her deputy and to the administrator, particularly in relation to general management issues. All were open and most cooperative in providing information as requested. CSCI surveys were distributed to residents, relatives and members of staff working at the home. Nineteen were returned from residents, most of whom had required assistance from a relative or a named member of staff to complete the forms. Fourteen surveys were received from staff in the home and twenty-one comment cards were received from relatives and advocates. Many of their comments and opinions are reflected in the content of this report. What the service does well: Each prospective resident is thoroughly assessed to ensure that the home is able to meet his or her needs. Fully detailed care plans are prepared to address each resident’s care needs; these provide clear guidance to the carers and are reviewed appropriately. Residents’ relatives responded very positively when requested to comment on the care provided at the home. One person described it as, “Absolutely wonderful, I feel completely confident that my Mother is receiving the best care possible”. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 6 Residents are given the opportunity to exercise choice, as far as they are able, in their daily lives. During the visit, all were consulted before any care was given or food offered. Gentle encouragement, however, was given when necessary. All administrative records are kept methodically and are stored securely. Members of staff appear to be friendly in their approach and have established good working relationships with the residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. A thorough assessment process and the provision of literature about the home, although now requiring some revision, enables prospective residents to make an informed decision regarding their admission and gives them assurance that their needs will be met. EVIDENCE: Each prospective resident is provided with comprehensive information about the home; however the content still requires review to reflect the management changes in the Company over the last seventeen months. Preparation for the publication of the new brochures is now well under way; the inspector was shown some of the draft documentation. Each person is fully assessed prior to admission to Ashton House to ensure that the home is able to meet his or her needs. All the completed records for the person who had just been admitted to the home were read on this Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 9 occasion. Not only had the Manager completed an assessment, but the hospital staff had also provided a very informative document about this person; the home also had a copy of the Social Worker’s assessment on file. These details had all been available to assist the nurse when the resident was admitted to the home. Intermediate care is not provided at this home. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The care planning systems in place provide clear information to staff, ensuring that they are able to care for all the residents’ needs. However, the medication systems do require improvement to ensure that residents are not put at any risk of potential errors. Care is delivered in a manner that preserves the residents’ privacy and upholds their dignity. EVIDENCE: Clearly detailed care plans are prepared for each of the residents; those relating to the people chosen as part of the case tracking exercise were read fully on this occasion. In each example guidance is provided for the carers to address the residents’ specific care needs. General and specific risk assessments are also prepared as required; all are reviewed and updated in a timely fashion and appear to reflect each resident’s current condition. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 11 It was observed that appropriate pressure relief is provided when specific risks are identified. Those considered ‘nutritionally at risk’ are also closely monitored and given supplements, as required. It was documented in the records that residents had received care from their General Practitioners, the community nursing team and other healthcare specialists when necessary. Medications are stored safely and securely; refrigerator temperatures are monitored correctly. Medication Administration Policies are readily available and appropriate reference literature is also provided. A photograph is provided for each resident to aid identification. One person had been identified in the care planning documentation that she was allergic to specific medication; the allergy had also been clearly recorded on her medication administration sheet. The majority of handwritten medications had been correctly signed and countersigned but there were some examples in the records examined where this had not been completed. More significantly, the administration of a Controlled Drug had been altered from twice daily to three times a day with no supporting signatures. An explanation for this alteration had, however, been recorded in the resident’s care plan. These shortfalls were identified to the deputy manager for attention. Members of staff were observed addressing the residents in a respectful but friendly manner. Those people who required assistance to use the toilet were helped discreetly and with due attention to the resident’s dignity. Each person knocked on the door before entering any bedroom. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Some opportunities are provided for varied and stimulating activities and social contacts, as desired. A reasonable choice and variety of meals ensures residents normally receive a nutritious and balanced diet. EVIDENCE: The home is working to build on the provision of suitable activities and stimulation for residents living at Ashton House. Carers are receiving training at the current time on the special needs of the majority of people living there. Although there is a focus on ‘one to one’ care, group events are also arranged; music and movement sessions are particularly popular. Well considered provision is made for the residents accommodated in the ‘Sunnyside’ unit. Where appropriate, some residents attend specialist clubs; one lady particularly appreciates the benefits of these outings. Client activity records are now maintained on a more regular basis although there is only limited available information on residents’ backgrounds or previous/current interests for many of the people living at the home. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 13 Family and friends are welcome to visit whenever the resident wishes. The majority of relatives who spoke to the inspector and who responded to the questionnaires were extremely supportive of the home and the staff working there, one person writing, “Families may have total peace of mind about residents at Ashton House”. A very few concerns were raised about some of the food provided. Staff were observed offering residents choice during the day, particularly about food and how they spent their day and about the care they received. One person had clearly been able to arrange her bedroom and bedding to her own taste, this had been respected by the staff. The service of two meals was observed during the visit. On both occasions, the majority of the residents ate their meals in one of the dining rooms; some chose to remain in their bedrooms or other areas of the home. A choice of food was offered and most people appeared to enjoy what they were eating. Many required some degree of assistance or gentle encouragement. Staff were seen to be attentive and supportive, giving residents time to consume their meal at their own pace. Nutritional supplements were offered where appropriate. Discussion with the catering staff on duty showed that any particular catering needs or requests had been communicated and were addressed. No special diets were required at the current time. Although some concerns were raised about overcooked vegetables and bland food, on the whole all those who responded to the surveys were positive in their comments with one person saying, “The food is first rate”. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A satisfactory complaints system enables residents and their families to feel assured that their views would be listened to and acted upon. Residents are offered a good level of protection against abuse. EVIDENCE: A copy of the home’s Complaints procedures is advertised in the front hall of Ashton House; the details are also included in the home’s brochure (the Service User’s Guide). Of the twenty-one respondents to the CSCI survey, only two had ever had to make a complaint about the home and all were satisfied with the overall care provided. There have been no formal complaints about Ashton House since the last inspection. The majority of staff employed at the home have now had training on abuse issues; the home also has comprehensive policies on the subject. A selection of information on sourcing advocacy support is provided, if the residents require this facility. POVA (Protection of Vulnerable Adults) legislation is correctly followed at Ashton House. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 15 Ashton House DS0000064572.V304129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Some maintenance attention and some isolated additional cleaning is required to create a comfortable and homely environment for the residents living in the home. EVIDENCE: During a walk around the property it was observed that the whole home was reasonably clean and fresh. The garden was also well maintained and looked attractive. It was noted, however, that parts of the carpet on the first floor corridor were stained and did require some attention. Since the last visit, the chairs in the sitting area on the top floor had been replaced and a new resident call system had been installed. A new assisted bath facility had also been provided. Initially, there had been some serious commissioning difficulties associated with this facility but these have since been resolved and it was reported that the bath is now being regularly used. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 17 Wheelchairs were stored tidily and also appeared clean. Sturdy grab rails are provided at strategic points throughout the building to assist the elderly people living there. The lift has been malfunctioning in recent weeks and is now scheduled for a full upgrade later in the summer. Arrangements are being made to reduce the disruption to the residents to a minimum during the necessary maintenance work. However, some residents had already been inconvenienced by the frequent breakdowns. The lift could not be used on the second day of the inspection. A visit was made to the bedroom of each of the residents who had been selected for case tracking. Each room had been personalised with photographs, treasured possessions and in some cases, some small items of furniture. Where appropriate, window restrictors had been installed to protect the resident from any untoward accidents. The laundry area on the ground floor was tidy and well organised; the person on duty in this area showed a good understanding of infection control protocols. It was noted that residents’ personal clothing was ironed prior to return to each person’s bedroom. Ashton House DS0000064572.V304129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents receive care from a more stable workforce but improved recruitment and some additional training would help to ensure residents are fully protected. EVIDENCE: On one day of the inspection the deputy manager was in charge of the home with ten carers on duty to look after the residents. Four more carers were in the home attending a training workshop on Dementia Care. A nurse and seven carers were scheduled to be on duty in the evening with a nurse and two carers overnight. The majority of people who responded to the questionnaires felt that there was normally an adequate number of staff on duty to care for the residents although there were some comments that the home is sometimes short of staff. Discussions with one member of staff, employed through an agency, who had never worked at Ashton House before showed that she had a good understanding about the home and knew what to do or where to source assistance in case of an emergency. Of the twenty carers employed at the home, three have achieved a National Vocational Qualification, Level 3 in Care and a further three people have Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 19 completed Level 2. Two carers are undertaking the training at the current time and a further nine people have made a commitment to commence the course. After earlier difficulties, the home has been successful in recruiting an additional five members of staff since the last inspection; their personnel files were seen on this occasion. In each instance, the prospective employee had completed an application form providing details of his or her employment history; records had been made of the interview processes, albeit very brief; and correct POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had been completed for each person. Two written references had been provided for the majority of applicants but in one case, no written reference had been obtained from the previous employer and the one verbal reference had not been later confirmed in writing, as is required. These anomalies were identified for urgent attention. It was observed that job descriptions filed in the notes had not been signed by the member of staff to signify awareness of all the responsibilities of the role. It is recommended that this good practice be introduced. Training requirements, including induction, are identified and arranged when possible. Most of the staff have now attended training on dementia care and also on abuse issues. It was confirmed that the members of staff delegated to carrying out manual handling training in the home have now completed the necessary update training to perform this role. This had taken longer than anticipated. As a result, although some of the carers have now received their mandatory training from these members of staff, there are still some identified individuals who have not yet been addressed; this shortfall is now being rectified. Four members of staff have identified on their questionnaires that they would like additional training to carry out their duties. Ashton House DS0000064572.V304129.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Robust management systems ensure that the financial interests, and the health, safety and welfare of people using the service are safeguarded. There is an evident commitment in the Home to improve the services for the benefit of the residents living there. EVIDENCE: The Registered Manager, an experienced trained nurse has recently successfully completed the Registered Managers Award. She has continued to attend training sessions on a number of topics throughout this year and was in fact attending a workshop on the first day of the inspection. Her deputy, also a trained nurse, and the home’s administrator support her in her role. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 21 The home is currently undertaking an audit of residents’/relatives’ satisfaction with all aspects of Ashton House’s services. Some completed forms were read during the visit. When the results have been collated, any areas for improvement will be identified and addressed. Residents’ satisfaction with meals and any complaints, concerns or accidents are also monitored on a monthly basis. A medication audit was completed in June. The Care Services Manager also visits the home on a monthly basis to check standards. She has recently conducted an inspection during the night. The Administrator continues to take responsibility for the personal monies for the majority of the residents in the home; the records relating to the four residents selected for case tracking were checked on this occasion. It was observed that correct records are maintained and that individual secure storage is provided. Residents’ status in relation to ‘Power of Attorney’ is also ascertained and the results maintained on file. Health and safety issues are generally addressed well at this Home. However, it was observed in the available records that fire safety training for some identified members of staff is now overdue. This is being addressed. When questioned, the agency nurse on duty was well aware of her duties if the alarm sounded. Records were provided to show that maintenance of equipment is addressed in a timely fashion and arrangements have been made to rectify the ongoing passenger lift problems. The few issues identified following an Environmental Health inspection in January have all now been addressed. Ashton House DS0000064572.V304129.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 1 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 x 2 3 x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 6(a & b) Requirement The Statement of Purpose and Service User Guide must be reviewed and updated to reflect the changes in the home. A copy must be provided to the Commission. (This requirement has been repeated from the last inspection). The person making the record in the drug administration documentation must sign any handwritten amendments; these must also be countersigned by a second witness. (This requirement has been repeated from the last inspection). The carpet on the first floor must be cleaned or replaced. The passenger lift must be repaired/replaced Two written references must be received before an applicant is appointed to a post at the home Members of staff must receive timely training in the moving and handling of residents (This DS0000064572.V304129.R01.S.doc Timescale for action 30/09/06 2. OP9 13(2) 01/09/06 3. 4 5 6. OP19 OP22 OP29 OP30 23(2d) 23(2n) Schedule 2.3 13(5) & 18 (1c) 31/10/06 31/10/06 01/09/06 30/09/06 Ashton House Version 5.2 Page 24 7 OP38 23(4d) requirement has been repeated from the last 2 inspections). All members of staff must receive timely training in fire safety. 30/09/06 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. 2 Refer to Standard OP28 OP29 Good Practice Recommendations It is recommended that at least 50 of care staff should be trained to NVQ, level 2 or equivalent. It is recommended that Job Descriptions should be signed by the member of staff to signify awareness of all the responsibilities of the role. Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Ashton House DS0000064572.V304129.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!