CARE HOMES FOR OLDER PEOPLE
Caer Gwent Care Home with Nursing Downview Road Worthing West Sussex BN11 4TA Lead Inspector
Miss Helen Tomlinson Unannounced Inspection 16th January 2006 7.30am 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 Caer Gwent Care Home with Nursing DS0000024126.V277341.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. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Caer Gwent Care Home with Nursing Address Downview Road Worthing West Sussex BN11 4TA 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) 01903 536649 01903 535526 Guild Care Mrs Alison Williams Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: Caer Gwent is registered to provide accommodation for up to sixty-one residents over the age of sixty-five years. All sixty-one could have personal or nursing care needs. The home combines a smaller old converted building and a large purpose built building. Accommodation for the residents is provided on two floors, in single, en-suite bedrooms. There is a large amount of varied communal space including three dining areas, four lounges of varied sizes and a conservatory. A hairdressing salon, small kitchen for residents and visitors use and a reception area, with seating, are also available. A third floor provides staff changing, refreshment and training areas. There is a large visitors car park to the front of the building and an enclosed garden to the rear. The garden is well maintained and accessible to residents, with some having patio doors from their bedrooms. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector arrived at the home at 7.30am and left the home at 3pm. A discussion with the night staff, on duty in the nursing wing, took place before they left the home. The registered manager was present throughout the inspection. During the course of the inspection thirteen residents, ten members of staff and three visitors were spoken with. A tour of the premises took place. Individual resident’s care plans were examined and other documents were read as was necessary. Staff were observed giving support and assistance to residents and generally interacting with them. At the last inspection one requirement and seven recommendations were made. At this inspection the requirement remains outstanding. This requires action from the Guild Care organisation, where the responsible individual is working on a solution. It is outside the control of the manager of the home. Five of the recommendations were met. Three additional recommendations were made following this inspection. What the service does well:
The home was clean, tidy and free from offensive odours. Residents commented that the home was always clean and they felt the environment was made homely, despite the large size of the home. A variety of communal seating areas were available, from small sitting rooms to larger lounges and dining rooms. Some residents preferred to stay in their bedrooms and staff respected this choice. Those who stayed in their bedrooms had call bells, newspapers, drinks etc to hand. Residents had personalised their bedrooms with items of furniture, photographs, pictures and other personal items. The Guild Care organisation provide a large amount of appropriate training for their staff. This resulted in residents being cared for by staff who could adequately meet their needs, were constantly looking at ways to improve the service and keeping themselves up to date. The night staff spoken with were included in all training, it was provided at suitable times for their shifts and they felt included in all that went on in the home and the larger organisation. Residents said the staff were polite and friendly, with “familiar faces” helping them, which they preferred. They said they could approach any member of staff, including the manager, should they be unhappy about anything in the home. They felt sure they would be listened to and “taken seriously”. The residents health care and social care needs were understood to be of equal importance by the staff. Both these needs were explored and included on the individual plan of care. A varied activities programme was in place, which included both group activities and one to one. Residents spoken with said they could choose whether to join in with activities or to stay in their own bedrooms or sit in other parts of the home. Although there had to be a routine for the home to
Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 6 run smoothly residents said this was not restrictive and they could make their own decisions about their daily routine, within the limits of meal times. Residents praised the quality, quantity and variety of food served. They said the menu was varied, with a good choice and they could have their meals served in their own bedrooms, should they wish. Meal times in the dining areas were a social event with staff talking to the residents and providing a nice atmosphere. Resident’s benefit from the home being run by an experienced manager who has been in post for several years. There is a consistency in the staff team which residents said was good for them. There are two bedrooms reserved for residents requiring intermediate care. At this inspection there was one resident in the home receiving support and assistance to enable them to return home. Other professionals, who visit the home as part of the intermediate care contract, to provide specific assistance and support to these residents, were spoken with. They said the staff at the home had a good understanding of assistance provided for rehabilitation, although no specific training for this had been provided. The documentation required was in place and detailed and staff were liaising with other professionals to secure the correct support for the resident. Staff benefit from being well supervised by senior staff, having the opportunity to discuss any issues and training needs. What has improved since the last inspection? What they could do better:
Residents receiving intermediate care and staff providing it, would benefit from specific training in rehabilitative care and support. At the last inspection the documentation regarding specific issues, such as pressure area care, was discussed. Some work had been carried out on improving the quality of information provided. On the files seen this remained insufficient in detail for all staff to fully understand the care required, including specific equipment which may be used. Information gained on assessment had not been transferred to a plan of care. The system for daily recording should be reviewed to make sure it is a true and accurate record. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 7 The system for recording visits made by the district nurses and the care they have provided should be reviewed. Staff should know what care the visiting nurses are providing. At the last inspection it was recommended that care staff who are responsible for the administration of medication should receive updated training for this procedure. This training had not been provided at this inspection, though a suitable course had been identified. The manager stated the training would be provided in the near future. A requirement made at the last inspection that residents own money must not be paid into any bank account, unless that account is in their name, had not been met. This is a matter for the Guild Care organisation, since the current procedure is used in all their care homes. The responsible individual was aware of the requirement and was investigating a change to the current system, which would meet the regulations. 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. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3, 4 and 6 Residents had copies of the terms and conditions of their stay at the home. Residents had their needs assessed, by a suitably experienced person, prior to being accommodated at the home. Residents benefit from the care they receive being provided by staff who are well trained. Residents said the staff were fully able to meet their needs. Residents accommodated for intermediate care would benefit from staff who have received specific training in maximising independence. EVIDENCE: A copy of the terms and conditions provided to residents was seen. This contained all appropriate information regarding the facilities and services provided and their rights and responsibilities. These were signed by the resident on becoming accommodated in the home. There was evidence, on the files seen, of an assessment of the residents needs, carried out prior to them becoming accommodated in the home. This included all personal and health care needs, preferences and choices and personal information. The registered manager usually carried out this assessment, or another suitably qualified person, should she not be available.
Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 10 As discussed in standard eight, not all this information was translated to the plan of care when the person became resident in the home. Guild care provide a large amount of training, for all their staff. The night staff spoken with said they were included in all training, being invited at times appropriate to fit with their shifts. This included the statutory training, but also specific training for the needs of the residents accommodated. Staff spoken with said they felt well supported, by this training, to do the job they were expected to carry out. Residents said staff knew how to meet their needs and they were satisfied with the general skill and knowledge of the staff helping them. This level of training, along with the support provided by both senior staff and managers within the larger organisation, result in staff being able to meet the needs of the residents accommodated. As discussed up dated training for those care assistants administering medication and additional training specific for rehabilitation would benefit both staff and residents. At this inspection one resident was at the home to receive intermediate care. This level of care is provided to assist and support the resident to return to their own home. Staff showed an understanding of this type of care, but had not received any specific training. They discussed helping this resident in the same way as the other residents in the home, rather than encouraging and supporting independence more. The links with other professionals, such as physiotherapists and occupational therapists, were present, with staff making sure these people were involved. Visiting professionals spoken with said it was “early days” in the provision of intermediate care in the home, but they were happy with the support from staff and the level of enthusiasm for working in partnership. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 All residents had a plan of care documented. The health care needs of the residents were met, but the relevant documentation was not always present. A recommendation from the last inspection had not been met. Residents were protected by the practices and procedures for giving medication. Standard ten was met at the last inspection. EVIDENCE: All residents files examined had a plan of care documented. These varied in the amount and quality of information provided. Information regarding the social, physical and health needs was included. Most gave a good picture of the resident and their needs, with details of how to meet their needs included. The resident’s preferences and choices were recorded. Not all health care needs identified on assessment had a documented plan of how staff should meet that need. The health care needs of the residents were met. On the nursing wing qualified general nurses provided the care for residents. On the personal care unit suitably trained care assistants, with support of other professionals as needed, provided the care. Some documentation, necessary to support the provision of
Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 12 care, was not present. This was particularly an issue on the nursing wing of the home, with plans of how to prevent pressure sores not being present on some files seen, where the resident had been assessed as being at high risk. One resident had not had a plan of how to meet their identified needs recorded for the first seven days of being accommodated in the home. Despite this the qualified nurses had signed the daily record as the care being provided “as agreed plan.” For one resident who had transferred from the personal care unit to the nursing care unit there was no new care plan written and no indication of why the transfer had been necessary. Whilst the plan which transferred with the resident was thorough, it was unclear if it contained all relevant information, if a change of need had occurred. There was some very good and thorough recording of information seen on some care plans and it was discussed with the manager that some training, regarding the quality of information required, may be needed. The qualified nurses should record in line with the Nursing and Midwifery Council code of practice. Other health professionals were consulted when necessary and G.P. visits were recorded. On the personal care unit not all district nurse visits were recorded. It was recommended that the system for recording these visits should be reviewed. At the last inspection a recommendation that new signs should be provided, where oxygen was stored. These were in place at this inspection. It was recommended that care assistants, on the personal care unit, who administer medication, should received up to date training for this part of their work. This had not been done at this inspection, though suitable training had been identified. The recommendation remains unmet. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14 and 15 Standard twelve was met at the last inspection. Residents were assisted and supported to maintain contact with their family and friends. Residents said they could make choices about their lives in the home and these were respected by staff. A recommendation made at the last inspection, regarding the assistance provided to residents at meal times, had been met at this inspection. EVIDENCE: Residents said they could have visitors at any reasonable time. They could see them in their own bedrooms or the communal lounges, as they wished. Visitors spoken with said they always felt welcomed into the home, could spend time alone with the residents, taking them out if they were able or helping with care tasks, such as at meal times, if they wished. Residents said there were trips out organised, in the minibus, or on a one to one basis, when weather and staffing allowed. Religious services took place in the home and residents could join in if they wished. The choices and preferences of the residents were documented in the care plans. These included their preferred name, likes and dislikes, rising and retiring times and how they liked to spend their time. A lifestyle assessment provided good information about the resident’s past life and gave a picture of the person. Residents said they were asked their choices and these were
Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 14 respected by the staff. The night staff discussed issues of residents wanting to rise early, but clearly recognised the need to respect choices, where these were made in an informed manner. Some detailed information seen in some of the care plans would assist the reader to understand the resident very clearly. This included how to understand a choice they may wish to make by alternative communication methods, other than verbally. At the last inspection a recommendation was made regarding the way assistance was provided for residents in the nursing wing, during meal times. Assistance needed was not given on a one to one basis by staff, who were worried that the food served would go cold. A new system had been introduced whereby there were two sittings at mealtimes, allowing for those who required more assistance to be given their meals separately to those requiring less help. Staff and residents said this worked very well, with the food being served hot, individually, when each resident was ready. The two sittings provided a less hurried mealtime. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Standard 16 was met at the last inspection. Residents were protected from abuse. EVIDENCE: At the last inspection two members of staff, who may be in charge of the home, were not aware of the correct procedure to follow should an allegation of abuse be made to them. At this inspection one of these staff members was no longer employed at the home. The other staff member had reviewed the procedures with the manager and was fully aware of the correct action to take. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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): 20,21,22 and 24 Standards 19 and 26 were assessed and met at the last inspection. Residents were happy with the amount and variety of communal space available in the home. Sufficient bathrooms and toilets were present to meet the needs of the residents. The specialist equipment needed for the residents was present in the home. The resident’s bedrooms provided a safe and comfortable environment for them, which could be personalised if they wished. EVIDENCE: The home was clean, tidy, warm and free from offensive odours. The furnishings and decoration are kept to a high standard and the home was well maintained. Residents were seen to use the various communal spaces, throughout the day. There is a large amount of varied space available, including large and small lounges, a conservatory and dining rooms. A seating area is present in the reception of the home. These areas were made homely, with domestic furnishings, footstools, plants and occasional tables. Residents
Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 17 said they could see their visitors in these rooms, some activities took place in them, or they could sit quietly, with a change of scenery from their bedroom. Residents bedrooms were personalised with furniture, photographs, pictures etc, as the residents wished. Staff said a risk assessment of any large items a resident wished to bring in, would be done, to ensure they safety of residents at all times. All bedrooms were light and airy with large windows and radiators which could be adjusted to suit their needs. Comfortable seating was available and residents could have personal leisure equipment such as televisions, radios, books and music centres, should they wish. Toilets and bathrooms were present in the corridors, close to the communal areas of the home. Most rooms had en-suite facilities, those which had not had a commode provided. Adaptations such as raised toilet seats, handrails, toilet frames, bath hoists and level access showers were present. For one resident who liked a daily shower, early in the morning, extra staff were provided to facilitate this. Other specialist equipment, such as hoists, mattresses and cushions were provided on an individual basis, as an assessment indicated. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 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 and 28 The staff numbers and skill mix was suitable to meet the needs of the residents accommodated. Residents were in safe hands at all times. Standard 29 was assessed and met at the last inspection. EVIDENCE: The number of staff on duty at the time of this inspection was suitable for the dependency of the residents accommodated. The skill mix of staff was suitable to meet their health and social needs. Qualified general nurses were on duty on the nursing wing at all times. There is a stable staff team, which meant the residents had consistent care provided by staff they knew. The training of staff included NVQ levels two and three. Some staff members had completed this training, others were on the course and some were waiting to start. There is a commitment within the organisation to continue to increase the number of staff with this qualification. Caer Gwent Care Home with Nursing DS0000024126.V277341.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): 31,35,36 and 38 The service benefits from being managed by an experienced person with appropriate qualifications and experience. The current procedures do not safeguard the individual finances of the residents. The requirement from the last inspection had not been met. Staff benefit from supervision by a senior member of staff. The health and safety of the residents was protected. EVIDENCE: The registered manager is a qualified nurse with many years experience in care of the older person. She has completed the registered managers award and up dates her practice by attending relevant training courses. She has worked for Guild care for many years and works closely with the responsible individual and managers of other services in the group. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 20 A requirement made at the last inspection that residents own money must not be paid into any bank account, unless that account is in their name, had not been met. This is a matter for the Guild Care organisation, since the current procedure is used in all their care homes. The responsible individual was aware of the requirement and was investigating a change to the current system, which would meet the regulations. A system of supervision for all staff, was in place in the home. Staff spoken with said they felt well supported by the manager and senior members of staff. All senior staff were delegated other staff to offer supervision and support. These one to one sessions were formal, structured and recorded. Staff had received training in health and safety and all showed an awareness of their role in protecting the residents in their care. All parts of the care home seen were free from hazards. Accidents were reported and recorded. The manager said all equipment was maintained in line with the manufacturers requirements. The fire procedures and training were looked at in detail at the last inspection. Those staff spoken with were aware of the correct procedure and had received up to date training. Caer Gwent Care Home with Nursing DS0000024126.V277341.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 3 3 3 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 4 4 3 3 x 3 x x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 2 3 x 3 Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? 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 OP35 Regulation 20 (1) Requirement The registered person shall not pay money belonging to a resident into a bank account unless the account is in the name of the resident to which the money belongs. This requirement remains unmet since the inspection of 27/09/05. The timescale given of 31/12/05 has expired. Timescale for action 31/05/06 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 3 4 Refer to Standard OP6 OP8 OP8 OP8 Good Practice Recommendations Staff would benefit from training specific to the needs of residents accommodated for intermediate care. Specific needs identified on assessment should have a detailed plan of care documented. The way of recording on a daily basis should be reviewed. Visits made by the district nurses should be recorded.
DS0000024126.V277341.R01.S.doc Version 5.1 Page 23 Caer Gwent Care Home with Nursing 5 OP9 Care staff who administer medication should receive up to date training. Caer Gwent Care Home with Nursing DS0000024126.V277341.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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