Inspection on 05/05/06 for Larchwood Care Home

This inspection was carried out on 5th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Larchwood Care Home 18/04/07

Larchwood Care Home 06/09/05

Larchwood Care Home 28/04/05

Larchwood Care Home 30/09/04

Larchwood Care Home 02/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Larchwood Care Home 108 Broad Road Braintree Essex CM7 9RX Lead Inspector Brian Bailey Key Unannounced Inspection 09:30 5th & 12th May 2006 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 Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Larchwood Care Home Address 108 Broad Road Braintree Essex CM7 9RX 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) 01376 347777 01376 345556 www.cshealthcare.co.uk Southern Cross Care Homes No 3 Limited Mrs Sharon Thompson Care Home 64 Category(ies) of Dementia - over 65 years of age (64) registration, with number of places Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 64 persons) 6th September 2005 Date of last inspection Brief Description of the Service: The owners of Larchwood are Southern Cross Healthcare and the registered manager is Sharon Thompson. Larchwood is a large purpose built two-storey care home for older people. The service user accommodation is arranged within three self-contained group living units, Acorn and Chestnut on the ground and first floor in one building, and Rowan, which is a larger unit on the ground floor in an adjoining building. Each unit consists of a group of bedrooms, lounge/dining area, bathrooms/WCs and kitchenette. All bedrooms are for single occupancy with en-suite WC facilities. All meals are prepared in a central kitchen. The home is set back from the main road in a residential area on the outskirts of Braintree. There are ample car parking facilities and access to public transport is good. There is a passenger lift available. The grounds adjacent to each unit are enclosed and there is a secure central courtyard area. Access to the building and all areas is good. Larchwood specialises in the care of older people with dementia and also frail elderly people. The accommodation fees as at 12/5/06 were disclosed by the manager as ranging from £426.09 to £707.09. Extras to fees include chiropody, hairdressing and toiletries. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of Larchwood was carried out on 5/5/06 and 12/5/06. This report is based on a range of information that has been accumulated from our inspection records, two site visits to the home, discussions and observations with service users, staff, the manager and visitors, questionnaires issued by CSCI and records kept at the home. Thirty standards were assessed, of these nineteen were met, ten were partly met and one not met. What the service does well: What has improved since the last inspection? The refurbishment work to upgrade the home over the past two years is almost complete and has significantly improved the overall appearance and accommodation used by residents. Improvements since the last inspection include the installation of a shower unit, new carpets fitted in the corridors of two units and new curtains in bedrooms and lounges. Information provided to residents and visitors about the range of services and facilities available at the home has been revised and updated. This information is also available in a video format. New pre admission assessment procedures have been introduced that require staff to record information in a more detailed and comprehensive manner. The manager was able to provide evidence that some of the requirements made at the last inspection had been addressed. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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): 1, 2, and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is well managed and residents and relatives are given clear information regarding the service. Providing residents with a statement of the home terms and conditions would enable them to have a better understanding of their rights of residency at the home. EVIDENCE: The home has a Statement of Purpose and a Service User guide, which provide information about the home. At the time of the site visit to the home, these documents were in the process of being updated and were in draft format only. However, as at 15/5/06, the final versions were agreed and copies are now available to residents and/or their relatives. The provider has introduced a new pre-admission assessment form that the manager uses to assess the needs of prospective residents. The forms are well laid out, comprehensive and enable the manager to record information on a Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 9 wide range of essential topics. Evidence of pre admission assessments was not available on all residents’ care files, as these had been filed away in error. The manager was however able to demonstrate from records of residents that had moved into the home in recent weeks that the new forms were in use. The care records of six residents were checked, but it was not always apparent who had completed the assessment and they were not all dated. Information received from the placing local authority prior to admission was varied in content. The manager must insist on detailed and up-to-date information being made available to enable a full assessment of need to be carried out. This will assist the manager with determining the resources that would be required to meet those needs. There was no evidence available to show that residents or their representative are provided with a statement of the home’s terms and conditions, although privately funded residents are provided with a contract. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded by a well-maintained system for administering medication although a formal assessment of staff competencies would help to minimize the risk of errors being made. Residents are looked after well in respect of their personal and health care needs and their care records are well documented, however a more frequent evaluation of each person’s care needs would ensure they always reflect the care needed. EVIDENCE: The care records of two residents from each of the three units were selected for inspection. The files were consistent in style and layout and contained a range of valuable information for care staff, but as already stated not all contained pre admission information. This is being rectified with the introduction of new assessment forms. The daily records were adequate although there is generally a need for more information to be recorded. The Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 11 six care records checked contained up to date care plans, but these were not being reviewed on a regular monthly basis and there was no information to evidence that either the resident or their representative had been consulted. However, two visitors spoken to considered that communication with staff at the home is good and they are made aware of any issues that arise. Information in the records included details of a monthly check of weight, visits by health care professionals and risk assessments. Residents seen and spoken with appeared well cared and had been enabled to maintain their hair, skin and nails in a healthy condition. The home had appropriate policies and procedures for the administration of medication. All medication is kept in locked trolleys within locked cupboards. The home uses a monitored dosage system which was well organised and maintains Medicine Record Sheets for each resident. These were up to date and accurate. Controlled drugs are kept in a separate locked cupboard and a register is maintained with two signatures for each entry. Staff that have the responsibility to administer medication are assessed to ensure their understanding of the system and their competency, but the system for checking this needs to conform to the requirements of the Skills for Care knowledge sets. Reports were available of monthly audits of medication and accidents that are carried out by the manager. None of the residents are recorded as having pressure sores. From observation and discussion with residents, staff and visitors it was evident throughout the visit to the home that residents are treated with dignity and their rights to privacy are respected. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 poor. This judgement has been made using available evidence including a visit to this service. Opportunities for residents’ to feel fulfilled, stimulated and to enjoy an interesting day are minimal and dependent only on the time made available by care staff and visitors. Residents benefit from being able to select from a balanced varied and enjoyable diet. Residents living on the first floor are unable to exercise their right to choice to spend time outside the building in the gardens. EVIDENCE: Relatives attending a relatives meeting in February 2006 complained that there were insufficient activities taking place in the absence of the activities coordinator. The lack of activities was highlighted at the inspection carried out in September 05. As at May 06, the situation has not improved despite the manager placing adverts for a temporary replacement. There was no evidence at the site visit that activities were available other than when care staff had time to sit with residents, which according to staff is rarely. At all times Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 13 throughout the visit staff were observed to be in the company of residents but were more often than not too busy attending to duties other than activities. One resident was busy doing some crochet work that clearly gave the person a great deal of satisfaction and pleasure to be able to show examples of completed work. It was evident from observation and discussion with three visitors that they felt welcome and able to visit at anytime. During this inspection, residents were served with a choice of meal. The food was well-presented and appetising in appearance and the residents were not rushed. Records showed that where possible, residents’ likes and dislikes were recorded. One resident spoken to said the food was liked and a choice was available but the majority of residents were unable to comment about the quality of food provided. The manager was in the process of creating pictorial menus to assist residents with making selections. Owing to the need for security and the prevention of accidents, residents living on first floor are unable to access the facilities on the ground floor or the gardens other than when staff are available to assist. Since the majority of residents are unable to decide whether they would prefer to sit outside and all have the right to access natural daylight, the provider must consider how this is to be achieved. This matter was raised at the last inspection and there was no evidence to show how this was being achieved. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 judgement has been made using available evidence including a visit to this service. The home has a complaints procedure, but this needs to be made more widely available to ensure that residents and visitors are clear about how to make a complaint and that any complaints made will be dealt with. Residents benefit from the home having procedures to protect them from abuse and from staff being provided with training to ensure they understand the procedures and how to follow them. EVIDENCE: The home had a complaints procedure that was available in the entrance hall and is included in the statement of purpose and resident guide. Relatives complained at meeting held in February 06 that only a limited range of activities were being provided. The manager acknowledged that this complaint was justified. Two comment cards returned to CSCI from relatives included the statement that they were not aware of the complaints procedure. The home has a policy and a procedure on the protection of vulnerable adults from abuse (POVA) and all staff, apart from the most recent appointments, have been provided with training on the understanding and recognition of abuse. Training certificates were available on staff files. Further POVA training has been arranged to take place in June 06. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although there are a few areas in the building that require attention, the refurbishment work over the past two years to make the home more homely, comfortable and attractive has been of significant benefit to residents. EVIDENCE: The refurbishment of the home is almost complete, which has significantly improved the general appearance of the home for residents. The manager described plans to make further improvements, which will include the wish to introduce more colour, to assist residents with direction and to provide a sensory room. New carpets throughout the building and appropriate floor covering in three rooms has helped with the odour control, although the carpet in the dining room of Acorn needs to be replaced with a more suitable floor covering. Despite being cleaned on a daily basis the carpet is stained from Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 16 food being dropped and is worn. A bathroom in Chestnut has been upgraded and an unused bath replaced with a shower. The floor covering in some en-suite WC’s in bedrooms on Rowan unit needed to be replaced in order to maintain odour control, which was unacceptable in one bedroom. The veranda outside of Chestnut unit on the first floor has safety bars fitted to prevent an accident but these do not provide an attractive outlook for residents. The manager has looked at alternative ways to achieve this but has not found a solution. The home has experienced many problems with the heating system of the past year, which has during cold weather left some areas too cold. Supplementary heating was provided and considerable work has been undertaken to improve the level of heating. It was not possible to determine as at May 06 how successful this remedial work has been. A resident spoken to said their bedroom was “a lovely room, clean and the decoration was very nice”. Bedrooms checked during a tour of the building appeared to be well decorated and furnished. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 judgement has been made using available evidence including a visit to this service. Effective staff recruitment procedures are place to protect residents. The provision of training for staff enhances their knowledge, which is of benefit to residents, but the lack of a comprehensive induction package may result in some staff not acquiring the basic skills to carryout their duties in a competent manner. EVIDENCE: Staff rosters were checked and it was found that the staffing levels had not changed since the last inspection. Staff were still of the opinion that the number of staff allocated to each of the units is insufficient. Two relatives spoken to during the inspection also shared this view. The manager is again reminded to monitor the dependency levels of residents to ensure that the current staff numbers available for each shift is sufficient to meet the needs of residents. Comment cards returned to CSCI from relatives included the view that the manager and staff were attentive, welcoming and supportive. All staff were observed to be extremely busy attending to the residents, with many demands for their attention they remained calm and patient and did not try to hurry residents. Information provided by the home shows that five staff have a National Vocational Qualification (NVQ) at level2, two staff have (NVQ) level 3 and Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 18 fourteen staff are registered to take the qualifications. This means that less than 50 of the care staff have the qualification although the target of 50 will be exceeded when the remaining staff have qualified. Records were available to show that all new employees are required to undertake an initial induction into the home during the first few days of employment. The form used needs to be developed, as it does not include all the main topics of information that new employees need to know. Southern Cross has introduced an induction programme that appears to meet the requirements of the Skills for Care Common Induction Standards but there was no evidence to show these were in use. Four staff files inspected during the inspection showed that the manager was following procedures and carrying out all the necessary recruitment checks for new staff. The files were well maintained and kept secure. Criminal Records Bureau disclosure checks were examined. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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, 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. Residents benefit from a well-managed staff team, good administrative systems and a consistent team approach to supporting residents. An effective system is place to ensure that residents’ money looked after by the home is safeguarded. Residents, staff and visitors are involved in providing feedback which influences services and standards. EVIDENCE: The manager is experienced at managing at a senior level, registered with CSCI and is currently taking the Registered Managers Award. Relatives meetings take place; the last occasion was on 19/2/06 when 17 people attended, which is a good response. Minutes of the meting were available. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 20 It was evident from observation that the manager generally operates an open door policy and is readily available for consultation. However, from discussion with staff and the manager, this practice clearly makes heavy demands on the manager’s time and some consideration should be given as to how staff report information to senior staff. Relatives and staff spoken to considered the manager to be approachable and supportive. The manager has demonstrated over the past year that she has a positive attitude towards inspection, endeavours to meet the National Minimum Standards and has kept the Commission well informed of any significant event that occurs at the home. The provider carries out monthly Inspection visits to the home and submits reports of the outcome to CSCI. A comment card returned to CSCI stated “I am welcome to share my views directly with the home which I have always found to be attentive to my parents needs” and “I am always made welcome by staff and management at whatever time I visit”. The home operates a Quality Assurance system and had issued questionnaires requesting people’s opinions about the quality of the services provided. The manager was awaiting the outcome of the feedback to enable a summary to be made available. Information provided by the home at the end of January 2006 showed that equipment and systems were being serviced at the appropriate intervals. A random check of records at the home confirmed these records continued to be up to date. Staff training records showed that a few staff require food hygiene and first aid training. A certificate showed that the local district council had awarded the home a Gold Award in February 2006 for the high standard of cleanliness and hygiene in the kitchen. Two health and safety requirements made at the last inspection had been addressed. The accounts of six residents money held by the home for safekeeping were checked and found to be up to date, accurate and all expenditure was in accordance with those items considered to be extra to the fees charged, such as chiropody, hairdressing and toiletries. Statements of each account are provided on a regular basis although these are due to be computerised and will be more readily available to service users and relatives. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 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 3 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 3 X 3 3 3 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 3 3 3 X 3 X X 2 Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP2 Regulation 5 Requirement The registered person must ensure residents are provided with a statement of the terms and conditions in terms of the accommodation to be provided. The registered person must insist on obtaining comprehensive and up to date assessments for people placed by a local authority. Care plans must be reviewed at least monthly. (Timescale of 01/12/05 not met) The registered person must ensure that staff authorised to administer medicines have been trained and assessed as competent to do so. The registered person must ensure that a range of activities are provided that meet residents expectations, preferences and capacities. Residents living on the first floor must be routinely provided with opportunities to access the garden areas of the home. (Timescale of 01/12/05 not met) Timescale for action 01/08/06 2 OP3 14 01/07/06 3 4 OP7 OP9 15 13.6 01/07/06 01/07/06 5 OP12 16 01/07/06 6 OP14 23 01/08/06 Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 23 7 OP19 23 8 OP19 23 9 OP30 18 10 OP38 13 The registered person must ensure that carpets in the Acorn dining room needs to be replaced with a more suitable floor covering. The registered person must ensure that the poor odour control in en-suite WC’s in Rowan Unit is improved. The registered person must ensure that all new staff are provided with appropriate induction training. Staff must be provided with training on food hygiene and first aid. 01/09/06 01/07/06 01/09/06 01/09/06 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 2 Refer to Standard OP16 OP28 Good Practice Recommendations The registered person should ensure that the homes complaints procedure is accessible to all visitors The registered person should ensure that the target of 50 of care staff acquire a National Vocational Qualification 2 is met. Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Larchwood Care Home DS0000017864.V293922.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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