Inspection on 07/06/06 for Minchenden Lodge

This inspection was carried out on 7th June 2006.

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

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

Other inspections for this house

Minchenden Lodge 04/07/07

Minchenden Lodge 31/01/06

Minchenden Lodge 10/10/05

Minchenden Lodge 07/02/05

Minchenden Lodge 04/06/04

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

CARE HOMES FOR OLDER PEOPLE Minchenden Lodge Blagdens Lane Southgate London N14 6DD Lead Inspector Tony Brennan Key Unannounced Inspection 7th June 2006 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 Minchenden Lodge DS0000010661.V292043.R02.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. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Minchenden Lodge Address Blagdens Lane Southgate London N14 6DD 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 1222 020 8886 1222 Scimitar Care Hotels Plc Ms Maria A Simpkins Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Scimitar Care Hotels PLC owns Minchenden Lodge. The company owns a number of other homes in the North London area. Minchenden Lodge is a long established home in a residential part of Southgate. There is easy access to public transport and shops. The home now has twenty-one single rooms and no longer has double rooms. The home is registered to care for twenty-five older people but this is no longer relevant given the new changes to the double rooms. The home aims to provide personal care only for older people. The aim of the home is to deliver good quality care in comfortable surroundings ensuring that service users needs are met as individually as possible. Fees are between £450 and £550. This report is available through the internet. Copies may also be obtained from the provider of this service. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken as part of the annual inspection programme. The inspector also sought to confirm that the eighteen areas for improvement identified at the last inspection were addressed. The inspection took place over one day. The registered manager, Maria Simpkins, assisted the inspector with part of the inspection. The inspector spoke with six people who live at Minchenden Lodge and four staff. The inspector observed care practice and interaction between service users and staff. The inspector toured the building and examined a number of records relating to the care, health and safety and management of the home. The inspector would like to thank the registered manager and staff who assisted him by answering questions about the running of the home. The inspector would also like to thank those people who live at the home who discussed their views of the service they receive. What the service does well: What has improved since the last inspection? Eighteen areas for improvement were identified at the last inspection. Of these eleven were met and there are a number of areas where some improvement has been made. Training has been provided to all staff on infection control to ensure that those who live at the home are protected from the risk of cross infection. A survey of the views of the quality of the servcie provided has been started to ensure that people living at Minchenden Lodge are involved in the improvement of the service. Staff have received training on the use of fire extinguishers and all fireguards on doors are now working. This will ensure that those who live at the home are protected in the event of a fire. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 6 What they could do better: Twelve areas for improvement were identified at this inspection. A number of areas for improvement were restated and four immediate requirements were made on outstanding areas for improvements. The inspector found that although some areas from the previous inspection were partially met there was a need for further work. Where this is the case, areas for improvement have been identified as part of this report. There is still a need to identify the needs of those who are coming to live at Minchenden Lodge. The inspector found that there were no assessments and plans to address the risk of falls. As this affects the safety of those who live at the home an immediate requirement was made to ensure that this issue is addressed promptly. Although the inspector observed that more activities were being provided, when this was discussed with a person who lives at the home they said, “they offer games and playing cards which is all very juvenile”. There is a need to provide activities that reflect the interests of those who live at the home. Staff were observed providing activities and those spoken to had not received training on the provision of activities. Discussion with the registered manager, care staff and training records showed that staff had not undertaken training in adult protection. This affects the safety and well being of those who live at the home an immediate requirement to address this issue was given. Staff need to complete the National Vocational Qualification in care at level 2 to ensure that they could safely meet all the needs of those who live at the home. The registered manager needs to complete the Registered Manager’s Award to ensure that she has all the skills necessary to manage the home in the best interests of those who use the servcie. The home has started to consult those who live at the home and their representatives about the quality of the service that is provided. Once this is completed a report must be presented to the Commission outlining how any areas needing improvement are to be addressed. Staff are not supervised on a regular basis to ensure that they are supported to meet the needs of those who live at the home. As there had been no improvement in this area an immediate requirement was given. The fire risk assessment and evacuation plan had not been reviewed. This presents a risk to the safety of those who live and work at the home, so an immediate requirement was given to ensure quick improvement of this area. The temperature of food cooked in the home is not recorded on all occasions. Seven requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the ‘Timescale for Action’ column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant section. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. Please contact the provider for advice of actions taken in response to this Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 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 Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate due to no new admissions. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are not assessed prior to admission to the home to ensure they receive the care and support they require. EVIDENCE: The registered manager explained that there had been no development of the assessment process since the last inspection. At the last inspection there had been a lack of assessments prior to admission to the home and service users spoken to had identified areas where they had not been fully supported. There had been no new service users admitted since then. The inspector spoke with the registered manager and explained that there was no evidence that these issues had been addressed. Minchenden Lodge DS0000010661.V292043.R02.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 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users personal, social and medical care needs are not planned for and met. Service users’ right to privacy is respected. Service users are fully protected by safe procedures for handling medication. Service users right to privacy is supported. EVIDENCE: A service user said staff were “very kind and understanding”. Since the last inspection there had been some improvement in the care plans. These have now been updated to include more information on the needs of service users. However, care plans did not cover the full range of service users needs. Care plans covered personal care needs, but did not provide details of how service users wanted these to be met. The inspector found that the preferences and choices of service users were not recorded in detail and care was not planned to support this. Care plans had been reviewed regularly. A service user said, “they get the doctor if I feel unwell”. Since the last inspection, information on service users pressure care needs had been recorded. The registered manager explained that Waterlow assessments still needed to be carried out. The inspector asked that these be completed to Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 11 ensure that service users pressure and skin needs are more clearly identified. There is still a need to develop assessments and prevention plans for falls. The registered manager explained that a new form was being produced for this. Service users records showed that they had access to a range of medical support to meet their needs. Medication procedures were in place. Records for the receipt, administration and return of medicines were all complete. The inspector checked the medicines for a number of service users and these were found to correspond with the medication administration records. Senior staff had recently received further training on the safe administration of medication. The temperatures of the medicines cardboard and trolley were recorded and were found to be within safe limits. The registered manager explained that service users medication is reviewed regularly depending on the needs of service users. Those service users who do not see the doctor regularly are referred to the doctor when necessary so that their medication can be reviewed. A service user said, “staff are very helpful” and “it is comfortable here, no one bothers you too much”. The inspector observed a member of staff talking with a service user. The member of staff listened and explained what she was going to assist the service user with. The inspector observed that the staff member did not rush the service user. Minchenden Lodge DS0000010661.V292043.R02.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 15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are provided with sufficient and varied activities to meet their needs. Service users are supported to maintain contact with relatives and other representatives of their choice. Service users are able to make choices about how they live in the home. Service users are provided with varied and balanced meals. EVIDENCE: The inspector observed that service users completed puzzles and had a music and movement session. A service user was observed leaving the home with a member of staff for a walk in the park. This service user commented, “staff take me out when I feel like it”. A service user commented, “they offer games and playing cards which is all very juvenile”. There is now an activities programme in place. This consisted of similar activities as seen on the day of the inspection. Staff spoken to and training records showed that care staff who provided most activities had not been trained in doing this. A service user said, “we get visitors when we want them”. The registered manager explained that the home operates an open door policy and does not have set times for visiting. Another service user said, “I don’t join in very much and staff don’t push me into anything”. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 13 A service user said that the food was “good”. Another service user said, “the meals are good and I can tell them if I’m not keen on anything”. The inspector spoke with the cook who showed the inspector an example of the new updated menu. The cook explained that service users were consulted about the changes to the menu. Service users were offered new options to see if they liked them before these were added to the menu. The inspector saw that meals were well presented and they were provided in a relaxed environment. Sufficient staff were available and when necessary, service users were observed being assisted to eat. Minchenden Lodge DS0000010661.V292043.R02.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 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: A service user said, “I don’t have any complaints, but I know who to tell if anything worries me”. The complaints policy explained how to make a complaint and how it would be dealt with. This was displayed around the home. The complaints record showed actions taken to resolve complaints. The registered manager explained that complaints were audited monthly to ensure that they had been appropriately handled. There had been three complaints in the last inspection year that had been investigated by the service and had been responded to appropriately. A service user said, “staff know how to treat me”. Service users said that they felt safe and could approach staff if they had any concerns regarding how they are treated. There were comprehensive policies on handling abuse and protection. Discussion with staff and the training records showed that staff still needed to be trained in adult protection. The registered manager has applied and got a place on the training for trainers course so that she can deliver this training. Minchenden Lodge DS0000010661.V292043.R02.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 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a safe and comfortable environment. The home is a clean and hygienic environment for service users to live in. EVIDENCE: A service user said, “this is a nice home to live in”. The inspector toured the home and found that it is appropriately decorated and furnished. All service users bedrooms were personalised and had phones and televisions. A service user said that their “bedroom is comfortable”. The registered manager showed the inspector where a walk-in shower was to replace the existing standard shower. There was enough space and this would provide further accessible facilities for service users. The toilets and bathrooms were adapted with raised toilet seats and chair lifts for the baths. On the day of the inspection the lift was out of action and the engineer was on site and by the end of the inspection the lift was working. The registered manager had made arrangements to ensure that service users were safe and staff were available to meet their needs. The inspector found that the home was clean and hygienic. Guidance and procedures were in place to prevent cross infection. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 16 Staff spoken to understood how to prevent cross infection. Protective clothing and hand washing facilities are available to staff throughout the home. Minchenden Lodge DS0000010661.V292043.R02.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 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Sufficient staff are available at all times to meet service users needs. Staff do not have the skills to meet all the assessed needs of service users. Service users are protected by the home’s recruitment practices. EVIDENCE: A service user commented, “staff are good”. Staff confirmed that they had sufficient numbers to meet the needs of service users. The inspector observed that there were sufficient staff available to ensure that service users in all parts of the home were supported. The rota showed that a consistent staffing level was maintained. The training records showed that since the last inspection there had been training on infection control. Staff spoken to by the inspector understood how to operate the fire extinguishers as they had recently received training on fire safety. Training records showed that staff had had training in all other areas of statutory required training with the exception of first aid as there were insufficient staff with this qualification to ensure the safety of service users. Subsequent to the inspection the home held training on first aid. The evidence of which has been sent to the inspector. Although five staff have completed and a number of staff have commenced the National Vocational Qualification in care at level 2, the home has still to achieve 50 of staff holding this qualification. The inspector examined staff records, which contained all the required information. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The registered manager does not have all the necessary qualifications to manage the home effectively and in the best interests of service users. Service users are consulted about the quality of the service provided and encouraged to make suggestions for improvement. Service users financial interests are protected by the home’s procedures. Staff are not supervised to ensure they are supported to meet the needs of service users. Service users and staff are not protected by the home’s health and safety procedures. EVIDENCE: The registered manger explained that she has still not commenced the Registered Manager’s Award. The registered manager explained that there had been no planned development of the service. A service user said, “you can talk to the manager in a confidential way”. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 19 The home has a system in place to consult service users and a questionnaire has been sent out to all service users and their representatives. The registered manager needs to ensure that a report and action plan is sent to the Commission that addresses any issues highlighted in the report. Service users meetings are being held to involve service users in decisions about the home. Either relatives or social service departments manage most service users money. Each service user has a separate account and any expenditure is recorded. The home does hold small amounts of cash for service users. These were checked and found to tally with the records seen. Discussion with the staff and supervision notes showed that some staff had had supervision. Not all staff had been supervised and there were gaps in the supervision records. Service users interests were not supported due to the lack of support provided to staff. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The fire emergency evacuation procedure and risk assessment plan still needs to be reviewed, as it was not complete. The inspector questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. The fireguard on the door of bedroom 20 has been replaced. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. Records showed that staff had received training on health and safety topics. The inspector discussed health and safety issues with staff and they demonstrated their understanding. The home has a system for monitoring accidents. The inspector found that there were gaps in the monitoring of cooked food temperatures for May and June. These were mainly at the weekend. This was brought to the attention of the registered manager. Fridge and freezer temperatures were recorded and within safe limits. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 1 X 2 Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement The registered persons must ensure that a detailed assessment of all the needs of service users is carried out prior to admission. (The timescale of 01/06/06 was not met). The registered persons must ensure that the service user plans are detailed and personalised to ensure that their choices and preferences are reflected and can be met. The registered persons must ensure that the risk of falls is assessed and a prevention care plan is in place for those service users at risk. (The timescale of 01/06/06 was not met). An Immediate Requirement was given. The registered persons must ensure that there are activities in place that reflect the interests and needs of all service users. The registered persons must ensure that staff receive training in providing appropriate activities for service users The registered persons must DS0000010661.V292043.R02.S.doc Timescale for action 01/09/06 2 OP7 15(1) 01/09/06 3. OP8 14 15(1) 01/07/06 4 OP12 16(2)(n) 01/09/06 5 OP12 18(1) 01/10/06 6. OP18 13(6) 01/07/06 Page 22 Minchenden Lodge Version 5.1 18(1) 7 OP31 18(1) 8 OP33 35(a) 9 OP36 18(2) 10 OP38 23(4) 11 OP38 13 ensure that training is provided on adult protection for all staff. (The timescale of 01/06/06 was not met). An Immediate Requirement was given. The registered persons must ensure that the registered manager completes the Registered Manager’s Award. (This requirement is within timescale and is restated). The registered persons must ensure that once the survey of service users, relatives and professionals views of the quality of the service is completed an action plan must be prepared for any areas of improvement identified in the survey. A copy of this report must be sent to the Commission. The registered persons must ensure that staff receive supervision six times a year and that this is recorded. (The timescale of 01/06/06 was not met). An Immediate Requirement was given. The registered persons must ensure that in consultation with the Fire Service, the fire risk assessment and the evacuation procedure are reviewed. (The timescale of 01/06/06 was not met). An Immediate Requirement was given. The registered persons must ensure that the temperatures of cooked food are recorded daily. 01/12/06 01/09/06 01/07/06 01/07/06 01/07/06 Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations The registered persons should ensure that 50 of staff achieve the NVQ at level two in care. Minchenden Lodge DS0000010661.V292043.R02.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. 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