CARE HOME ADULTS 18-65
Oaklodge 11 Oak Villas Manningham Bradford West Yorkshire BD8 7BG Lead Inspector
Stevie Allerton Key Unannounced Inspection 21 September 2006 11:30
st Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 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 Oaklodge DS0000001314.V302609.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 Adults 18-65. 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. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oaklodge Address 11 Oak Villas Manningham Bradford West Yorkshire BD8 7BG 01274 546920 P/F 01274 546920 N/A 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) Mr Ronald Berry Mrs Doreen Berry, Michael Stephen Berry, Anita Anne Berry Mr Anthony Cook Care Home 31 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (26), Old age, not falling within any of places other category (5) Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The places for OP are for the service users specified in the letter dated 29 April 2004 only. Date of last inspection Brief Description of the Service: Oak Lodge provides care and support for up to 30 men and women with mental health needs, for those aged 18 - 65 years of age on admission, although some older service users are accommodated. There are facilities for regular respite care for those living independently who require additional support. The home does not provide nursing care. It is one of a group of homes owned by the Berry family and is managed by Tony Cook on their behalf. Oak Lodge is a large detached property located in the Manningham area of Bradford, close to public transport systems, shops and local community facilities. Bedrooms are on three floors, with communal rooms on the ground and lower ground floors, all accessible by passenger lift. The house stands in its own grounds, with good car parking facilities. Current care fees are £283.29 per week. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector over the course of one day. The Manager, Tony Cook, was on duty and made himself available to answer questions and supply care records, etc. Mr Steve Wiggins, Operations Manager was also present for most of the day. Michael Berry, one of the registered providers, joined the Manager and was given feedback on the findings of this inspection at the end of the visit. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, reports from other agencies, i.e., the Adult Protection body, and information supplied by way of an annual questionnaire. This information was used to plan the inspection visit. The inspector case tracked four service users. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method, the inspectors assessed all twenty-one key standards from the Care Homes for Younger Adults National Minimum Standards, plus other standards relevant to the visit. The inspector spoke with identified service users and relevant members of the staff team who provide support to them. Documentation relating to these service users was looked at. Where possible, contact was also made with external professionals to obtain their opinions about the quality of services provided at the home. The inspector would like to thank everyone who took the time to talk to her and express their views. What the service does well:
The home provides good support for people with enduring mental health problems, who will either stay there over a long period or receive shorter periods of support in times of crisis. Service users say that the staff are very supportive and help them with any areas of their lives they find difficult, be that budgeting money, limiting the extent to which they use alcohol or other substances, or improving their selfcare skills.
Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 6 The home works well with other health and social care professionals to provide a support package for each individual. Some very positive feedback was received via comment cards, demonstrating the confidence which other professionals have in the home’s ability to work together with them, in the best interests of the service users. What has improved since the last inspection? 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. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. Prospective service users are provided with the right level of information about the home and what it can offer, so that they can make an informed decision about living there. Proper assessment is carried out before admission, to make sure that the service will be able to meet their needs. There is a good introduction process for service users referred for admission to the home, which is flexible in response to the person’s needs. EVIDENCE: A new resident was in the process of being introduced to the home and was having her second stay during the inspection visit, so was selected for casetracking. Her care notes showed the process of pre-admission assessment, with all professionals involved in her care contributing to the whole picture. Staff from the home were invited to a ward round at the hospital to discuss future care needs. Assessment information from the hospital was made available to all of the staff in the home to read and discuss. A basic care plan could be seen, that had been put in place for the first few days, after which a full care plan would be developed with the service user. The inspector spoke briefly to the prospective service user, who was quite apprehensive. She said that she had not enjoyed her first stay at the home, Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 9 as she had been unwell and spent all of the time in her room, but was willing to give it another go and hoped that this stay would go better. The home’s service user guide was on display in the hallway. The Manager explained that it had also been translated into Urdu and was recorded on cassette tape by an Urdu-speaking member of staff (this could also be produced onto CD if needed). Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. The care and support plans for each service user reflect their changing needs and are based on risk assessment, ensuring a good balance between upholding individual rights and the staff team’s duty of care. Care plans address cultural needs and human rights. Staff demonstrated a good regard for privacy when seeking permission to enter service users’ rooms. EVIDENCE: Three service users were selected for case-tracking, along with the person on their pre-admission visit. Male and female service users were selected, including a non-English speaker. Specific care plans were in place for a wide range of assessed support needs, including personal and physical support where this is needed. Records show that risk is managed appropriately, with the agreement of the service user wherever possible. It could also be seen where service users do not agree with their own plan, their views being incorporated into the records.
Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 11 Detailed recording could be seen during the process of introducing a new service user, which was then incorporated into their initial basic care plan. Good practice was to be seen in the notes of one person that staff have developed an effective strategy with, regarding the amount of items collected and stored in their room. The care records contained a written agreement that the service user would allow staff to enter her room periodically, for health and safety reasons. Service users spoken to said that they felt able to approach the Manager and staff about how the home runs and felt they could have sufficient say in daily events and routines, mainly through the monthly residents’ meetings. Non-English speakers are supported by the staff having a list of key words in the appropriate language, for food, drink, etc., so that they can communicate at a basic level if there are no community language speakers on duty. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. Service users benefit from the home’s location in the community, which allows for easy access to shops and other facilities in the local area. They are able to choose at what level they mix and socialise with other people living at the home. The appointment of a specific Activities Co-ordinator has really had a positive impact on the service. He has been able to explore a variety of avenues in the community where service users can develop interests, either collectively or on a one to one basis, demonstrating some creative thinking and also an ability to reflect on the events he has organised and how they could have been improved. Meal provision meets the expectations of the service users and the home tries to promote healthier eating. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 13 EVIDENCE: Since the last inspection a new post of Activities Co-ordinator has been created. The Activities Co-ordinator came in especially to speak to the inspector about the work he has been developing with the service users. Records were available, to show what activities or outings had taken place, who took part and how the event went, so that the success or otherwise of each activity can be evaluated, and there were many photos from the outings on display. There is a trip out every Tuesday; for example, 9 service users and 2 workers went to the National Railway Museum at York the previous week. Other trips have included various museums, 10-pin Bowling, a Safari Park, shows, etc. Service users said that they enjoyed the different outings they had been on. The Activities Co-ordinator also works on an individual basis with service users, e.g., taking people swimming. This has been done after consultation with the care staff and an assessment of likely risk. He has also established contacts with other community resources, such as MIND, where service users can mix and socialise with people other than those living at Oak Lodge. He has been successful in negotiating concessionary rates for service users and carers at a variety of venues, such as the cinema, where some of the Asian residents have been to see Bollywood movies. Everyone is now registered for the Access Bus service, which has increased opportunities to get about in the community. Perhaps the greatest change so far has been the enrolment of three service users on courses at the Cathedral College, one of which will lead to an NVQ in gardening. The inspector had lunch in the dining room along with staff and service users and was able to speak to some of them. Lunch was self-service and consisted of a variety of cold meats, fish and salad stuffs, along with bread, so that people could make sandwiches if they wished. Service users were spoken to about the food. All made positive comments and one said that in his opinion it was first class. The Manager explained that the home was keen to promote a healthier diet and had replaced some foodstuffs with a lower-fat equivalent, for example. The cooks are able to produce traditional meals for the Asian service users. The menus showed that there were 2 choices of main meal, as well as a vegetarian or Halal alternative. One of the service users who was case tracked was recorded as having a poor dietary intake and needing constant encouragement. This was in evidence during the inspection. Meal replacement drinks have been prescribed to supplement dietary intake. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality n this outcome area is good. This judgement has been made using available evidence, including a visit to the home. There are proper arrangements in place for the safe storage, handling and recording of medication. Staff have a good level of knowledge about the effects of both prescribed and illicit drugs. Service users have the support they need in order to manage their mental and physical health within the community, with appropriate input from other health professionals. Staff are sensitive to cultural and gender issues with regard to personal care. EVIDENCE: Specific care plans were in place for a wide range of assessed support needs, including personal and physical support. Care plans for one of the service users case tracked were discussed with that person’s key worker. She demonstrated a good level of knowledge about the support plans and which were the priority areas for her client. Discussions are presently taking place between the Manager and staff regarding gender and personal care issues.
Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 15 Documents indicted that the staff work closely with other mental health professionals; this was confirmed by two comment cards, returned by Community Psychiatric Nurses (CPNs) involved with clients at the home. One described the service as “one of the few residential care settings who work well and in collaboration with the Assertive Outreach Team. They are prepared to go the ‘extra mile’ with their residents and a genuine caring attitude is always present”. Advice is also sought appropriately from primary health care professionals; the Practice Nurse from one of the GP surgeries has been out to speak to staff and advise on ways of lowering cholesterol, which is a problem for some individuals. Medication systems were examined; these remain the same as on previous inspections. The Deputy takes the lead in drugs management and ordering, as before. A weekly audit is carried out; this means that staff can quickly pick up if someone is beginning to regularly refuse their medication and raise this with the appropriate CPN, etc. A random check on some of the Controlled Drugs showed that these were in order and properly accounted for. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. Staff are aware of adult protection issues and seek advice from the appropriate sources when necessary. The provider’s complaints procedure has been used to good effect. Staff and volunteers are vetted appropriately, prior to working with the service users. EVIDENCE: The complaints procedure is on display and appears to be understood by service users, some of whom have used it. A complaint made to CSCI regarding the cleanliness and state of repair of the home was referred to the provider to investigate, which they did in a timely manner, responding where required. There has been some in-house training for staff regarding Adult Protection, which has raised awareness; however, places are awaited on Bradford Social Services Department’s Adult Protection course. A copy of the local policy and procedure, “No Secrets”, is available for reference. A recent incident between two service users was appropriately referred to the Adult Protection Unit, to ensure that individuals were safeguarded. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 30 Quality in this area is adequate. This judgement has been made using available evidence, including a visit to the home. Service users’ rooms meet their needs and there is a range of communal areas that are well used. The environment does suffer damage and extreme wear and tear. Some of the communal carpeted areas (the stairs in particular) appear to be beyond cleaning now and need to be replaced. Cleanliness in the kitchen was much improved from the last inspection. EVIDENCE: A tour of the building was carried out, accompanied by the Manager. A selection of service user’ rooms was seen, some of which were highly personalised and some bare of any personal possessions. Some service users smoke in their bedrooms (which is permitted), but are very careless about using ashtrays or bins, so some of the floor coverings were damaged with cigarette burns. The carpets have been taken up in the rooms affected in this way. The Manager said that flame retardant bedding and furnishings were in place and that staff try to manage the risks. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 18 A number of doors throughout the building had damaged plasterwork around the frames, which the Manager said had been listed for repair. The carpets on the staircases, and in the main entrance and hallway, were very badly stained and worn and are now beyond cleaning. The kitchen was much tidier than on the last inspection and storage appeared to be well organised. A higher level of cleanliness was seen on this visit. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. Staff are properly recruited and trained and are well supported by their Managers. They have a good record of being able to work closely with other health care professionals, who hold them in high regard. Although training is mainly provided in-house, further opportunities to achieve NVQ qualifications would enhance the professional status of the staff. EVIDENCE: The recruitment file for one of the most recently appointed staff members was seen; this contained two written references and evidence of an identity check and Criminal Records Bureau (CRB) disclosure. The Induction training in place follows the Skills for Care standards. Discussions took place with various staff members. The key worker role was discussed with one carer, with particular regard to communication. She described the support that she gave as a key worker, communicating with the aid of translated key words, or the help of other bi-lingual staff, to this nonEnglish speaking resident. The records showed that she had some input to multi-disciplinary review meetings for her client’s continuing aftercare.
Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 20 One of the Senior Care staff described her role in supporting the key workers; she also had delegated responsibilities for particular areas, including supervising the cleaning and catering staff and some other management tasks. One of the care staff had been subject to an assault by a service user recently; she said that the management team had been very supportive in maintaining safety for her as a worker, adjusting her work patterns whilst there was still a risk. The Manager said that some staff experience incidents of racism, sometimes because of service users’ mental ill health, but not always. He said that all incidents are challenged, although the level at which they are challenged varies according to circumstances. Staff training has mainly taken place in-house of late, although the Manager and the Activities Co-ordinator have both attended an external course on Recovery from Mental Health Problems. The District Nurse has offered training on specific areas and the Assertive Outreach Team have also offered talks to the staff team. Bradford SSD are offering Mental Health training in 2007 and the Manager finds that MIND are a very useful source of reading material, all accessible to staff in the office. Only 25 of the care staff have NVQ qualifications; the staff are reported as being keen to have NVQ training, but the home has not yet found an appropriate provider for their work with younger adults. Regarding mandatory training, Fire training has recently been carried out, and the provider indicated that Food Hygiene as well as First Aid and Health and Safety refreshers were planned. The staff rota appears to provide sufficient cover to meet the current needs of the service users and there is not a great deal of staff turnover. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. Service users are enabled to have a say in the running of the home and there are good working relationships between the Manager, the staff and the registered provider. There appear to be clear messages being given about rights and responsibilities and that action will be taken to ensure that vulnerable people are safeguarded. There is an internal system in place for monitoring, audit and development. Health & Safety is taken seriously and risk assessments reflect behaviour and lifestyle issues as well as the safety of the premises. Record keeping is good. Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 22 EVIDENCE: A selection of regulatory and operational records was examined, including: • service users’ care plans, • accident and incident reports, • residents’ meetings minutes, • financial records, • fire safety records, • personnel files, • staff rotas, • training records, • staff handover sheets, • menus and food records, • cleaning schedules, • medication records, • maintenance records and repairs log. All of the records supplied either during or prior to the visit were informative, readily available and appeared to be accurate and up to date. Staff explained that the care plan documents were being revamped; they were finding that, although the required information was there, it was not always accessible quickly enough Oaklodge DS0000001314.V302609.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23(2)(b) Requirement Timescale for action 31/12/06 2 3 YA24 YA35 23(2)(d) 18(1)(c) The registered provider must ensure that damaged areas of plasterwork are repaired throughout the home. The registered provider must 31/03/07 ensure that badly stained and worn carpets are replaced. The registered provider must 31/03/07 take steps to provide the workforce with NVQ training, so that at least 50 of staff achieve a qualification. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oaklodge DS0000001314.V302609.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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