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Inspection on 11/07/05 for Cloisters Nursing Home

Also see our care home review for Cloisters Nursing Home for more information

This inspection was carried out on 11th July 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is welcoming and staff care for service users in a courteous and respectful manner. The food is generally of a good standard and well presented and tasty. The maintenance and servicing records are thorough, up to date and well maintained. Staff work well as a team and staff morale was high.

What has improved since the last inspection?

The staff have worked hard in order to maintain a good level of record keeping with the exception of some minor issues identified. Overall this was a positive inspection and the home was continuing to work well with the service users in meeting their needs.

What the care home could do better:

Three requirements from the previous report had not been addressed. Shortfalls were identified in relation to induction and foundation training, NVQ training and staff records. Where service users are accommodated with a diagnosis of dementia staff training in relation to this must be carried out for all staff. Shortfalls identified as a result of the pharmacy inspection must be addressed by the home as a matter of urgency. Any improvements made must be maintained and monitored by the Responsible Individual. Generic risk assessments must be up to date and in place.

CARE HOMES FOR OLDER PEOPLE Cloisters Nursing Home 70 Bath Road Hounslow Middlesex TW3 3EQ Lead Inspector Rekha Bhardwa Clare Henderson Roe Unannounced 11 July 2005 10.00 am 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 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. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cloisters Nursing Home Address 70 Bath Road, Hounslow, Middlesex TW3 3EQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8572 4131 020 8577 5358 Cloisters Care Limited Care Home 61 Category(ies) of Physical Disability (0), Physical Disability - over registration, with number 65 years of age (0), Old age, not falling within of places any other category (0) Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 61 beds for the elderly frail over the age of 60. 2. All service users must be over 60 years of age at the time of their admission to the home. 3. Five named service users with Dementia can be accommodated, as agreed by the NCSC on 06/05/04, for as long as there is no deterioration, which affects the well being of other service users. The rooms used for each of these service users will revert to the category of the unit once this service user no longer occupies it. Date of last inspection 15/11/04 Brief Description of the Service: Cloisters Care Home is a 61-bedded care home giving nursing care to frail elderly service users. Twenty-eight of these beds are on the ground floor and thirty-three on the first floor. The purpose built building is situated on a busy thoroughfare close to the Hounslow Central shopping parade and transport links. There are fifty-one single rooms, thirteen with en suite washbasins and toilets. There are five shared rooms, four en suite and two with bathrooms. There are six assisted bathrooms. A stairway and a two passenger lifts connect the ground and first floor. All areas of the home are wheelchair accessible. The home provides a large parking area to the side of the building and a garden to the rear. Alpha Health Care Limited, a private company, owns the home. The Registered Manager was on annual leave and the Head of Nursing was Acting Manager on the day of inspection.The home also has an administrator, registered nurses, care staff, chef and kitchen assistants, a maintenance person who has supervisory responsibilities for a team of domestic staff and an Activities Organiser. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 17 hours were spent on the inspection process. The Inspectors carried out a tour of the home, and inspected service user plans, staff files and maintenance records. 6 service users, 3 visitors and 8 staff were spoken with as part of the inspection process. What the service does well: 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. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1, 2, 3, 4 & 5. The home does not provide intermediate care. Information about the home was out of date and therefore did not provide an accurate picture to service users and visitors. Service users are assessed prior to admission to ensure the home can meet their needs. Staff had not all received training in respect of service users specialist care needs, so this could compromise service users care. Prospective service users and their representatives are encouraged to visit the home in order to allow them to make an informed choice. EVIDENCE: Copies of the Statement of Purpose and Service Users Guide are available in the service users bedrooms. Some of the information was out of date, to include the ownership details for the home. These documents need to be reviewed and updated to provide current information to service users, relatives and visitors. Each service user has an accommodation agreement. The main contract is with Hounslow Primary Care Trust. 14 service users are privately funded. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 8 A pre-admission assessment is carried out for all prospective service users, and where there are any issues identified, these are discussed and clarified. Samples of these were viewed and had been clearly completed. In addition, copies of continuing care assessments and/or Social Services assessments are obtained. Therefore the home can ascertain if it is able to meet the needs of prospective service users. There are service users accommodated at the home with a diagnosis of dementia. The home is registered to accommodate 5 named service users with such a diagnosis and the conditions of this registration are stated on the Registration Certificate. Some staff spoken with had not received any training in dementia care, and this needs to be addressed. The specialist needs of service users with cultural and religious care needs are ascertained at the time of the pre-admission assessment to ensure that these can be met by the home. Where possible service users are encouraged to visit the home prior to admission, where this is not possible the service users representative is encouraged to visit. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 8, 9 & 10 The health and personal care needs of service users had been identified and were being met. Shortfalls in the management of medications potentially place service users at risk. Staff are courteous to service users and generally personal support is provided in such a way as to promote and protect the service users privacy, dignity and independence. EVIDENCE: Samples of service users plans were viewed. Overall these were comprehensive and identified service users needs and the action to be taken to meet these needs. Updates had been carried out monthly and whenever a service users condition changed and staff were clear on the formulation of care plans for any new needs identified. One care plan was to be updated to reflect a positive response to treatment for an infection. Wound care documentation was up to date and clearly showed the care and progress of each wound. Risk assessments for the use of bedrails had been carried out and written consents obtained. Staff spoken with were aware of the processes to be followed in the event of an accident and the documentation to be completed. One service user was transferred in a wheelchair without footplates and another service user was transferred using an unacceptable moving & handling technique. Both issues were discussed with the Acting Manager. Evidence of input from Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 10 healthcare professionals was recorded. In discussion it was apparent that for one service user, their care needs were not always being met. This was discussed with the registered nurse on the floor and it was agreed that a more proactive approach was required. The CSCI Pharmacist Inspector carried out an inspection on 11/07/05 and a separate report is available. The requirements and recommendations resulting from that inspection have been incorporated into this report. Staff communicated with service users in a courteous and respectful manner. Service users spoken with said that the staff are caring and one service user said it was their ‘home’. Service users preferred term of address is recorded and respected. Service users choice for rising and retiring is respected. Service users receive their own post and can have a private or mobile telephone if they so wish. Service users receive treatment and care in their own rooms. Screening is available in the double rooms, and these were either single occupancy or had married couples accommodated therein. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 13 & 15 Social activities are in place in accordance with service users wishes. Visiting is encouraged for service users to maintain contact with family and friends. capabilities. Food choices are provided and service users preferences are met. EVIDENCE: The activities co-ordinator was very clear on the provision of social activities to meet service users needs. Social activity history sheets that identify service users individual interests had been completed. Care plans for social and leisure interests were also in place. The activities co-ordinator said that she was planning a relatives and residents meeting to discuss outings for the summer. The Responsible Individual clarified that a budget for activities was available plus any additional expenditure for entertainers which could be invoiced direct to the company. There is a weekly activities plan and the activities co-ordinator explained that this may change depending on the wishes of the service users. The weather was very hot and outdoor activities had been arranged, and the activities co-ordinator said that they ensured that service users were appropriately protected from the sun. One service user required a review of the activities suited to their needs and this was discussed. There was no hairdresser employed and the activities co-ordinator has been carrying out simple hair care, plus some service users have individual hairdressing arrangements in place. Arrangements to recruit a hairdresser are underway. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 12 Relatives and friends were seen visiting service users. Service users can choose whom they wish to see and their wishes are respected. If a problem was to be identified, then where appropriate the service users Care Manager would be involved. There is some information in the Service Users Guide regarding maintaining contact between visitors and the service users. The activities co-ordinator arranges visits from the local schools at Festival Times. The lunchtime meals were sampled and were well presented and tasty. Service users spoken with said that the food was generally satisfactory. One service user expressed dissatisfaction with the food and this has been discussed with the management and catering department. Hot and cold drinks were available to service users. The lunchtime meal was well presented and service users choices were respected. Staff were available to assist service users and the meal was conducted in a calm manner. The kitchen facilities were not viewed on this occasion. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 & 18 The home has clear complaints procedures and service users said that any concerns are promptly addressed. Systems were in place for the protection of vulnerable adults. EVIDENCE: The home has a clear complaints procedure. There had been no complaints since the last inspection and service users spoken with said that any concerns raised are addressed. The telephone number for the CSCI needs to be added to all copies of the complaints procedure. Staff spoken with were clear about protection of vulnerable adult procedures to include Whistle Blowing. There had been no protection of vulnerable adults issues identified. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19 & 26 The home is generally clean and tidy and the environment is safe for service users. Policies and procedures plus staff training for infection control are in place to safeguard service users from infection. EVIDENCE: A brief tour of each floor was carried out and the home was clean, tidy and well maintained. Bedrooms were personalised and homely. Corridors were clear and there is adequate space for the transporting of service users in wheelchairs. Risk assessments for window restrictors on the first floor were not seen, and it is acknowledged that it is the top section of the window that opens, thus not posing a direct risk to service users. The Responsible Individual said that work would be done to install window restrictors on that floor. An inspection by the Environmental Health Officer had been carried out on 29/06/05 and the maintenance man was addressing the issues that had been identified. The laundry facilities were clean and tidy. Infection control procedures are in place and staff receive training in this topic. Protective clothing to include gloves and aprons was available. A requirement has been set regarding Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 15 infection control as part of the pharmacy report findings. Sluice rooms with machines for the disinfecting of bedpans and such like items are available on each floor. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The home was adequately staffed to meet the needs of the service users. Some areas of staff training need review to ensure that staff have the skills to meet the needs of the service users. The vetting and recruitment practices need reviewing to ensure they are complete so as to safeguard service users. EVIDENCE: The floors were staffed appropriately to meet the needs of the service users. Staff spoken with said that there is good teamwork on each unit and they enjoy their work. The home has a registered nurse in charge of training two days per week. The training records were comprehensive and up to date. 25 of the care staff were qualified to NVQ in care level 2 or above. This was discussed with the Responsible Individual who said that work would be done to ensure systems for the provision of NVQ training for care staff is in place. The staff employment files viewed contained details of the applicants completed application forms, clear Criminal Record Bureau (CRB) checks having been obtained by the umbrella body, 2 references, photographs, evidence of identity. In one instance a member of staff had been employed before the CRB check had been received and there was no evidence of a POVA first check result. Health declarations were not seen. These issues were discussed with the management. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 17 Induction and Foundation Training in line with the Social Skills Council core standards had not been introduced. New staff undergo an in-house induction programme prior to working unsupervised, but this programme is not based on the core standards. This was discussed with the Responsible Individual. Each member of staff has a training profile and there is evidence of ongoing staff training in topics relevant to the care of the service users. There is also a training plan for January – September 2005. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 Reports for the Regulation 26 visits to the home by the Responsible Individual need to be forwarded to the CSCI to evidence regular monitoring of the home. The financial procedures in place were clear and safeguard service users monies handled by the home. Overall the home is well maintained and this provides a safe environment for the service users to live in. EVIDENCE: The reports of the Regulation 26 unannounced visits carried out by the Responsible Individual had not been forwarded to the CSCI each month. This needs to be addressed. Staff meetings take place each month and minutes are recorded. The departure of the Registered Manager had not been communicated to the CSCI. The Head of Care was in the post of Acting Manager. The need to communicate any changes in Registered Manager to the CSCI was discussed with the Responsible Individual. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 19 The home holds small amounts of money for some service users and clear records of income and expenditure are maintained. There is a safe facility. Samples of the maintenance and servicing records were viewed and these were up to date, thorough and well maintained. Staff had received mandatory training to include fire safety and drills, moving & handling, infection control and other health and safety topics. The maintenance man had risk assessments carried out for all specific areas of risk identified, but the homes generic risk assessments could not be located. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 2 Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 21 YES 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 1 Regulation 6 Requirement The Statement of Purpose must be updated. This must be freely available in the home and copy must be submitted to the CSCI. The Service Users Guide must updated. Copies must be provided to each service user and a copy submitted to the CSCI. All staff caring for service users with a diagnosis of dementia must receive appropriate training. Care plans must be kept up to date and accurately reflect each service users condition. Safe practices must be observed when transporting a service user in a wheelchair. Correct moving and handling procedures in line with current legislation must be employed. Medicines must be administered as instructed. Medicines must be recorded accurately when administered. The correct multi-patient lancing system must be used to test blood glucose. Arrangements must be reviewed to collect waste medicines. Timescale for action 01/09/05 2. 1 6 01/09/05 3. 4 18(1)(a) 01/09/05 4. 5. 6. 7. 8. 9. 10. 7 8 8 9.4 9.4 38.3,38.4, 8.1 9.3,26.5 17(3) 13(4) 13(5) 13(2) 13(2) 13(3) 13(2) 01/08/05 11/07/05 11/07/05 15/07/05 15/07/05 01/08/05 01/08/05 Page 22 Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 11. 12. 9.4 9.4 13(2) 13(2) 13. 14. 15. 9.4 9.4 9.4 13(2) 13(2) 13(2) 16. 16 22(7)(a) 17. 19 12(1)(a) 13(4)(c) 18. 29 19 Schedule 2 18(1)(a) & (c) 26 12(1)(a) (b) 13(4)(c) 19. 30 20. 21. 33 38 Sticky labels must not be used on the MAR. Medicines must be stored at the correct temperature in the clinical room. The clinical room must be maintained at less than 25 degrees. Oxygen must be secured in the home either chained or in a trolley. Dates of opening must be written on calogen in addition to another liquid medicine. Copes of the current feeding regimen for this service users on PEG fees must be available for immediate reference. The telephone number of the CSCI must be included on all copies of the complaints procedure. Risk assessments must be available on all bedrooms that do not have a window restrictor in place. Where the risk assessment indicates that a window restrictor is required this must be fitted. (previous timescale 20/12/04 not met) All records required under Schedule 2 of the Care Homes Regulations 2001 must be in place. (previous timescale 20/12/04 not met) Induction and foundation training must be in keeping with NTO specification. (previous timescale 31/01/05 not met) Copies of the monthly Regulation 26 visit report must be forwarded to the CSCI. Generic risk assessments for all areas of risk must be in place in the home. These must be reviewed annually and whenever a relevant situation changes. 01/08/05 01/09/05 01/08/05 01/08/05 15/07/05 01/09/05 11/08/05 11/08/05 01/09/05 01/08/05 and ongoing 11/08/05 Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 23 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. Refer to Standard 8 9.4 28 Good Practice Recommendations That staff be proactive in meeting service users needs. That bulk prescribing is considered in the home, particularly for lactulose. That the home takes prompt action to ensure that 50 of the care staff become qualified to NVQ level 2 or above. Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST 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 Cloisters Nursing Home G61-G10 s10959 Cloisters v214250 110705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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