CARE HOMES FOR OLDER PEOPLE
Edwina House 64-66 Grovelands Road Palmers Green London N13 4RJ Lead Inspector
Tony Brennan Key Unannounced Inspection 3rd May 2007 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 Edwina House DS0000027807.V333449.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. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Edwina House Address 64-66 Grovelands Road Palmers Green London N13 4RJ 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) 020 8886 6658 020 8882 6265 Mr Sooreeadeo Hurree Mrs Elizabeth Ann Hurree Mr Sooreeadeo Hurree Care Home 22 Category(ies) of Past or present alcohol dependence (0), registration, with number Dementia (0), Old age, not falling within any of places other category (0), Physical disability (0) Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Where service users are admitted only for intermediate care, dedicated accommodation is provided. 3rd April 2006 Date of last inspection Brief Description of the Service: Edwina House is owned and managed by Mr Sooreeadeo Hurree and Mrs Elizabeth Hurree. The home is registered to care for twenty-two people. The home is comprised of two semi-detached two-storey houses, which are joined and extended. There are fourteen single and four double bedrooms. There are two communal areas for sitting and dining. The home has a passenger lift. There is a garden to the rear of the property. The home is within walking distance of shops and public transport links. The home aims to provide a supportive and caring environment for those who use the service. Currently the homes fees are £500 per week. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced key inspection was undertaken as part of the annual inspection programme. I sought to confirm that the areas for improvement identified at the last inspection were addressed. The inspection took place over one day. Sooreeadeo Hurree, registered provider, assisted me with the inspection. I spoke with the four people who live at Edwina House and three members of staff. I observed care practice and interaction between people living at the home and staff. I toured the building and examined a number of records relating to the care, health and safety and management of the home. I would like to thank Sooreeadeo Hurree and staff who assisted me by answering questions about the running of the home. I would also like to thank the five people who live at the home who discussed their views on the service they receive. What the service does well:
I spoke with the registered provider who explained that people visit the home so that they can make an informed decision about whether they would like to live at the home. Records showed that visits had taken place for one person who had come to live at home recently. Peoples needs identified so that they receive the care and support that they require. I found that the four people case tracked had care plans that detailed their needs. The care plans generally reflected the personal preferences of these people. I spoke with one person who had been case tracked who said; “ the staff asked what I like”. Two of the people case tracked had been identified in their initial assessments as having dementia. There was guidance on how this affected the two people and what staff needed to do to support them. Peoples health needs were identified and actions to meet them put in place to ensure their well-being and safety. There were risk assessments to cover falls, nutritional needs, manual handling and tissue viability needs. I found that daily notes showed that the people case tracked had been able to access medical services. There was evidence to show that where necessary GPs had been consulted. The records of medicines received, administered and returned to the pharmacist were all complete. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 6 Systems for the safe handling of medication ensure the safety of people living at the home. I spoke with people living at the home and they confirmed that activities were provided regularly. Examples of this were going to the shops, listening to the radio and games. I observed that three people spent some time in the garden talking to each other and with a member of staff. I also observed that staff spent time talking to people who live at the home. People living at home have a range of stimulating activities that meet their personal and cultural needs. People living at the home were supported to maintain their religion. One person case tracked was identified as being a member of the Church of England. Their care plan identified that the person would like to be involved in any festivals celebrated at the home relating to their Christian religion. I observed a number of people enjoying a choice of meals. Meals are provided that are in line with peoples personal preferences and nutritional needs. People who live at the home were generally pleased with the quality of the food provided. A person who lives at the home said, “ the food is good. If you want something different the staff will get it for you.” Meals are provided that are in line with peoples personal preferences and nutritional needs. The complaints policy explained how to make a complaint and how it would be dealt with. People with whom I spoke confirmed that they knew how to make a complaint. People living at the home told me that they felt protected and safe. People living at home are safe and know that their concerns or complaints will be acted upon. I examined the rota and found it showed that a consistent staffing level was being maintained. I observed that staff were available at key times a day (e.g. mealtimes) to assist people. Staff were also observed spending time with people both individually and in small groups. This allowed more attention to the individual needs of people who live at the home. People at the home are supported by sufficient staff to meet their needs. I examined four staff files and found that these contained all the required information relating to their recruitment. I found that there were no unexplained gaps in the employment history of recently recruited staff. The recruitment procedures of the home ensure that people living there are safe. The home has a system for obtaining the views of the quality of the service it provides and ensures that any areas for improvement are addressed. A survey of the views of people who live at the home, relatives and professionals was in place. The registered provider explained that he takes time each day to talk with people who live at the home. In this way he is able to know the views of people at the home about the service they receive. People at the home are consulted about the quality of service they receive so that they can affect improvements to the home. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 7 Fire drills were taking place and the fire alarm was tested regularly. I found that the fire risk assessment had been reviewed and now included an assessment of all the potential fire risks in the home. I discussed health and safety issues with staff and they demonstrated their understanding. The home provides a safe environment for people living there. What has improved since the last inspection? What they could do better:
Six areas for improvement have been identified at this inspection. In bedroom 4 the vanity unit was broken with chipped areas. In bedroom five the carpet was stained and the paintwork had dirty marks on it. In a toilet on the first floor the cover to the light fitting was not in place. The registered provider
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 8 agreed to ensure these are areas where address to improve the environment for the people living at the home. Food hygiene training must be provided for all staff. Staff do not have all the skills to ensure the safety of people living at the home It was a recommendation of the last random inspection report that 50 of staff achieves this qualification. Although the number of staff with this qualification has increased, the home still has not reached a level of 50 . The registered provider explained that a number staff have been registered to complete this qualification. Once these staff have completed the qualification, the home will exceed the 50 target. Achieving this target will ensure that staff understand how to meet the needs of people living at the home. 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. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 9 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 Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed prior to admission to the home to ensure they receive the care and support they need. EVIDENCE: I spoke with the registered provider who explained that people visit the home so that they can make an informed decision about whether they would like to live at the home. Records showed that visits had taken place for one person who had come to live at home recently. I case tracked four people who had recently come to live at the home. These were found to have detailed assessments of their needs. As part of the
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 11 assessment process information on the needs of people had been obtained from health professionals. This had been used to form the home’s own assessment of the needs of these three people. A person recently admitted to the home was identified in their initial assessment as having a risk of falls which had resulted in a fracture prior to their admission. The home had carry out risk assessments and an appropriate prevention plan had been put in place. Staff spoken to were clear about this person’s risk of falls and the measures to prevent this. Nursing and care staff spoken to were able to explain the individual needs and preferences of the three people case tracked. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 12 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. People’s personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. People’s right to privacy is supported. EVIDENCE: I found that the four people case tracked had care plans that detailed their needs. The care plans generally reflected the personal preferences of these people. I spoke with one person who had been case tracked who said; “ the staff asked what I like”. Two of the people case tracked had been identified in their initial assessments as having dementia. There was guidance on how this affected the two people and what staff needed to do to support them. The initial assessment for one person case tracked identified that their behaviour could be challenging to the service. Staff spoken to were able to explain how it
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 13 should be addressed. I observed staff interaction with this person, this showed that they approached her in a sensitive manner. There were risk assessments to cover falls, nutritional needs, manual handling and tissue viability needs. These provided an assessment of the level of risk and where necessary guidance was in place to ensure that risks to people were minimised. I found that daily notes showed that the people case tracked had been able to access medical services. There was evidence to show that where necessary GPs had been consulted. Daily notes also confirmed that the people case tracked had access to services from opticians, chiropodists and dentists. The records of medicines received, administered and returned to the pharmacist were all complete. All medicines are stored at the appropriate temperature. Separate records were maintained for controlled drugs. I found these were complete and the amount of medication held corresponded with those recorded in the controlled drugs book. Training records also contained certificates confirming that this training had taken place. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 14 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. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. People living at the home are able to make choices about how they live in the home. The menu reflects the preferences of people living at the home and offers a balanced diet. EVIDENCE: I spoke with people living at the home they confirmed that activities were provided regularly. Examples of this were going to the shops, listening to the radio, and games. I observed that three people spent some time in the garden talking to each other and with a member of staff. I also observed that staff spent time talking to people living at the home. Daily records also showed that people had been involved in activities.
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 15 People living at the home were supported to maintain their religion. One person case tracked was identified as being a member of the Church of England. Their care plan identified that the person would like to be involved in any festivals celebrated at the home relating to their Christian religion. I spoke with the person who confirmed this had happened. I spoke with people live who at the home who confirmed they could see visitors when they choose. Daily notes on the two people case tracked confirmed that they had received regular visits from members of their family. Since the last inspection more varied options had been offered at mealtimes. There was a record which confirm this. I observed a number of people enjoying a choice of meals. People who live at the home were generally pleased with the quality of the food provided. A person who lives at the home said, “ the food is good. If you want something different the staff will get it for you.” There was specific guidance on individual people’s plans where they had dietary needs. I saw that meals were well presented and they were provided in a relaxed environment on all three units. Where people needed pureed foods this was provided. Sufficient staff were available and when necessary, people who live at home were observed being assisted to eat. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 16 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 who use the service are confident that their complaints will be listened to, taken seriously and acted upon. The home’s procedures protect people from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. People with whom I spoke confirmed that they knew how to make a complaint. The complaints record showed actions taken to resolve complaints. There were no complaints since the last inspection. There are policies on handling abuse and protection. People living at the home told me that they felt protected and safe. I found that staff have received training on adult protection matters. Training records show that staff had attended Enfields adult protection training. Staff spoken to were able to explain the signs of abuse and how this should be responded to. Edwina House DS0000027807.V333449.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 adequate. This judgement has been made using available evidence including a visit to this service. People do not live in a home that provides a safe and homely environment. The home is not clean and hygienic. EVIDENCE: Since the last inspection the ground floor hallway carpet has been deep cleaned. However, when I walked round the building I found there were a number of areas where the decoration and fabric of the home was in need of improvement. In bedroom 4 the vanity unit was broken with chipped areas. In bedroom five the carpet was stained and the paintwork had dirty marks on
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 18 it. In a toilet on the first floor the cover to the light fitting was not in place. These issues were discussed with the registered provider who agreed to ensure that these areas would be addressed to improve the environment for people living at home. There is a passenger lift providing access for people who live at the home to all floors. I observed that people were able to access all areas in the home safely. This included the garden where a number of people were seen to be sitting. The home has the necessary adaptations to support people to access all areas safely. This includes the provision of handrails and assisted baths. Bedrooms were personalised with items of furniture and pictures belonging to the people who live at the home. The home has policies on the prevention of cross infection. In bedroom 16 the carpet smelt of urine. This was brought to the attention of the registered provider who agreed that the carpet would be deep cleaned. At the last inspection it had been found that staff had not received infection control training. Records showed that a number of staff had recently been on this training. I spoke with staff who were able to explain safe methods of working which would prevent cross infection. Edwina House DS0000027807.V333449.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 adequate. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available at all times to meet the needs of people who live at the home. Staff do not have all the skills to meet all the assessed needs of people who live at the home. People who live at the home are protected by the home’s recruitment practices. EVIDENCE: I examined the rota and found it showed that a consistent staffing level was being maintained. This confirmed that sufficient staff are available to meet the needs of people. People living at the home told me that there was sufficient staff available to meet their needs. I spoke with staff who said that sufficient staff were available to meet the needs of people who live at home. I observed that staff were available at key times of the day (e.g. mealtimes) to assist people. Staff were also observed to spend time with people both individually and in small groups. This allowed more attention to the individual needs of people who live at the home.
Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 20 It was a recommendation of the last random inspection report that 50 of staff achieve this qualification. Although the number of staff with this qualification has increased, the home still has not reached a level of 50 . The registered provider explained that a number staff have been registered to complete this qualification. Once these staff have completed the qualification, the home will exceed the 50 target. People living at the home told me that staff were generally understanding and able to meet all of their needs. One person spoken to said, “ the staff understand what I need”. Training records showed that, with the exception of food hygiene training, all statutory training had been provided. Discussions with staff and records seen confirmed that training was provided in a number of areas relating to the care and well-being of people living at home. I examined four staff files and found that these contained all the required information relating to their recruitment. I found that there were no unexplained gaps in the employment history of recently recruited staff. A health check has been carried out to ensure that staff coming to work at the home could safely meet the needs of people. The files of two nurses were seen, these had evidence of their current professional registration. Edwina House DS0000027807.V333449.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): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people reserve the care they need. People who live at the home are consulted about the quality of the service provided and encouraged to make suggestions for improvement.The financial interests of the people who live at the home are protected by the home’s procedures. People who live at the home and staff are protected by the home’s health and safety procedures. EVIDENCE: Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 22 Both the registered provider and the registered manager are qualified nurses. They have between them over 20 years experience of care and nursing of older people. People living at home told me that the registered manager and the registered provider are at the home most days a week. People and staff stated that the registered provider and the registered manager were both approachable and listen to what they had to say. The home has a system for obtaining the views on the quality of the service it provides and ensures that any areas for improvement are addressed. A survey of the views of people who live at the home, relatives and professionals was in place. The registered provider explained that he takes time each day to talk with people who live at the home. In this way he is able to know the views of people at the home about the service they receive. Staff meetings take place to ensure that staff are aware of plans to develop the service. The home does not hold money for people who live at the home. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. Fire drills were taking place and the fire alarm was tested regularly. I found that the fire risk assessment had been reviewed and now included an assessment of all the potential fire risks in the home. I questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. I discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents and any issues that are highlighted by this are acted upon to ensure the safety of people living at the home. The kitchen is clean and there is now a cleaning rota in place. The registered manager explained that he has implemented a new safety system in the kitchen based on food safety guidelines. The temperature of food delivered and cooked was recorded. Since the last inspection temperatures of the fridges and freezers have been recorded and were found to be within safe limits. Edwina House DS0000027807.V333449.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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X 3 X X 3 Edwina House DS0000027807.V333449.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 OP19 Regulation 16(2)( C ) Requirement The registered persons must ensure that bedroom 5 is redecorated. The carpet must be cleaned or replaced. This will ensure that the bedroom is clean and safe for people living at home The registered persons must ensure that the Vanity unit is replaced in the bedroom identified to the registered provider. The bedroom must provide a safe and pleasant environment for the person whose bedroom it is to live. Timescale for action 01/07/07 2 OP19 16(2)( C ) 01/07/07 3 4 5 OP19 OP26 OP30 16(2)( C ) 23(2)(d) 18(1) The registered persons must 01/07/07 ensure that the light fitting in the first floor toilet is replaced. The registered persons must 01/07/07 ensure that the carpet in bedroom 16 is deep cleaned. The registered persons must 01/07/07 ensure that the training is provided on food hygiene. Edwina House DS0000027807.V333449.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. Refer to Standard OP28 Good Practice Recommendations The registered persons should ensure that 50 of staff achieve National Vocational Qualification in care at level 2. Edwina House DS0000027807.V333449.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area Office 4th Floor Aspect Gate 166 College Road Harrow Middlesex HA1 1BH 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
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