Inspection on 01/08/06 for Coombe Grange Residential Home

This inspection was carried out on 1st August 2006.

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

The inspector 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

Coombe Grange Residential Home 02/09/09

Coombe Grange Residential Home 28/01/08

Coombe Grange Residential Home 27/09/05

Coombe Grange Residential Home 25/05/05

Coombe Grange Residential Home 22/11/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Coombe Grange Residential Home Coombe Lane Sway Lymington Hampshire SO41 6BP Lead Inspector Pat Griffiths Unannounced Inspection 1st August 2006 09:30 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 Coombe Grange Residential Home DS0000061686.V303046.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. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coombe Grange Residential Home Address Coombe Lane Sway Lymington Hampshire SO41 6BP 01202 767776 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) Coombe Grange Limited Mrs Valerie Anne Clarke Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40), Old age, not falling within any other category (40) Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: Coombe Grange is set in a rural location on the edge of the village of Sway in the New Forest, with limited access to local amenities. It provides accommodation and personal care for up to 40 elderly residents, some of who may have dementia. The home is on ground, first and second floors and there is a lift between ground and first floors. There are a variety of aids and adaptations to allow residents to move about more independently. Twentyfour of the bedrooms are single, and eight are doubles. There are two communal toilets and a bathroom on the ground floor, and one toilet, two bathrooms and two showers on the first floor. There are large, accessible, gardens around the building. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was unannounced and took place on 1st August 2006, starting at 10am and finishing at 5pm. All key standards were examined and the visit included looking at areas of the home such as bedrooms, communal/shared areas and the home’s kitchen and laundry as well as the garden. Documents and records were examined and staff working practices was observed where this was possible without being intrusive. Residents, visitors and staff were spoken to in order to obtain their perceptions of the service that the home provided. The home’s registered manager was present throughout the visit and was available to provide assistance and information when required. Other information included in this report is obtained from sources such as a pre-inspection questionnaire and information that the Commission for Social Care inspection had received since the last visit made to the home September 2005, such as statutory monthly reports made to the home for the owner and notices received about incidents that had occurred in the home. The current scale of charges in the home is £425 – 600 per week, with additional charges made for services such as hairdressing, chiropody and newspapers. What the service does well: What has improved since the last inspection? Residents’ safety needs have been enhanced through the provision of a ventilation system in food preparation areas, as recommended by the environmental health officer. Parts of the home have been decorated as part of the rolling programme of decoration. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 6 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. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. There are procedures in place to ensure that the home identifies the assistance and support that potential residents need before they move into the home. Standard 6 does not apply to this service EVIDENCE: The home had written policies and procedures concerning the admission of new residents to the home and these referred to the importance of assessing the help required by potential residents before they moved into the home. A sample of the records of three residents was examined, including those concerned with identifying the help and care that people needed. The home has a five-page pre-admission assessment document and it was evident from these completed documents that the admissions to the home had all been properly planned. The manager or her deputy complete the pre-admission assessments by visiting potential residents and identifying the help and Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 9 support that they need and by inviting them to visit the home before they move in. The manager said that prospective residents are referred by their social workers or by their families, who usually visit the home before bringing the prospective resident to see the home. The home does not provide intermediate care and the manager said that respite care is provided if there is a bed available when the enquiry is made. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The home had systems in place to ensure the personal and healthcare needs of residents were met. Medication policies and procedures in the home do not protect the service users. Working practices in the home ensure that residents’ privacy and dignity is promoted. EVIDENCE: Three care plans were examined and found to contain detailed information, based on the assessments the home had carried to identify the service users needs. The care plans identified the health, personal care and social needs of the individual service users and set out the actions staff had to take to meet those needs. Risk assessments concerning falls and moving and handling had also been completed and included in the care plans. The daily notes seen by the inspector referred to the actions taken by staff to provide the needs set out in Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 11 the plans. The manager said that the senior care staff review the care plans monthly and the manager then audits the reviews. The records seen by the inspector also indicated that a range of healthcare professionals visited the home and that arrangements were made for treatment for service users when it was necessary. Residents said that they saw and received treatment from among others, doctors, podiatrists and opticians and when required arrangements to attend outpatient clinics were made by the home. The home has written policies and procedures for the management and administration of medication, which had been supplied by the homes management company. They do not reflect the current practice in the home as they mention the role of the registered nurse and compliance with the (now defunct) UKCC codes of conduct. A requirement has been made for the policies and procedures to be reviewed and adapted to inform the practices in the home. The inspector saw that the resident’s medication is kept in a locked and secure metal cupboard in the office and a medical refrigerator is also available. The home uses a ‘blister pack’ dosage system, which is provided monthly by a local pharmacist. Other medicines such as liquids or those that were to be taken only when required are administered from their original containers. The home uses medication administration record sheets (MAR) to record the receipt, administration and disposal of medication in the home, these were checked were found to have been used appropriately. The manager said that staff had completed training in ‘Safe handling of Medicines’ at a local college and only the manager or senior staff administered medication. The staff also have access to the Royal Pharmaceutical Society guidelines for administering medication in care homes. The home promotes the independence of residents and following assessment by their GP several residents manage their own medication. They have secure storage available in their bedrooms and the staff manage the ordering and delivery of their medication to the home. Staff were seen to knock on doors and wait to be invited to enter bedrooms, and residents felt that their privacy was respected. Most residents were accommodated in single rooms and they said they appreciated their privacy. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home organises a range of social activities and also promotes residents self-determination, enabling residents to exercise choice about all aspects of their daily life. Residents are able to maintain links with relatives and representatives. A balanced and varied selection of food is available to meet the tastes and choices of residents. EVIDENCE: The home employs activities organisers for each day of the week and they undertakes different activities, such as general knowledge quizzes, lead discussions on current affairs and organise games such as ‘floor darts’ and ‘horse racing’. The inspector joined in with some of the residents for one of the quizzes, which involved remembering the names of indoor games, alphabetically, which led to an interesting discussion about the types of games the residents had played as children. Several residents commented ‘I like this, it keeps me thinking’ and ‘my legs might not work properly but my head does’. The inspector was also shown painted ‘stained glass windows’ that several residents had completed during one of the monthly visits of an arts and craft activities group. The manager said that there were also reminiscence sessions, the last of which involved smelling and naming herbs from the garden. Other Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 13 activities have included music and movement sessions and entertainment such as a pianist and a slide show of the wildlife in Dorset. Some residents spoken to said that they enjoyed the activities that were arranged, and others indicated that they preferred their own company. Visitors were seen coming and going during the course of the day, taking relatives out for lunch or to hospital appointments. Several visitors spoke to the inspector, saying how happy their relatives were with the care and support from the staff in the home ‘nothing seems to be too much trouble’. ‘Visiting arrangements are open, they always ring me if anything happens to my relative’. One new resident commented ‘it’s so nice, not at all what I expected and the staff are lovely’. Residents told the inspector that they could get up and go to bed at times that suited them, could take their meals in their bedroom or in the dining room and could go out and about if they wished. One resident, who has not been in the home very long, still drives a car and was going out for the afternoon and commented, ‘when I ring the bell they are there straight away’. Another resident who ‘likes to stay active and get out and about’, commented that the home was ‘a long way from anywhere, but I manage with taxis’. Details of the leisure interests and individuals preferred lifestyle were recorded in their care plans. The manager said that she and the cook plan the menu, which have a twelve week rotation and include seasonal variations. The local greengrocer and butcher deliver to the home, other supplies are delivered by the supermarket or national suppliers. Meals were seen to be unhurried and residents commented that the food was good, the inspector sampled lunch and found that it was well cooked and attractively presented. Residents told the inspector that they liked most of the choices available and knew that they could ask for something different if they didn’t like what was on the menu. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home had a clear complaints procedure to address the concerns of residents and relatives/representatives. Arrangements are in place to protect service users from the risk of abuse. EVIDENCE: The home has a written policy and procedure about how complaints could be made about the service that is provided and an abbreviated form is provided in the statement of purpose and service users guide. All residents and relatives spoken to were confident about raising any concerns with the home’s manager and did say ‘I have nothing to complain about’. The manager said that there had been no complaints and none have been made to the commission about the home. The home had written procedures available regarding adult protection. These were intended to provide guidance and information for the staff to ensure that that the risk of residents suffering harm was prevented. Staff spoken to said that they received training about protecting vulnerable adults and an examination of staff training records confirmed this. The manager said that the home also has other guidance such as ‘No secrets’ and is awaiting the up- to date copy of the Hampshire Abuse Procedure. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home’s environment was safe and well maintained. Arrangements are in place to ensure that the home is clean and hygienic. EVIDENCE: The exterior and interior of the home, décor, furnishings, fittings and equipment were in reasonable repair. The home has a large attractive garden, which is safe for residents and has several access points. There are steps and ramps in some areas, but most access is level. There are lots of large colourful hanging baskets and tubs around the building and the flowerbeds are also full of colourful seasonal flowers. There were several tables and chairs set out with parasols for the residents, which the manager said had been well used recently in the hot weather. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 16 The home employs a maintenance person to undertake minor repairs and redecoration in the home and the gardening. The home was clean, tidy and odour free at the time of the visit and residents and visitors spoken to were all positive about these aspects. The home is well maintained and suited to the residents’ needs. It is decorated and furnished to a standard that creates a homely ambience and there is a rolling programme for decoration in place. The inspector toured the home, looking at some of the bedrooms, the communal areas, kitchen, laundry and gardens. The home has three sitting rooms and five quiet sitting areas as well as a smoking area for the three smokers that live in the home. Bedrooms were seen to be homely, and had been personalised with items of furniture, pictures and ornaments. The kitchen has recently had a new extractor fan fitted over the cooker, which had been a requirement from an environmental health inspection. The kitchen was compact but contained sufficient equipment for the numbers the home caters for. The kitchen assistant showed the inspector the new foods standards agency folder that is used for recording fridge and food temperatures as well as being a kitchen diary for things like the kitchen cleaning schedules. The home’s laundry, although cramped and quite small for the size of the home and number of residents accommodated, was appropriately sited and equipped. The home had comprehensive procedures in place concerned with infection control and these referred to, among other things, effective hand washing and the use of protective clothing. The manager said that there are two cleaners daily during the week and the care staff manage the laundering of the residents clothing and bed linen. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The home has an appropriate level and mix of staff, ensuring that the needs of residents can be met. The home had clear staff recruitment, training and development procedures to ensure that service users are protected and supported, but need to clarify staff qualifications. EVIDENCE: The total number of staff employed to work in the home at the time of the visit was thirty-one. The manager said that usually there are seven care staff working in the morning, three on the ‘late’ shift and three at night, two of whom are ‘up and awake’ staff, with a further person ‘sleeping in’ in case of emergency. During the day the staff are supported by management and domestic staff, including a cook. Agency staff are rarely used in the home but occasionally holidays and sickness leave gaps on the roster, and the manager said that none have been needed during the past two months. The manager said that seven members of staff have obtained National Vocational Qualifications (NVQ) in care and that a further six are currently undertaking the training, three at level 2 and three at level 3. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 18 Most staff, residents and relatives indicated that the staffing levels in the home were sufficient and most residents also expressed confidence in the abilities and competence of the staff to meet their needs, ‘there always seems to be someone around to help me. I have no problems with the abilities of the staff’ ‘it is very good, I don’t find anything wrong with it. Everyone is nice and so polite and everyone tries hard. They always have time for me’ ‘they’re all wonderful’ Staff training, which includes manual handling, fire safety, first aid and health and safety was all seen to be up to date in the training records. The manager said that all new staff undertake an induction period, which lasts three months. The inspector and manager discussed new training programmes that are available locally and the induction training that has been recently introduced to satisfy the requirements of the training body for the social care workforce, Skills for Care (previously the Training Organisation for Personal Social Services or ‘TOPSS’). Staff that spoke with the inspector said that they felt the training provided had ensured that they knew how to care for the residents in the home. The inspector looked at four staff files, where it was apparent that the statutorily required information and checks had been obtained and conducted before staff had started work in the home. Two of the files did not contain a photograph of the staff member, but the manager said that this would be rectified. Several carers in the home are from Europe and overseas and have been attending language classes at the local college and felt that they had settled in well at the home. Some of these carers are nurses in their own country, but employed at the home as carers. The inspector noted that on the staff photo gallery they are identified as nurses and discussed with the manager that they are not registered as nurses in this country and cannot undertake nursing tasks. It was also discussed that labelling them as nurses could lead to false impressions or expectations being made by the residents and their relatives about the care provision in the home. The home has credited these carers as having an NVQ3 in care because of their nursing experiences in their home country. The inspector suggested that an assessment by an NVQ assessor would evaluate their training, knowledge and skills to ensure that they did have the necessary skills and experience for a carer at NVQ level 3 and that they could met the needs of the residents in the home. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home is well managed with residents having clear and accessible means of influencing policy and practice. The service users financial interests are safeguarded and their welfare is promoted through sound policies and procedures. EVIDENCE: The manager has a considerable number of years experience in a senior capacity, has completed the Registered Managers Award and has undertaken specialist training in dementia care. There are clear lines of accountability within the home and within the company. Residents that spoke to the inspector commented on how nice the home was, and that they are also consulted formally regarding the services offered. The Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 20 manager said that the quality assurance survey of the residents for this year has not yet been done. She confirmed that, when completed, the results would be made available to any interested parties on request. The home’s administrator confirmed that there was no involvement by the home in residents’ financial matters. Information about advocacy services was available for residents and their families should they want private and impartial advice on personal or financial matters. Records examined by the inspector indicated that the home’s equipment, services and systems such as the passenger lift, boilers, fire safety equipment, the fire alarm, emergency lighting and portable electrical equipment are checked and serviced at appropriate intervals. There were contracts in place for the disposal of clinical waste Staff said that they attended regular and compulsory fire and other health and safety training and residents said that the home’s fire alarm system was checked regularly. Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 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 3 X X X X X X 3 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 3 Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement The responsible person must ensure that appropriate policies and procedures are made available for staff in the home regarding medication Timescale for action 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations The responsible person should ensure that all overseas care assistants are assessed by an NVQ assessor, to evaluate their training, knowledge and skills to ensure that they have the necessary skills and experience for a carer assistant at NVQ level 3 Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Coombe Grange Residential Home DS0000061686.V303046.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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