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Inspection on 11/05/06 for Tang Hall

Also see our care home review for Tang Hall for more information

This inspection was carried out on 11th May 2006.

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

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

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

Relatives and friends of service users are made welcome in the home and there is good communication between the manager and visitors. The manager and staff know the service users well and ensure that individual care is provided. The home regularly holds parties for service users on occasions such as birthdays and wedding anniversaries. The monthly visits by the local church are enjoyed by those who attend. The opportunity to worship, sing hymns and listen to readings from the bible enables individual`s spiritual and religious needs to be met. Service users enjoy a varied diet and staff make sure that likes and dislikes are taken into account when planning the menus.

What has improved since the last inspection?

Since the last inspection visit, Erulla Filbey has completed the registration process and is now Registered Manager of the home. A new laundry room with appropriate flooring and equipment has been put in place.Some work has been done by the proprietor on a Quality Assurance system and submitted to the Commission for Social Care Inspection, although this would be improved if there was greater input from the registered manager. Members of staff have now received training around fire safety, which was a requirement from the previous inspection visit.

What the care home could do better:

Although the standard of hygiene throughout the home is acceptable, some areas have an unpleasant odour coming from the carpets, some of which are old and stained. In addition newly laid flooring in a bathroom was showing signs of `lifting`. The home would be greatly improved flooring in these areas were to be replaced. Although there is an appropriate complaints procedure in place, it would be improved if minor concerns were also documented. The manager has had training around the Protection of Vulnerable Adults (PoVA) and given information to staff. Service users would be better protected if all care staff had formal training around PoVA.

CARE HOMES FOR OLDER PEOPLE Tang Hall 18 Cottage Grove Bockings Elm Clacton On Sea Essex CO16 8DH Lead Inspector Ray Finney Unannounced Inspection 11th May 2006 09:30 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 Tang Hall DS0000045521.V298130.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. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tang Hall Address 18 Cottage Grove Bockings Elm Clacton On Sea Essex CO16 8DH 01255 421304 01255 423079 tanghall@abc-care-solutions.co.uk 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 Raju Ramasamy Mr Inayet Patel Mrs Eroulla Filby Care Home 20 Category(ies) of Dementia (20), Mental disorder, excluding registration, with number learning disability or dementia (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (20) Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Persons of either sex, aged 65 years and over, who require care by reason of a mental disorder (not to exceed 20 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 20 persons) The total number of service users accommodated must not exceed 20 persons Future admissions to the shared room must be as a result of active choice of service users to share a room One person, under the age of 65 years, who requires care by reason of a mental disorder whose name was made known to the Commission in January 2006 10th October 2005 Date of last inspection Brief Description of the Service: Tang Hall is a detached two-storey Care Home, situated in a quiet residential road in Clacton-on-Sea. The home is within walking distance of local shops and a few minutes drive from the town centre. The property has been extended several times but remains in keeping with the appearance of other houses in the surrounding area. Accommodation is provided on two floors, access to the first floor is by means of a passenger lift. The home has 18 single bedrooms and one double room, many with en-suite facilities. Communal areas include a large lounge, dining room, small lobby and a quiet room set aside for meetings or private visits. There is a small and secure garden to the rear of the property, with access via patio doors from the dining room. There are parking spaces to the front of the property. The home charges £419.00 per week with additional charges of between £3.50 and £6.00 for chiropodist or hairdresser services. This information was provided to the commission in February 2006. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was looked at when compiling this report. The manager of the home provided information in a pre-inspection questionnaire. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. Surveys were returned from relatives of service users and one Health Care Professional. A visit to the home took place on 11th May 2006; this included a tour of the premises, discussions with the manager, conversations with relatives and a visiting health professional and observations of interactions between service users and members of staff. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and the inspector was given every assistance from the registered manager, Erulla Filbey. What the service does well: What has improved since the last inspection? Since the last inspection visit, Erulla Filbey has completed the registration process and is now Registered Manager of the home. A new laundry room with appropriate flooring and equipment has been put in place. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 6 Some work has been done by the proprietor on a Quality Assurance system and submitted to the Commission for Social Care Inspection, although this would be improved if there was greater input from the registered manager. Members of staff have now received training around fire safety, which was a requirement from the previous inspection visit. 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. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the needs of prospective service users are assessed. EVIDENCE: Three service users files were examined during the inspection visit. All have pre-admission assessments. The assessments are based on ‘Activities of Daily Living’ and ‘Needs for Daily Living’. The records also show that assessments are reviewed on a monthly basis. The manager explained to the inspector at the visit how assessments are carried out and how information is used from service users, relatives and other professionals, such as social workers. This consultation ensures that the home is able to meet individual assessed needs and appropriate admissions take place. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the service user’s health, personal and social care needs are set out in a plan of care. Service users are supported to make decisions about their lives with assistance. Service users are protected by the home’s policies and procedures for dealing with medicines. The home ensures that service users are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Records examined during the visit show that care plans are compiled using information from the assessments. Daily routines, health, personal and social care needs are identified in care plans. The manager has a system of Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 10 recording when care plans need to be reviewed and evidence was seen that care plans are reviewed at least monthly. Discussions with staff confirm that the manager and senior carers have input into compiling care plans. Service user records contain risk assessments on manual handling, nutrition, Waterlow Scale for Pressure Sores as well as a general risk assessment. The manager demonstrates a high level of familiarity with service users’ needs as well as their likes and dislikes. During the inspection visit, a Community Staff Nurse visited the home and provided positive comments about the health care provided. Records show that the home ensures service users have access to optician, dentist, chiropodist and G.P. services. The home operates a Monitored Dose System for medication. During the inspection visit the Pharmacist visited the home to discuss the drug orders and prescriptions. There is a good relationship between the home and the Pharmacy with evidence of good communication. The Medicine Administration Record sheets examined were all in order and contained appropriate information. Observations on the day of the inspection visit showed that members of staff treat service users with respect. A visiting health care professional states that she is able to see service users in private. Overall comments from relatives about the care provided are positive. A member of staff spoken with was able to demonstrate a good awareness of service users’ needs. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced by service users in the home satisfies their interests and needs. The home ensures service users are supported to maintain contact with family and friends. The home supports service users to exercise choice and control over their lives. Service users are provided with a wholesome, appealing diet that they enjoy. EVIDENCE: An activity planner was examined on the day of the inspection visit, which shows that the home provides a variety of activities for service users. Members of staff arranged ‘arts and crafts’ activities and good interactions were observed between members of staff and service users during a glasspainting session that took place. A visiting singer was popular with service users. One service user spoken with recently celebrated a 60th wedding Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 12 anniversary and received a card from The Queen. A party was laid on and the home regularly has parties for occasions such as birthdays. A white board on the wall in the dining room contains pictures and information about events. There are also reminders about things like the date and the weather. Another display board has pictures of service users taking part in various social activities. A visiting parson comes in monthly to conduct a church service; this is well attended and enjoyed by many of the service users. Rotas show that staff hours are used flexibly to meet the social needs of service users, with more carers on duty during the morning and early afternoon. Surveys received from relatives show that they are welcome in the home at any time. There is a pleasant, small, quiet lounge where service users can meet with visitors or, if they prefer, can entertain visitors in their own rooms. A visiting relative was enthusiastic about the way the manager and staff make visitors welcome. Service users spoken with who were able to express a preference said they choose what they want to do. One service user didn’t want to spend much time in the communal areas but “loves the radio and loves the room” and enjoys being there – “I’ve got everything I want in my room”. There is information available about advocacy services through the North Essex Advocacy Team. Menus examined show that the home provides a variety of foods. Service users spoken with said that the food is good. On the day of the inspection visit, the manager discussed how the home had devised a different menu for a service user who was vegetarian. Service users were observed to enjoy the main meal on the day of the visit. One service user who had gone out with a social care professional was eager to get back for the meal and staff ensured there was a hot meal available even though it was quite some time after the lunchtime meal had finished. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the home has a complaints procedure that ensures complaints will be taken seriously, listened to and acted upon, although the process would be better if minor concerns were recorded. Procedures in the home ensure service users are protected from abuse, although staff would benefit from formal training around the Protection of Vulnerable Adults. EVIDENCE: The home has an appropriate complaints procedure in place that gives timescales for responding to complaints. One complaint had been recorded in the past year and this had been dealt with appropriately. On the day of the visit, the manager was able to explain to the inspector how the home deals with minor concerns when they are raised and is always available to discuss issues with residents or their representatives. Relatives spoken with are confident that they will be listened to. However, minor concerns and how they are dealt with could be documented more thoroughly. The manager was able to demonstrate a good awareness of abuse and has recently completed a Protection of Vulnerable Adults (PoVA) training course. Members of staff have been provided with PoVA booklets. Although staff have been given information on PoVA, the home could ensure greater protection of service users if all staff were to have formal PoVA training. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the environment is safe and is reasonably well maintained, although flooring in some areas throughout the home need to be replaced. Overall the home was clean and hygienic, although some carpets need to be replaced. EVIDENCE: During the inspection visit it was observed rooms are generally clean and tidy. In particular service users’ bedrooms are well maintained and decorated to an acceptable standard. New flooring has been laid within the past few months in one of the bathrooms and the surface has already deteriorated and ‘lifted’. The manager is liaising with the company who installed the flooring to get the problem rectified. Records examined show that maintenance checks have been carried out on gas installations and electrics, fire alarm system, loft, bath Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 15 hoist and fire extinguishers. Portable Appliance testing (PAT) has been carried out. A certificate of Fire Safety Instruction for staff training was examined. Overall, the standard of cleanliness throughout the home is acceptable. However, on the day of the inspection visit there was some evidence of unpleasant odours in some isolated areas. This seems to be coming from carpets in some of the bedrooms. The manager said that there are a high percentage of service users with continence issues and the home ensures carpets are cleaned regularly. The home would benefit from replacing the carpets in the areas where the odours are obvious. A new laundry room has now been completed, that contains appropriate washing and drying equipment. The floor covering is impermeable and washable. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of service users are met by the numbers and skill mix of staff. Although the home ensures service users are in safe hands, the home needs to ensure the recommended percentage of care staff have appropriate training. The home’s recruitment policy and procedures ensures the protection of service users. The home’s training programme ensures staff are trained and competent to do their jobs. EVIDENCE: Staffing levels are worked out based on service users’ needs. Rotas that were examined at the inspection visit and observations of staffing levels show that the home uses the staff team flexibly to ensure adequate staffing levels at busy times, with 5 carers on for the early shift and 3 for the afternoon shift. Although staffing levels are lower in the afternoons, the manager said that was because many of the elderly service users have a nap in the afternoon. Therefore, the majority of activities are planned for earlier in the day when people are more alert and willing to join in. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 17 Information provided in a Pre Inspection Questionnaire shows that 50 of care staff have a National Vocational Qualification (NVQ) at level 2 or above. However, discussions with manager show that these numbers include staff who are qualified nurses and who obtained their qualification abroad. The proprietor feels that these hare higher qualifications than NVQ, although there is no documentary evidence as to the whether these qualifications equate to what is required for NVQ. The records of three members of staff were examined and all contain evidence of an appropriate recruitment process. Two references are sought for new members of staff; enhanced Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (PoVA) checks are carried out. Appropriate identification documents are on file, including passport, driver’s licence and birth certificates. There is a training programme in place that includes Basic Food Hygiene, First Aid, Manual Handling, Health & Safety and Infection Control. In addition most care staff have received Fire Training and Dementia Training during the last 12 months. The manager has also planned updates for manual handling, fire safety and medicine training. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the home is well run, although the manager should continue to develop management skills and complete management qualifications. The home is run in the best interests of service users and their views are taken into account, however the quality assurance system needs further development. The home ensures the financial interests of service users are protected. The home ensures the health, safety and welfare of service users and staff are promoted and protected. Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 19 EVIDENCE: Since the last inspection visit the Acting Manager, Erulla Filbey, has completed the registration process and is now Registered Manager of the home. Erulla has a sound background and experience in the field of care. Although not experienced in the field of management, she is undertaking the NVQ level 4 in Management and Care. The manager should continue to develop management skills and complete management qualifications to ensure service users benefit from a well run home. The manager discussed the homes processes around Quality Assurance with the inspector. The proprietor has made a comprehensive Quality Assurance document available to the commission, but there needs to be more involvement from the manager in implementing a Quality Assurance system that is based on seeking the views of service users. The manager was able to explain what the home does to get the opinions of service users and other interested parties and how this information is used by the manager to direct practices within the home. The manager has an ‘open door’ policy and actively seeks the views of relatives and other interested parties. The manager and staff are able to demonstrate that there is good communication with service users and every effort is made to find out likes, dislikes and wishes. Since the inspection visit the manager has developed a new questionnaire for relatives. Overall the home was able to document some good practices around seeking the views of service users and other interested parties, however, the system would be improved if the report more closely reflected the views of those using the service. On the day of the inspection visit a sample of service users financial records was examined. The home keeps appropriate written financial records for individual service users finances. At the time of the inspection visit there were no service users who managed their own finances. Service users pay for visits by the chiropodist or the hairdresser and also buy their own toiletries. Costs vary between £3.50 and £6.50; receipts are obtained and recorded appropriately. The manager ensures safe working practices by that includes appropriate staff training (see evidence for National Minimum Standard 30). The home is maintained to a standard that ensures the health and safety of service users and staff (see evidence for NMS 19 and 26). The home records any accidents, injuries and incidents of illness and reports them to the Commission for Social Care Inspection. Risk assessments are in place around areas such as manual handling (see evidence for NMS 8). Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 2 17 X 18 2 2 X X X X X X 2 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 2 X 2 X 3 X X 3 Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 21 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 OP16 Regulation 17(2) The registered person must Schedule ensure that a record of all 4(11) complaints is kept; this relates to the recording of minor concerns 13(6) The registered person must make arrangements, by training of staff, to prevent service users being harmed or suffering abuse; this relates to the training of staff around Protection of Vulnerable Adults 23(2)(b) The registered person must ensure the premises are kept in a good state of repair; this relates to the flooring in the bathroom 16(2)(k) The registered person must keep the care home free from offensive odours; this relates to the carpets in some service users rooms 9(2)(b)(i) The registered manager must ensure she has the qualifications, skills and experience necessary to run the care home; this relates to completing NVQ level 4 in Management and Care 31/07/06 2 OP18 30/09/06 3 OP19 30/09/06 4 OP26 30/09/06 5 OP31 31/12/06 Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 22 6 OP33 24(1) The registered person must establish and maintain a system for reviewing and improving the quality of care; this relates to further development of the Quality Assurance system 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations The registered person should ensure 50 of care staff acquire NVQ training Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tang Hall DS0000045521.V298130.R01.S.doc Version 5.2 Page 24 - 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. 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