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Inspection on 11/10/07 for St James Park Nursing Home

Also see our care home review for St James Park Nursing Home for more information

This inspection was carried out on 11th October 2007.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People considering moving into St James Park receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. Residents are offered a menu that provides a varied and well balanced diet served in pleasant surroundings. A menu to order breakfast, lunch and supper is provided for the following day and has recently been extended into `night foods`. On the days of inspection the home was very clean, of comfortable temperature and adequately staffed. The home is well equipped, attractively decorated and suitably furnished. A programme of recreational and social activities is provided.

What has improved since the last inspection?

Provider organisation BUPA Care Homes has appointed a Director of Quality to ensure service users are satisfied with all aspects of the service and has introduced the "Personal Best" programme for the motivation and encouragement of care staff. A new system of care planning documentation has been implemented to ensure that all nursing and care staff are aware of and can properly meet the needs of residents. To ensure residents are properly nourished the BUPA Menu Master and `Night Bite` system have commenced, thereby making food available 24 hours a day. Daily cleaning schedules and room checklists have been introduced to ensure that a room is ready for a new resident.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE St James Park Nursing Home Bradpole Bridport Dorset DT6 3EU Lead Inspector Gloria Ashwell Key Unannounced Inspection 11th October 2007 14:30 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 St James Park Nursing Home DS0000020498.V352504.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. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St James Park Nursing Home Address Bradpole Bridport Dorset DT6 3EU 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) 01308 421174 01308 427564 holdehe@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Mrs Helen Holden Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing- Code N To service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category- Code OP The maximum number of service users who can be accommodated is 46. 8th January 2007 Date of last key inspection Brief Description of the Service: St James Park is a large care home registered to provide nursing care to a maximum of 46 older people, owned by BUPA Care Homes (CFC Homes) Limited. The nominated Responsible Individual; is Mrs Greenwood. The home is situated in the quiet country village of Bradpole, a short drive away from the town of Bridport. The home is close to a bus route, with a bus stop within walking distance for buses to and from Bridport. The accommodation is arranged over three floors and a passenger lift provides access to all floors of the home. Currently available for use are 30 single and six double bedrooms; most have en-suite facilities. (Some rooms registered for use as bedrooms are not routinely used for this purpose.) Communal rooms include a lounge, library, conservatory style dining room, three communal lounges (including one with a large dining area), five assisted bathrooms and one assisted shower. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. Fees are charged weekly; at present fees range between £544 and £800 per person. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 5 Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector arrived at 12.30 on 2 October 2007, toured the premises and spoke to residents and staff. By arrangement with registered manager Mrs Holden she arranged the next visit which took place at 14.30 on 11 October 2007 when documentation relating to care provision and the premises was discussed and examined. The duration of the inspection (both days combined) was 5 hours. The inspector spoke to Mrs Holden, nursing, care and household staff and most of the residents accommodated at the time. The inspector observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined, and the resident spoken with. Additional information used to inform the inspection process included reports periodically sent to the Commission by the provider organisation, the Annual Quality Assurance Assessment (AQAA) completed in advance of the inspection by Mrs Holden and questionnaires completed and sent to the Commission by residents, doctors, social care professionals and the relatives of residents. Since the previous key inspection a random inspection was conducted during July 2007, to consider specific concerns regarding the health and safety of residents; the resultant report included a number of necessary improvements with particular regard to the promotion of dignity and good individual care. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: People considering moving into St James Park receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. Residents are offered a menu that provides a varied and well balanced diet served in pleasant surroundings. A menu to order breakfast, lunch and supper is provided for the following day and has recently been extended into ‘night foods’. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 7 On the days of inspection the home was very clean, of comfortable temperature and adequately staffed. The home is well equipped, attractively decorated and suitably furnished. A programme of recreational and social activities is provided. 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. The summary of this inspection report can be made available in other formats on request. St James Park Nursing Home DS0000020498.V352504.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 St James Park Nursing Home DS0000020498.V352504.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 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user guide contains relevant information about the home providing prospective residents and their representatives with an accurate understanding of the people for whom the service is intended although the format of the information may not be suitable for service users who have specific needs for example those with impaired sight. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. The home does not provide Intermediate Care so Standard 6 does not apply. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 10 EVIDENCE: The service user guide is made available to all residents and prospective residents. The Statement of Purpose and service user guide are available in a standard format; it is recommended that this information be made available in alternative formats, appropriate to the needs and capacity of individual prospective residents or their representatives who might find the standard format difficult to read and fully understand. The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the registered manager when she visited the prospective resident at the previous address. In advance of making the decision to enter the home the closest relatives visited St James Park to view the premises and meet residents and staff. Following pre-admission assessment of the persons needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them; a copy of the ‘letter of offer’ is kept on file. Questionnaire comments provided in advance of the inspection included “full, clear and helpful information has always been provided”. St James Park Nursing Home DS0000020498.V352504.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. This judgement has been made using available evidence including a visit to this service. Residents feel they do not always receive an acceptable level of respect and their dignity is not properly protected; more must be done to ensure residents are properly cared for, with particular regard to the time taken in responding to calls for assistance. EVIDENCE: Some residents believe they are properly cared for; comments made in questionnaires completed in advance of the inspection included “It’s comfortable…the people are easy to get on with”. However, other residents said they sometimes have to wait a long time for a response after ringing the call bell; “you can ring the bell but everybody just disappears, not every time, but too often to be comfortable. The care staff St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 12 …are over-stretched so the bell is pretty well useless…they are kind…but tend to rather leave you in the lurch ”. Comments made on questionnaires in advance of the inspection included “sometimes the girls don’t answer the bell” and “responses to bell are sometimes up to 30 minutes probably due to shortage of staff on duty”. The call bell system provides records of times of response which have been recently audited by the registered manager who identified that it has recently taken up to 20 minutes to respond to a call. This problem was also referred to in the report of the June 2006 inspection and must be resolved to ensure residents feel safe and properly cared for. Each resident has a written plan of care ensuring that staff have sufficient information upon which to base their care practice; the home has recently implemented a new documentation system introduced by the provider organisation. Medicines prescribed by doctors are safely stored and carefully administered to residents by trained nurses, thereby protecting residents from medicine errors. Records show that residents receive prescribed medicines at the correct times and in correct amounts. Residents wishing to do so can manage their own medicines in accordance with a risk assessment process; none have chosen to do so at present. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and tranquil. Recently concerns regarding the standards of health and social care have been made known to the home manager and the Commission. The manager quickly and properly responded to each concern but there remain areas for improvement e.g. an ‘in use’ urine drainage bag was left lying on the carpeted floor thereby posing a risk of infection and a trip hazard; when brought to the attention of the manager she promptly arranged for the bag to be differently kept but the circumstance had been reliant upon the inspector’s observation and action. St James Park Nursing Home DS0000020498.V352504.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of daily life in the home is good with residents assisted to maintain as much independence as possible. Social and leisure activities are suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. On the ground floor there is a dining room adjoining the main lounge; residents may also take meals in their bedrooms. EVIDENCE: The inspector spoke to a number of residents; only a few of the frail and seriously unwell residents were able to express an opinion regarding the standard of recreational activities and social life within the home but those who did indicated satisfaction. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 14 The home employs an Activities Organiser for 35 hours each week to arrange local excursions, visiting entertainers, one-to-one and small group social and recreational activities. Comments made by questionnaire in advance of the inspection included “residents are kept motivated with various activities trips out, flower arranging etc.” Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. The inspector observed the serving of lunch in the dining room. Residents appear to be satisfied with the quality, choice and quantity of food provided; one resident said “the food’s very good” and those sitting nearby overheard and agreed. The home has recently introduced the availability of ‘Night Bites’ – a menu from which residents can select light meals and beverages throughout the evening and night. St James Park Nursing Home DS0000020498.V352504.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 adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint; all complaints are recorded and properly investigated. The Home Manager has properly dealt with allegations by involving the correct agencies and taking appropriate in-house actions. EVIDENCE: Since the previous key inspection some concerns have been raised regarding the well-being and standard of care afforded particular residents. On investigation these concerns were partly substantiated; the registered manager promptly and properly took actions designed to ensure the improvement of care practices. To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each resident. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 16 The home adheres to a policy/procedure for the prevention of abuse and staff have received training in this subject to ensure that they remain vigilant to protect vulnerable residents from risks of abuse and know how to properly manage any allegation or suspicion of abuse. St James Park Nursing Home DS0000020498.V352504.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. St James Park is a well-appointed and comfortable home, being almost entirely purpose-built and thereby suited to the needs of frail, elderly people. On the days of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: St James Park is a spacious and well designed home, with wide corridors, good sized bedrooms, bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 18 The home was clean, tidy and comfortable throughout; there were no unpleasant odours. Service users confirmed that this was the usual high standard; one described the cleanliness of the home as “always very nice”. Household staff said they had suitable and sufficient equipment and cleaning materials and felt well supported in their role. St James Park Nursing Home DS0000020498.V352504.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 adequate. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents. Recruitment practices ensure the protection of residents from potentially unsuitable staff but more must be done to ensure that staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Trained nurses lead the care teams and at all times the home is in the overall charge of a trained and competent nurse. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The inspector spoke to a number of staff, including registered nurses, care workers and household staff. All were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 20 The records of 2 recently employed staff members were examined and found to contain all essential information including two written references, health details, evidence of identity and of induction training. At present approximately 30 of the care staff currently employed by the home hold a National Vocational Qualification in care; the home is therefore not meeting the standard for at least 50 of the care staff to hold an NVQ. However, staff are encouraged and supported to undertake training relevant to their work; some staff have recently attended training on the Mental Capacity Act, the registered manager has attended an update on the understanding and promotion of Adult Protection and the provider organisation’s system of ‘Personal Best’ has been recently introduced to motivate and encourage all grades of staff. The home keeps clear records of training which show that all ‘core subjects’ are regularly attended by each employee; these include the subjects of fire safety, moving and handling, and control of infection. St James Park Nursing Home DS0000020498.V352504.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and properly maintained for the comfort and safety of residents, visitors and staff. Recently there have been a number of concerns raised by residents and their representatives with regard to the standards of health and social care of particular residents. The home has introduced measures to improve these aspects, including the provision of ‘Night Bites’, nail kits and a new system of care planning documentation, designed to ensure that all staff understand and properly meet all needs of the people in their care. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 22 EVIDENCE: Registered manager Mrs Holden is supported in her role by a Head of Care who is an experienced nurse employed at St James Park on a full time basis. Questionnaire comments received in advance of the inspection provide evidence of the high regard in which Mrs Holden is held by service users: “the manager is an excellent team leader who manages the home very well and fairly for both residents, staff and relatives” and “excellent manager”. The home has ongoing systems for quality assurance; a satisfaction survey is periodically issued with responses audited by the provider organisation and a consequent action plan implemented by the manager to ensure any shortfalls in provision are met. Periodic meetings for residents and their relatives take place and due to recently raised concerns, arrangements have been made for those relatives who wish to, to have private meetings with the registered manager to discuss any concerns they may have about the home and the standards of service it provides. Additionally, the provider organisation has appointed a Quality Manager working within a number of care homes operated by BUPA, including St James Park who will speak individually with service users to establish their impressions of the service standards. With the exception of the personal allowances of some residents (for which all transactions are confirmed by receipt), the home does not manage the finances of residents. Staff trained in First Aid and health care are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal. Details of equipment servicing and maintenance were provided to the Commission in a questionnaire. The inspector examined some records to verify this information including the records of regular checks/tests of fire safety equipment. The home has recorded a fire safety assessment; to ensure full compliance with current standards it is recommended that a detailed escape plan be also recorded, to include specific reference to the currently accommodated residents. St James Park Nursing Home DS0000020498.V352504.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St James Park Nursing Home DS0000020498.V352504.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 OP8 Regulation 13 Timescale for action The registered person shall make 11/11/07 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. The registered person shall 11/11/07 ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users: Staff must ensure that residents do not experience undue delay when requesting assistance. Requirement 2. OP10 12 St James Park Nursing Home DS0000020498.V352504.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. 2. 3. Refer to Standard OP1 OP28 OP38 Good Practice Recommendations The service user guide should be made available in alternatives to the standard format. At least 50 of care staff should be trained to NVQ level 2 or equivalent. A detailed escape plan should be recorded, to include specific reference to the currently accommodated residents. St James Park Nursing Home DS0000020498.V352504.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 St James Park Nursing Home DS0000020498.V352504.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!