Inspection on 26/06/08 for Cerne Abbas Care Home

This inspection was carried out on 26th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Cerne Abbas Care Home 26/03/08

Cerne Abbas Care Home 14/06/07

Cerne Abbas Care Home 11/05/06

Cerne Abbas Care Home 24/01/06

Cerne Abbas Care Home 24/01/06

Cerne Abbas Care Home 25/08/05

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Cerne Abbas Care Home Cerne Abbas Dorchester Dorset DT2 7AL Lead Inspector Gloria Ashwell Key Unannounced Inspection 26th June 2008 10:00 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 Cerne Abbas Care Home DS0000065834.V364907.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. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cerne Abbas Care Home Address Cerne Abbas Dorchester Dorset DT2 7AL 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) 01300 341008 01300 341111 cerne.abbas@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Manager post vacant Care Home 66 Category(ies) of Dementia (40), Mental disorder, excluding registration, with number learning disability or dementia (26) of places Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Dementia aged 55 years and over on admission (Code DE) maximum 40 places Mental disorder, excluding learning disability or dementia (Code MD) maximum 26 places The maximum number of service users who can be accommodated is 66. 25th August 2005 2. Date of last inspection Brief Description of the Service: Cerne Abbas Care Home is situated on the outskirts of the village of Cerne Abbas in West Dorset. It is within reasonable walking distance of the village centre with amenities including a post office, church, public houses and tearooms. There is a GP practice in the village. Car parking spaces for visitors are provided at the rear of the home. A public transport bus service serves the village of Cerne Abbas, neighbouring villages and the nearest towns (Dorchester and Sherborne). The home is registered to provide specialist nursing care for 53 older people with dementia and 18 younger adults who have acquired brain injury including Huntingtons Disease. This report relates to all the 3 units, known as ‘Houses’. The part of the home delivering care to the younger adults is Cloisters House, situated on the first floor. A passenger lift provides access to the House. The parts of the home delivering care to the older persons are on the ground floor: Orchard House and Atrium House, each with lounge and dining areas. Electronic number keypads are used on the doors leading to each House. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 5 The home provides nursing and care staff on a 24-hour basis and employs catering, domestic and maintenance staff. In addition to the nursing, personal care and accommodation provided, the scale of charges for the home includes the provision of social activities, catering for all meals and laundry and housekeeping services. Fees are charged weekly; the fee range quoted in the service user guide at the time of inspection was £550 - £750 per week on Atrium House or Orchard House, and between £800 and £1500 for residents accommodated on Cloisters House. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link: http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. Both visits of this inspection were unannounced; two inspectors arrived at 10.00 on 7 July 2008, toured the premises and spoke to residents, visitors, staff and the Acting Manager, and two inspectors visited the home at 10.00 on 11 July 2008 and with the acting manager discussed and examined documents regarding care provision and management of the home and toured the premises. The duration of the inspection (both visits and the hours spent in the home by each inspector combined) was 22 ½ hours. The inspectors spoke to the acting manager, care and household staff and most of the residents accommodated at the time both individually and in small groups in the communal areas, and observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. The care records of eight people who live at the home were examined in detail. 2 of these people were accommodated in Atrium House, 5 in Cloisters House and 1 in Orchard House. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: People considering moving into Cerne Abbas Care Home receive a full assessment and are provided with the opportunity to visit and spend time at the home in advance of admission. The home provides good standards of nursing and social care to residents with varying needs including people of great frailty who are highly dependent on Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 7 staff for assistance, and people with specific mental health needs who require patient understanding and skilled management. The special needs of elderly people with dementia are met by provision of staff training, use of appropriate activities and innovative decoration e.g. use of colours, decorative techniques and signage. Meals are appetising and of good quantity and quality; they are served in attractive dining rooms and staff provide assistance to residents unable to eat and drink independently. The premises are spacious with car parking spaces and an enclosed garden to the back of the building. Each unit, known as a House, has its own small garden, including first floor Cloisters House which has a fully enclosed roof terrace. Medicines prescribed by doctors are administered to residents by trained nurses thereby protecting residents from risks of medicine errors. Residents wishing to do so may store and administer their own prescribed medicines in accordance with a risk assessment process to ensure it is safe for them to do so. 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. The summary of this inspection report can be made available in other formats on request. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so St 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents (or their representatives) are provided with information about Cerne Abbas Care Home and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: The records of two recently admitted residents included details of preadmission assessments carried out by the acting manager when she visited the prospective residents at their previous addresses. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 10 In advance of making the decision to enter the home the closest relative/ representative of each prospective resident visited Cerne Abbas Care Home to view the premises and meet residents and staff. Following pre-admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed, but improvements must be made to aspects of medicine handling to ensure the protection of residents. EVIDENCE: The care records of eight people who live at the home were examined in detail (2 from Atrium House, 5 from Cloisters House and 1 from Orchard House) and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 12 Medicine handling is carried out by registered nurses and medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. Residents wishing to do so can manage their own medicines; at present none have chosen to do so. During the tours of the premises, a number of medications (creams and skin care lotions) were found in the bedrooms of people for who they had not been dispensed i.e. the containers bore the names of other past/present residents. This circumstance was noted during the first visit on 7 July 2008 and was brought to the attention of the acting manager, but again on the second visit on 11 July 2008 some bedrooms were found to contain medications labelled with another person’s name. To ensure promotion of good control of infection and medicine handling procedures it is required that all medications/medicines are administered only to the person for whom they have been prescribed and dispensed. Residents are treated with respect and their privacy and dignity is protected at all times. A ‘Have Your Say’ questionnaire returned to the Commission by the relative of a resident stated “the general atmosphere is relaxed, friendly and caring”. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social and leisure activities are suited to the preference and ability of residents. Residents are encouraged to maintain contact with the local community; visits by their friends and relatives are welcomed by the home. Meals provide good nutrition and are liked by residents. EVIDENCE: The home employs a full time Activities Organiser who arranges local excursions, one-to-one and small group social and recreational activities. Relatives who were visiting residents at the times of this inspection were satisfied with the range of activities, meal provision, staff and premises; a ‘Have Your Say’ questionnaire returned to the Commission by the relative of a Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 14 resident stated that the range and frequency of recreational and social activities was “always very good”. Residents are supported and encouraged to spend their time as they wish; e.g. the times of getting up and going to bed, to be in their bedrooms or lounges during the day. The home has a minibus adapted for use by disabled people, with wheelchair facilities including a ‘tail lift’. Some staff are designated drivers of the minibus having each completed associated training with Dorset County Council; they work in association with a specific policy giving guidance on accompanying residents on excursions. Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. There was evidence that every resident receives adequate nutrition and ‘healthy eating’; is actively promoted. Residents select meals in advance from menus and the home additionally operates a policy of ‘over catering’ enabling residents to change to a different meal option at the time of serving. Each House has a regular supply of ‘smoothies’ (nutritious and refreshing cold milk and fruit based drinks) and the evening meal includes a selection of ‘finger foods’ for supper. Fresh fruit is available as a healthy option for desserts. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and are confident their complaints are listened to. Service users are safeguarded against risks of abuse in its various forms. EVIDENCE: Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home has a complaints policy and procedure; no complaints have been received since the previous inspection and there have been no allegations or investigations regarding the ‘safeguarding of vulnerable adults’. To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each resident. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 16 All staff receive training on the safeguarding of vulnerable persons and the home has implemented associated policies and procedures. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is properly equipped, comfortable and suited to the needs of residents but processes for general cleanliness and control of infection must be urgently improved to ensure the safety of residents. EVIDENCE: Cerne Abbas Care Home consists of three units, known as Houses. The part of the home delivering care to the younger adults is Cloisters House, situated on the first floor. A passenger lift provides access to the first floor. The parts of the home delivering care to the older persons are on the ground floor: Orchard House and Atrium House, each with lounge and dining areas. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 18 There are bathrooms equipped for the use of persons requiring assistance and a range of hoists to assist residents with impaired mobility. Specialist nursing beds and equipment for pressure relief are in good supply. At both visits of this inspection tours of the premises identified a number of significant failings regarding the general upkeep and cleanliness of the premises. For example, beds had been made with soiled and worn linen and misshapen pillows and the bed linen had been roughly pulled over, not smoothed to promote the comfort and well being of the residents who would later sleep in them. Some bedrooms were overheated, bleak and institutional in aspect, containing few personal possessions of the residents they accommodated. Some bedrooms contained damaged items of furniture e.g. drawers without handles, and there were many soiled and stained armchairs, sometimes without seat cushions. There were toilets blackened with staining, which could not be effectively flushed. The air extraction fan of the Cloisters ‘smoking room’ was out of order, and the door of the toilet leading off this room was without a functioning door lock. Many ceilings were discoloured by water damage and a number of window frames were rotten, preventing the windows from being readily opened and closed. Bedrooms in the area of Atrium House known as ‘Manchester Lane’ have ceiling windows bearing only a pale and thin blind, which will not keep out the early daylight of mid summer and may result in residents waking at an undesirably early hour. During the first visit of this inspection the generally poor condition of the premises was drawn to the attention of the acting manager who promptly drew up an action plan, but although a number of the deficits had been resolved by the second visit, numerous others were apparent. A related requirement is contained in this report. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. EVIDENCE: The home is at all times in the charge of a trained nurse and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. A recently employed staff member said “The (acting) manager is very approachable and supportive.” The records of three recently employed staff members were examined and found to contain all essential information including written references, interview assessment, health details and evidence of identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 20 The home has developed and implemented a comprehensive induction process for all new staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training; the acting manager is also the training coordinator. Clear records of staff training, supervision and appraisal are kept, indicating that all staff receive training appropriate to their needs. However, the home is recommended to meet the standard for at least 50 of care staff currently employed by the home to possess a National Vocational Qualification (NVQ). Care staff are required to undertake (and as necessary update) training in core subjects including fire safety, moving and handling, food hygiene, adult protection and emergency aid. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general, the home is properly managed but more must be done to ensure it operates in the best interests of service users and protects them from risks of harm related to poor standards of premises hygiene. EVIDENCE: The post of registered manager has been vacant since early January 2008; an Acting Manager is at present in charge of the home. (Shortly after the inspection the Commission was notified that a new manager has been appointed and will be applying to the Commission for registration.) Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 22 The home has processes for quality assurance; satisfaction surveys are periodically issued and the home has developed and implemented processes of internal audit reflecting aims and outcomes for service users. Records are kept of all accidents and for most there is evidence of subsequent investigation, review of the care plan and periodic audit to identify any trends e.g. time, place, person, and activity. The home manages the finances of most residents with regard to the safekeeping of monies for personal expenditure; a sample of documents were examined and found to clearly show income and expenditure. Staff trained in emergency response are on duty in the home at all times; all staff receive periodic training in fire safety. The use of bedrails by some residents is in compliance with relevant Health & Safety guidance; persons involved in assessing, maintaining and checking bed rails receive training in this work. Portable bedrails are not used; only rails permanently fixed by the manufacturer to profiling beds are used. During the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. All staff are supervised and each has a personal profile containing records of appraisal ensuring that performance standards are monitored and training needs are identified, in the interests of providing good care to residents. Recruitment practices ensure the protection of residents from potentially unsuitable staff. The provider organisation has not fully discharged essential duties of effectively monitoring the home; the monthly reports required by regulation have been carried out at the necessary frequency but do not identify the significant failings in the general condition and cleanliness of the premises which were apparent during this inspection. The home has a written assessment of the ‘Health & Safety’ of the premises and working practices and keeps records of fire safety checks and tests, including drills and staff training. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 23 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 3 8 3 9 2 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 1 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 (2) Timescale for action The registered person shall make 07/07/08 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. This means that all medications/medicines must be administered only to the person for whom they have been prescribed and dispensed. 2. OP26 23 (2) The registered person shall ensure that the premises are kept in a good state of repair and all parts of the care home are kept clean. 07/08/08 Requirement Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 25 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 OP38 Good Practice Recommendations The home should meet the standard for at least 50 of care staff currently employed by the home to possess a National Vocational Qualification (NVQ). The monthly written report on the conduct of the care home should involve more careful consideration of the general standard of the premises. Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cerne Abbas Care Home DS0000065834.V364907.R01.S.doc Version 5.2 Page 27 - 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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