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Inspection on 05/09/08 for Howard Castle Care Centre

Also see our care home review for Howard Castle Care Centre for more information

This inspection was carried out on 5th September 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Residents looked well cared for. They said they were well looked after. Staff support residents to maintain contact with their family and friends. Residents and relatives said: "the staff are lovely, there is a very high standard of care" "care is excellent, there is good communication, they (staff) are respectful of residents." "the staff are friendly and welcoming" The care plans that we read clearly set out the needs of the residents. When we spoke to those residents or discussed their care with staff, the needs matched those written in the plans. The care is regularly reviewed, taking into account peoples changing needs and individual wishes. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of those spoken to were pleased with the quality and choice available. We tasted the food that was served to residents. It was well presented, hot enough and tasty. Staff recruitment records were clear and concise and contained all relevant information. The vetting process helps protect residents.

What has improved since the last inspection?

Some recent redecoration in the home has improved the environment for residents. A new activities co-ordinator has been employed. Residents spoke highly of her. She has had little time to make many changes but has already helped to improve the quality of life for people living in the home. The activities coordinator has started to keep good records relating to residents social care. These are person centred and reflect individual needs, wishes and abilities. Te CSCI pharmacist inspected the home earlier this year. He made a number of requirements and recommendations that the manager has already taken action on. These were about storage of medicines and training for staff.

What the care home could do better:

The building was adapted for use many years ago. Although some recent redecoration has improved the look of the home there are a number of things that make caring for people with nursing needs difficult. The passenger lift is old and breaks down often. This restricts the social life of those residents on the first floor. Some of the corridors are narrow and some bedrooms and bathrooms are small. This makes it difficult to move hoists around. The laundry is housed across the yard. The building it is in is not easily kept clean and laundry is transported across the yard in all weathers. The heating system is not reliable and sometimes the water is not hot enough in resident`s rooms. In questionnaires, when asked what the home could do better relatives and residents said: "The laundry is not good, whites are never white" "The furniture is poor, the laundry is poor" "The baths and toilets need improving" "The lift and stair lift keep breaking, the heating doesn`t always work" Staff said: "The equipment needs updating and the premises modernised" "We need better shower rooms with more room for hoists" Some of the health and safety checks had not been carried out at the correct intervals. Staff training records for the past year could not be found and therefore the manager was unable to tell which training was up to date.

CARE HOMES FOR OLDER PEOPLE Howard Castle Care Centre Dacre Street Morpeth Northumberland NE61 1HW Lead Inspector Janet Thompson Key Unannounced Inspection 5th and 17th September 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Howard Castle Care Centre DS0000063758.V371895.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. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howard Castle Care Centre Address Dacre Street Morpeth Northumberland NE61 1HW 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) 01670 - 510634 01670 513529 www.europeancare.co.uk European Care (England) Ltd Manager post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th August 2007 Brief Description of the Service: The home is a large two-storey building that has undergone considerable alteration to provide a care home environment. Situated near the centre of Morpeth, the home is within easy walking distance of the local shops and amenities. A small, enclosed car park is available with ramped access to the home. There are large, level landscaped gardens at the front of the house with a spacious and well-used patio area. The home can accommodate up to forty service users including those with nursing needs. The home has thirty-six bedrooms, four of which are registered as double rooms. Fourteen of the bedrooms have en-suite facilities. There is one main dining room and three lounges. There are a number of assisted bathing and shower facilities on each floor and one passenger lift. The fees for the home range from £389-£430. Further information about the home can be obtained from the service user guide, which is available in the home. This contains the statement of purpose and previous inspection reports. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This was an unannounced inspection which took place over two days. The previous manager for the home has left. A manager has recently been appointed to the post. He was present at the second day of inspection. How the inspection was carried out: Before the visit we looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received comments from five staff, seven relatives and two residents. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. Feedback was given to the manager at the end of the second visit. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Some recent redecoration in the home has improved the environment for residents. A new activities co-ordinator has been employed. Residents spoke highly of her. She has had little time to make many changes but has already helped to improve the quality of life for people living in the home. The activities coordinator has started to keep good records relating to residents social care. These are person centred and reflect individual needs, wishes and abilities. Te CSCI pharmacist inspected the home earlier this year. He made a number of requirements and recommendations that the manager has already taken action on. These were about storage of medicines and training for staff. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. EVIDENCE: Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessment. We spoke to residents about the admissions procedure. Two residents could remember coming to see the home before they were admitted. One residents said her daughter had visited on her behalf and someone from the home had come to see her in hospital. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. EVIDENCE: Four care plans were examined and three were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Residents looked clean and well cared for. The nurse reported that none of the residents are suffering from tissue damage caused by pressure. One resident Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 11 spoken to described how his care needs had increased due to a fall. He said staff always attended promptly when he rang for assistance. He also said that staff supported him to walk on the days when he was feeling stiff or weak and they let him walk by himself if he was feeling better. Residents said they were well looked after. They said: “My bed is very comfortable and I can have a bath when I like” “I am well looked after, the staff are good here” Relatives said: “The care is excellent” “I always find (resident) relaxed, comfortable and clean” “The full time nurses are very good and caring” Some people did comment that staff turnover was high with a resulting variation in high standards. These questionnaires were sent out at a time when the manager had just left. It is very common for staff turnover to increase when there is a change of manager. The current manager has had a very good response to recruitment and this should start to settle down. A staff member said that when a resident goes to hospital there is not enough information sent with them. The manager has already written a hospital transfer from which contains all essential information about residents. This will be put at the front of resident’s case files to be available if a hospital admission is required. Medication ordering, administration, storage and disposal were not examined because a CSCI pharmacist has just carried out an inspection. The manager reported that he has taken steps to address the requirements made at that inspection. We have extended the timescales for these and they will be reassessed at the next inspection. Staff were seen to treat residents politely and respectfully. There was a good atmosphere in the home. Residents seemed relaxed with staff. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. EVIDENCE: An activities co-ordinator is employed at the home for 25 hours per week. She has not been in post long but residents already know her name and appear to like her very much. She supports residents to use a range of services within the local community. Residents are encouraged to be in control of their own lives and enjoy their own interests and hobbies. Each resident has a social history assessment carried out. This describes each individuals likes, dislikes and fears, religion and beliefs, leisure, sport, hobbies and preferred relaxation. The activities co-ordinator then records what individuals have achieved on a daily basis. This is working well and given more time will be excellent. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 13 Residents said: “Yes there is enough to do if you want” “We get chivvied to join in but never pushed” “She has started to ask us what we want to do, things are better now” “You always have a choice, food, bedtime, what to do.” One resident liked to stay in his room. He said staff often called in on him just to see if he needed anything. Residents also said they liked the food. In questionnaires there were no poor comments on food. We ate the food at the home. It was well presented. The food was hot enough and very tasty. The standard of the cooking was very good. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 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 protected from harm through thorough policies, procedures and staff training. EVIDENCE: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. The manager is currently carrying out a training needs analysis to see if staff need further training in adult protection. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable home that is generally pleasant and clean. The environment does not help promote independence for residents. EVIDENCE: The home was generally clean and free from odours. Although some recent redecoration has improved the look of the home there are a number of things that make caring for people with nursing needs difficult. This year has seen an increase in the number of problems associated with on older building. Some of these have been brought to the attention of CSCI by relatives. The passenger lift is old and breaks down often. This restricts the social life of those residents on the first floor. Some of the Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 16 corridors are narrow and some bedrooms and bathrooms are small. This makes it difficult to move hoists around. The heating system is not reliable and sometimes the water is not hot enough in resident’s rooms. The laundry is housed across the yard. The building it is in is not easily kept clean and laundry is transported across the yard in all weathers. In questionnaires, when asked what the home could do better relatives and residents said: “The laundry is not good, whites are never white” “The furniture is poor, the laundry is poor” “The baths and toilets need improving” “The lift and stair lift keep breaking, the heating doesn’t always work” Staff said: “The equipment needs updating and the premises modernised” “We need better shower rooms with more room for hoists” The gardens looked nice and residents said they were well used in good weather. Resident’s own bedrooms were well personalised and comfortable. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported and protected through staff numbers. Staff skill and ability could not be demonstrated fully. EVIDENCE: The usual staffing for Howard Castle is: Two qualified nurses all day. Five care assistants all day One qualified nurse and three care assistants at night. The off duty rosta for the home showed that these staffing levels were being met. At the last inspection it was noted that over 50 of the home’s staff were qualified to NVQ level 2 or above and a training programme was in place to provide an overview of training achieved and required. The manager has only been in post a few weeks and could not find this training programme. He has started to carry out a training needs analysis for staff and put together his own Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 18 programme. At this point in time it is not clear whether staff training is up to date. Three staff recruitment files were examined. Two were for new staff members, two for registered nurses and one for existing care staff. All files showed that a suitable application form had been used. Two references were obtained. Criminal Records checks and Adult Protection checks were done. There was evidence that staff’s identity had been checked. The home aims to give all applicants an equal opportunity of employment. Standard forms are in place to ensure that everyone goes through the same process at application. A diversity monitoring form is used to ensure the equal opportunities policy is adhered to. Residents spoke well of staff. Their comments have been reflected in other areas of this report. Howard Castle Care Centre DS0000063758.V371895.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are protected through reflective management taking account of the diverse needs of the service. EVIDENCE: The home does not yet have a manager who is registered with CSCI. The manager has only been in the post full time for a few weeks. He is experienced in nursing and management and has previously been registered as a manager in a different home. He has also worked as a nurse in the past at Howard Castle. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 20 The manager has made himself known to residents. All residents spoken to knew his name and one remembered him from his past employment in the home as a nurse. Residents thought that things had improved in the few short weeks since the appointment of the new manager. Whilst the home was running without a manager staff have managed to work as a team to maintain good standards of care for residents. The manager has some good ideas for change within the home and staff seem to support him in these. Staff spoken to were clear about their role and responsibilities. They were open and honest throughout the inspection. Servicing and maintenance agreements are in place for facilities and equipment. This included electrical and gas safety certification. Fire safety checks and test were not up to date. The weekly fire alarm test had only been done twice in July and twice in August. This was said to be because the person who does the checks was on holiday and there was no-one appointed to do them in his absence. There were no checks made at all on the hot water system. This was said to be because it was running too cool due to the failure of the boiler. Therefore staff had assessed that there was no risk of overheated water scalding residents. The manager had taken immediate action on this. All hot water outlets should be checked from now on. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Residents personal monies were well accounted for. Records were examined and showed that two signatures were obtained for all transactions. Three amounts of money were counted and were correct. Howard Castle Care Centre DS0000063758.V371895.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 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 2 3 X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 2 Howard Castle Care Centre DS0000063758.V371895.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 (2)18(1)( c) Requirement Additional training in support of best practice guidelines must be provided to all staff involved in the handling and administration of medication. The risk of medication errors is reduced if appropriately trained staff are involved in giving medicines. Best practice guidance and the provider’s current policy must be followed when storing, giving and recording all medicines. This will help to make sure that people’s health and welfare are protected from the risk of medication errors or omissions. Medication must be stored securely, safely and in line with legal requirements to prevent tampering with medicines and theft. Stocks of medication must be checked regularly and ordered in a timely fashion. This will make sure that people receive their medication as prescribed and the treatment of their medical Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 23 Timescale for action 31/10/08 2. OP9 13 (2) 31/10/08 condition is not affected. 3. OP38 13(4) Ensure all health and safety checks are carried out and are up to date. 01/10/08 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 OP26 Good Practice Recommendations Give serious consideration to the re-siting of the laundry facility. 2. OP9 Staff should sign and date handwritten entries they make on the MAR charts. Each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. A system should be in place to record all medication kept in the home and carried over from the previous month. This helps to confirm that medication is being given as prescribed and assists in checking stock levels Medicine cupboards and the fridge should be locked when not in use. Regular monthly prescriptions should be seen before being sent to the pharmacy. This makes sure a check can be made that all the medicines required have been listed and prevents people from being without. The medicines policy should be updated to reflect local requirements and practices within the home. Providing clear guidance and up to date guidance will help staff understand how to handle and administer medicines safely. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 24 A maximum/minimum thermometer should be used to monitor the fridge temperature to confirm that medicines are stored within the appropriate temperature range and so are safe to use. Regular audits of the medicines systems should be carried out together with regular checks on controlled drug stocks. This will help to ensure that staff are following all medicine policies and that medicines are safe and secure in the home. 3. 4. 5. 6. 7. OP19 OP22 OP28 OP30 OP31 Give serious consideration to reorganisation of the layout of the building to meet the needs of residents with physical disabilities. Demonstrate that an assessment of the premises has been carried out to ensure that suitable and working passenger lifts are in place. Confirm that more than 50 of staff have achieved NVQ level 2. Produce a training and development plan for staff. The manager should apply for registration with CSCI. Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Howard Castle Care Centre DS0000063758.V371895.R01.S.doc Version 5.2 Page 26 - 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. 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