Inspection on 28/02/08 for Mountdale Nursing Home

This inspection was carried out on 28th February 2008.

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

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

Mountdale Nursing Home 06/01/09

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Mountdale Nursing Home 59 Mountdale Gardens Leigh On Sea Essex SS9 4AP Lead Inspector A Thompson Unannounced Inspection 28th February 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 Mountdale Nursing Home DS0000070308.V360333.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. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mountdale Nursing Home Address 59 Mountdale Gardens Leigh On Sea Essex SS9 4AP 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) 01702 421019 01702 511777 mountdalenursing@yahoo.co.uk Mr Davinder Thakar Mr Nathaniel Dogar vacant post Care Home 22 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (22), of places Terminally ill (4) Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Terminal Illness to include persons aged 55 years and over, to be provided up to and including 4 residents. (Total number not to exceed four). Number of service users to whom nursing and personal care is to be provided must not exceed 22. (Total number not to exceed twenty two). To provide personal and nursing care to 6 service users over the age of 65 years with a diagnosis of Dementia. Date of last inspection Brief Description of the Service: Mountdale is a purpose built establishment, situated in a predominately residential area of Leigh on Sea. A local bus route provides access to Southend on Sea town centre. The home provides accommodation with nursing to twenty-two older people including the provision of care for people who have dementia. The residents accommodation is situated over three floors, with assisted access provided by a passenger lift, supplying all floor levels. The current range of fees charged by the home for nursing care and accommodation is £543.32 - £656.00 per week. Other charges are incurred for hairdressing services, newspapers etc. Mountdale Nursing Home DS0000070308.V360333.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 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced key inspection took place on Thursday 28th February 2008. The content of this report reflects the inspector’s findings on the day of the inspection along with information provided by the service and feedback by residents, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions were entered into with residents, the manager, matron, deputy matron, visitors and staff on duty. CSCI survey questionnaires were also provided to residents and staff. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Comments received from residents included: ‘ the food very good’, ‘the staff are helpful and always come when I need them, ‘ there are not many activities we could do with more to do, there are outings thought, we are going to Strawberry Fields for a meal next Saturday. ‘I don’t have any complaints if I did I’d tell the manager who is very good’. ‘I have complained in the past and the manager dealt with it properly’. ‘I get asked for my choice at mealtime, the food is good and the portions are good, too much sometimes’. ‘The staff are friendly’ Visitors spoken with said they had no concerns about the care provided to residents by the staff and manager. All were complimentary about staff attitudes and the atmosphere in the home, however not all relatives thought that there were always sufficient numbers of staff on duty. Questionnaires were also left at the home so that relatives and visiting health & social care professionals had the opportunity to make their views on the service known to the Commission. Staff confirmed they received good support from the management team. They also said that they had been offered training opportunities appropriate to their roles, and that at present there were weekly training sessions in the home’s training room on various subjects. Twenty six standards were looked at and the outcomes for residents against twenty of these was good, with six adequate. As a result this report includes five statutory requirements for action, and three good practice recommendations. What the service does well: Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 6 Mountdale provides a clean and comfortable environment for people who need nursing care. Nursing staff carry out a detailed assessment of each persons needs and the person or their relative is offered the opportunity to visit the home before making a decision to move in. People living at the home receive a good standard of care and both residents and their relatives who were spoken with indicated that they were satisfied with the care provided by the home. People who spoke with the inspector said that staff were available when needed, that they listened to residents and acted upon their wishes. What has improved since the last inspection? What they could do better: The medication room needs to be kept locked when not in use (immediate action was taken on this issue by the manager with the fitting of a new lock on the medication room door by 3/3/08). Activities available to residents should be offered daily, and follow a structured programme based on their expectations and preferences. A system must be in place to ensure that the views of residents and stakeholders have been sought regarding the service provided by management and staff. The Commission must be notified of any incidents that may result in an adult protection investigation. Staff must be trained for their roles so they are equipped with the skills to meet the needs of residents. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 7 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. Mountdale Nursing Home DS0000070308.V360333.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 Mountdale Nursing Home DS0000070308.V360333.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): 1,3 Quality in this outcome area is good. People’s needs are assessed prior to admission so the individual and the home can be sure the placement is appropriate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider/manager visits prospective new residents to undertake an assessment of nursing need. Evidence of this process was seen in care plan files for people admitted since the last inspection, and from discussion with relatives. Assessment headings covered included: nursing care, personal care, medication, history, pain management, breathing, skin care, risk assessment, communication, sensory, dental and nutrition. Files seen also included copies of assessments by PCTs and hospitals. A care plan is compiled after admission, as seen on individual files. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 10 Many of the people who move into the home do so from the hospital and therefore it is not always possible for them to visit prior to moving in. However where it is possible to do so people are encouraged to visit to have the opportunity to see if Mountdale is suitable for them. The manager said that since the last inspection the service users guide had been updated. This was seen and contained up to date information about Mountdale and the services offered. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. The health and personal care service users receive is individualised and based on their assessed needs, but methods of storing medication presented the potential of risk to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were inspected. These included background information, personal details, and next of kin contacts. Care needs were shown under individual assessed headings, and included a nursing diagnosis, desired outcomes, nursing actions needed and a review date. Regular reviews had been recorded with an evaluation form showing actions taken and any changes. There were risk assessments covering general risks that recorded the assessed risk, with the perceived consequences and the controls and actions needed. There were also separate risk assessments covering manual handling (with a specific plan of care), and the use of bed rails, with, where appropriate, the signed agreement to their use by the resident and relative. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 12 GP visits had been recorded as were all medical appointments attended, with the reason for the consultation/visit show and the outcome. The manager said that the care plan format used was being revised by the deputy matron. The new format would include an interim plan of care completed within 48 hours of admission and clearer recording of daily needs. Continence issues are supported by the community continence nurse and hearing needs are provided for by GP referral to a local hospital. An NHS dentist visits the home to provide checkups and treatment to residents, as does a chiropodist and an optician. The local hospital also now offers advice on the prevention of falls to support the home on this subject, copies of assessments carried out by PCT staff were seen. The homes medication policy and procedure covered ordering, receipt, storage, administration, self medicating and returns of unused stocks. The manager said that only trained registered nurses deal with medication in Mountdale Nursing Home. Medication administration records were inspected no shortfalls were noted, however the room used for the storage of medication was not kept locked. This presented a risk to residents as there were some loose packs of unused medication seen in this room ready for disposal. The manager undertook to have a lock fitted to the door. Confirmation that this had taken place was sent by e-mail to the Commission on 3/3/2008. Discussions with individual residents indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with residents. Staff on duty were seen to be caring in their dealings with residents, and those spoken with said staff were helpful and considerate. Visitors spoken with were also complimentary regarding staff attitudes and the care provided. Some residents said they had their own private telephone, others use the home’s payphone. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 13 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 adequate. People who use this service can expect to be encouraged to maintain contact with family and friends and to be provided with good food, but they could not be certain they would have the opportunity to regularly participate in activities to suit their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider/manager said that activities are offered to residents by staff and that in 2007 he had employed an activities coordinator to provide a regular programme of activities in the home. Unfortunately this had not continued and the current approach in the home is that in future all staff will become involved in offering daily activities. The provider/manager said that new staff are made aware of this expectation and he planned to provide training on activities to all staff. Residents spoken with said that occasionally they play bingo and some board games, however until regular, varied in-house activities are offered to residents by staff trained for this role there remains a statutory requirement on this issue in this report. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 14 Residents meetings had commenced in 2008 with minutes of issues discussed and decisions made seen. The provider/manager said he intended to stage monthly meetings to ensure that residents had the opportunity to air their views on the service provided. Some personal allowance monies are held for safekeeping and records of transactions and receipts are kept. A random sample of these checked were acceptable. Information on how to access local independent advocacy services was not displayed in the home. This is recommended to ensure residents and their relatives know how to contact these services if they wish. Inspection of private rooms confirmed that residents had been permitted to bring their own personal items with them on admission. There was also confirmation of this direct from residents, who told the inspector of the furniture and personal items they had brought in with them. Nutrition records seen evidenced choice and variety. The main daily meal is lunch with choices, there is also a choice at tea. All residents spoken with said they got enough to eat, the food was good and there was always a choice. Some relatives spoken with said they eat at the home sometimes and they also thought the food was good. The lunch time meal was observed, the atmosphere was relaxed with staff offering support to residents who needed assistance with eating. Some residents ate in the lounge others chose to eat in their own room. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Complaints are responded to and managed. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure contains guidance on how to make a complaint and who to complain to. Also included were timescales for responses from the home. There was a template for recording issues raised and records had been kept of complaints received and of any investigation and resulting outcomes. Residents spoken with said they knew who to speak to in the home if they any concerns, and that in the past management had responded positively to any queries/issues they had raised. The provider/manager said there had been no complaints since the last inspection. The homes policy on adult protection (POVA) was inspected, there was written guidance for staff on recognising and reporting abuse and action to be taken by staff if abuse is suspected. Staff spoken with displayed awareness of this subject and the provider/manager had taken appropriate action on an issue made known to him in 2007, unfortunately he had not informed the Commission of this and is required to do so on any future POVA referrals. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 16 The provider/manager and a senior nurse have recently (2008) qualified to train staff in-house on POVA matters. This training was planned but had not been initiated at the time of this inspection. Staff training records seen showed that staff had received training on POVA in the past but for several this was in 2005. It is recommended that staff are provided update training on this subject so that they are kept informed of current good practice on recognising and reporting any suspected abuse. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Quality in this outcome area is good. The people living at Mountdale benefit from a comfortable and well maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mountdale Nursing Home is a modern care home equipped with twenty single and two shared rooms, three with en-suite facilities. Communal space comprised of one main lounge/dining room on the ground floor and a smaller lounge on the first floor, although the provider/manager said this was usually only used as a visitors lounge. Outdoor space was available in the garden with a pleasant sitting area at the end of the rear garden. Some of the rear garden directly behind the home is used for car parking. Bedrooms seen were well decorated, clean comfortable and some were made homely with people’s personal possessions. During discussion with residents all Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 18 said their rooms were comfortable. Since the last inspection all bedrooms had been fitted with new carpets There were two bathrooms and one shower room, all offering fully assisted facilities. All bathrooms had a wc and there also four separate wcs around the building. On the day of the inspection the premises were considered to be clean, hygienic and policies and procedures were in place confirming that working practices to control the spread of infection are followed. The laundry is on the 2nd floor and was considered small for the size of the home. The provider/manager said he was hoping to build an extension on the ground floor, which would include a new laundry room. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Residents are supported and cared for by a team of experienced and properly recruited staff who had been mostly trained for their roles. This judgement has been made using available evidence including a visit to this service EVIDENCE: The home’s staffing rota was inspected and showed that staffing levels are one nurse and four carers on mornings and one nurse and three carers on afternoons. Night staffing is one nurse and two carers. The provider/manager said that he was actively recruiting new staff to try to ensure that the use of agency staff is kept to a minimum. On the day of the inspection four new staff were undergoing initial induction around the home. Separate and additional rostered staff were employed to undertake cooking, maintenance and domestic duties. Discussion with staff and records confirmed that regular staff meetings had begun. Minutes were seen for meetings in December 07 & January 08. Staff records and discussion with staff evidenced that new staff had been recruited properly with application forms completed, interviews held, written references obtained, written terms & conditions issued and criminal records checks undertaken. Copies of proof of ID with photograph were also on file. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 20 The provider/manager said that induction for new staff was now based on the Skills for Care induction format. Unfortunately this could not be checked as there were no staff in post who had been employed since the last inspection, except those commencing induction on the day of this inspection. Induction records will be checked at the next inspection. Staff employed before the last inspection said they had received induction when they started and records of this process were seen. Training records and discussion with staff confirmed that staff had been provided training on: health & safety, COSHH, manual handling, first aid, food hygiene, infection control, POVA and fire safety. The training on POVA needed updating for many staff and only four staff had been trained on dementia awareness. Training just commenced in February included nine staff accepted onto an NVQ2, it is recommended that 50 of care staff obtain this award or equivalent. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 Quality in this outcome area is good. Management systems are good and the home is run in the best interests of residents, but they could not be certain their views had been sought. This judgement has been made using available evidence including a visit to this service EVIDENCE: The co-registered provider/manager is a trained nurse and has managed the home since the beginning of 2007. Although residents meetings had commenced and the provider/manager said he encourages free flowing communication between residents/relatives and the home, there was no formal quality assurance (QA) process in place. The views of residents and stakeholders must be included when planning for service improvements, and evidence needs to be available for inspection of the Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 22 numbers involved in the process, with summaries of the findings and of any resulting actions taken. There is a requirement on this issue in this report. Residents personal allowance monies were held for safe keeping by the home. The system used and records kept were seen and were acceptable. Random samples of records that are required to be kept were inspected. These included, complaints, assessments, care plans, staff rotas, staff recruitment, visitors book, nutrition, medication, background info’ and next of kin details, cash held for safekeeping and fire procedures. All seen were satisfactory. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling, fire safety, food hygiene, first aid and infection control. Certificates and service records were seen to confirm that the home’s fire equipment & alarms, passenger lift, hoists, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within recommended timescales. The home had COSHH sheets for cleaning substances used (seen) and the manager said there was a premises fire risk assessment in place. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 3 3 3 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 3 X 2 X 3 X 3 3 Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 Requirement Medication must be kept secure so that only authorised staff have access to medication supplies in the home. Timescale for action 04/03/08 2 OP12 16 The range of activities and 31/07/08 recreational interests available to residents must satisfy their expectations and needs. All incidents that could involve a POVA investigation must be notified to the Commission. Staff training needs to include dementia awareness to ensure staff have the skills to meet the needs of residents. 30/04/08 3 OP18 37 4 OP30 18 31/07/08 5 OP33 24 A system must be developed and 31/08/08 implemented for periodically reviewing and improving the level of services provided by the home taking into account the views of residents, their relatives and other stakeholders such as health & social care professionals. Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP14 Good Practice Recommendations Information on how contact independent advocacy services should be made available to residents and their representatives. 50 of care staff should reach NVQ level 2 or equivalent so that staff have the skills for their role. Staff should be provided update training on safeguarding adults (POVA), so that they are aware of the latest good practice guidance on this subject. 2 3 OP28 OP30 Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Mountdale Nursing Home DS0000070308.V360333.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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