Inspection on 31/08/05 for The Lodge Walton

This inspection was carried out on 31st August 2005.

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

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

Other inspections for this house

The Lodge Walton 18/12/08

The Lodge Walton 19/06/07

The Lodge Walton 26/09/06

The Lodge Walton 26/01/06

The Lodge Walton 27/01/05

The Lodge Walton 10/08/04

The Lodge Walton 11/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Lodge - Walton 82 Kirby Road Walton on Naze Essex CO14 8RJ Lead Inspector Sara Naylor-Wild Unannounced 31 August 2005 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 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. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lodge - Walton Address 82 Kirby Road Walton on Naz Essex CO14 8RJ 01255 850809 Telephone number Fax number Email 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 Ramesh C Chopra Mrs Renuka R Chopra Mr Rajeev Chopra Manager post vacant Care Home (CRH) 21 Category(ies) of Physical disability (PD), 2 registration, with number Old age, not falling within any other category of places (OP), 21 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 21 persons). 2. Two persons, under the age of 65 years, who require care by reason of a physical disability, whose names were made known to the Commission in May 2003. 3. The total number of service users accommodated must not exceed 21 persons. Date of last inspection 27/01/2005 Brief Description of the Service: The Lodge is located in a residential area on the outskirts of Walton-on-theNaze. The property is a two-storey brick building with a tiled roof, with car parking space at the front, and attractive gardens to the rear. The house is on a local bus route, and has easy access to the town. The home provides 24hour personal care and support, and has a through-floor lift and other equipment (e.g. mobile hoist, hand rails, etc.) to assist service users with limited mobility. The Lodge is registered to provide residential care to 21 Older People (i.e. over the age of 65). The home currently accommodates two service users who are under the age of 65, and this information is reflected in the home’s registration certificate. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 31st August 2005, and took place over 6 ½ hours. During this time the inspector spoke with service users, staff and visitors to the home. Samples of records relating to service users assessment of need care planning, medication records and staff files were also seen. Since the last inspection the registered manager had resigned her post, and the proprietor was seeking to appoint to the vacancy. The deputy Manager Monica Smith was fulfilling the role of acting manager in the interim, and the inspection was conducted in her presence. The inspection was scheduled in response to concerns voiced to the Commission regarding the ethos and operation of the home. Therefore the main part of the inspection was used to observe and discuss practice with service users and staff at the home. The inspector was able to conclude that although overall service users were not presented with any immediate risk, there were serious issues of concern in the lack of professional guidance to staff in respect of the ethos of the home or acceptable standards of care provision. There were some issues identified within the home which have been raised by CSCI with ESSD under POVA procedures. In total 22 of the 38 standards were assessed at this visit, only two complied with the standard, 7 had minor shortfalls and 11 major shortfalls. In addition, 8 requirements raised at the previous inspection had not been addressed and are repeated in this report. Following this inspection discussions were held with the proprietor in order to urgently address these serious concerns, and the action taken will continue to be monitored by the Commission. It should be noted that the findings of this inspection reflected quite a marked change in the standards of care previously provided in the home. What the service does well: Service users stated that with some notable exceptions, the staff’s attitude to them was caring and patient. They identified some staff who took particular efforts to assist and support them, including housekeeping staff. Meals were also on the whole praised as being tasty and appealing. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 6 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 Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 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 standard(s) 3 and 4. Service users’ full needs assessments were not being completed. Service users spoken with did not feel the home delivered according to its Statement of Purpose. The home failed to adequately meet the needs of some service users. EVIDENCE: A sample of service users’ files demonstrated that full assessments of need were not undertaken. Some files contained details provided by the placing authority, but were not supplemented by additional information gathered before or at the point of admission. In one particular instance a family member had provided very detailed information to the home to assist with meeting the needs of a service user, but these had been kept in their room rather than adopted within the care planning tools. Service users spoken with did not feel the home delivered the service according to the expectations they were given prior to admission. They stated that they did not feel that the home had made attempts, through discussions The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 9 with them, on how to work with them on how they would like their care delivered. This was particularly evident in the approach the home took in meeting the needs of a service user on respite stay. From records and discussions with staff and family members, it was apparent that the home had not conducted risk assessments regarding moving and handling and as a consequence were ill equipped to provide safe moving and handling practice for this person. In another case the recommendations made by district nurses in respect of a frail service user were not progressed due to lack of awareness and provision in areas which could reduce the risks of falling to this service user. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Care plans were not completed and did not provide sufficient instruction to staff in meeting complex needs. Service users’ health care needs are not fully met. Medication procedures are not complied with. Service users did not feel that all staff treated them with respect. EVIDENCE: Care plans were not completed and, in some cases, not present at all in the group of documents sampled by the inspector. Risk assessments were also not completed. The daily records of a frail service user, who had suffered a stroke and was confined to bed, stated that her needs were being monitored by staff. However, apart from an incomplete chart recording the frequency and side that staff had turned the service user onto, there was not other health monitoring records, including fluid input/output charts, meal consumption, skin integrity, etc. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 11 The deputy manager stated that district nurses had instructed that this service user should be assisted to sit in a chair for meals, to help with both the management of pressure areas and encourage eating. This had been carried out on two consecutive days, but as the service user was left alone during this time and did not recognise their loss of abilities they had fallen from the chair on both days. The deputy had therefore instructed staff that the service user must remain in bed, to prevent her falling. There was no risk assessment carried out in respect of the falls and no consideration had been given to alternative ways of reducing the risk of falls, such as additional staff monitoring during the short time the service user was in the armchair. This indicated that the operation of the home was not designed to support the wellbeing of service users but to tailor their needs to the expectations and availability of staff. The medication records and stock were seen during the inspection. The home operates a monitored dosage system, with some as required medication dispensed from original packaging. However, at the time of inspection the medication of a respite service user had been provided to the home by the family in home made dosset boxes. These contained no reference to the drugs contained including dosage and frequency. Therefore the home had no record of the medication the service user was prescribed. However, they had accepted this medication and dispensed it without guidance or record for over a week at that time. This is in direct contravention of the Care Homes Regulations 2001 and an immediate requirement notice to take action to rectify the practice, and notify the Commission of the action taken, was issued. Evidence was gathered during the inspection that did not support the view that service users were always treated with respect. Service users stated that they had heard other service users spoken to in a harsh manner by named staff members. Staff gave testimony of being instructed that service users who needed the toilet should use their continence pad or be told to wait. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Service users’ statements indicated that the home was not operated in their best interests, but to meet the expectations of staff. Service users maintained contact with family and friends. Service users did not feel that they had control over their lives or were provided with choices. Meals were provided to a good standard. EVIDENCE: There is an overall culture in the home that service users’ needs are met according to staff priorities. Examples have been previously provided in this report. Additionally, service users spoke of being ignored by staff or told to wait without an apparent reason. Service users received family and friends and during the inspection at least three visitors attended the home. Those spoken to were not wholly satisfied with the levels of care provided in the home, and felt that without their intervention not all the needs of their service user would be met by the home. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 13 Service users stated that they had been told by the home that they would be offered choices and control over their personal space, as for example where a prospective service user was told they would be able to make a decision on the carpeting in their room from a selection provided by the home. However, without notice or opportunity to make such a decision. the carpet was replaced. Generally they did not feel that the home supported them in maintaining control in their lives. Comments on the food provision were very positive, and although it was a hot summers day at the time of the inspection visit, service users were insistent that they preferred a hot roast meal as delivered on the day. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Service users do not feel able to utilise the complaints procedures. Service users are not protected from abuse. EVIDENCE: Service users stated that they did not generally complain, as they did not believe that their comments would be professionally received or acted upon. In particular, they did not trust that they would not be treated differently if they did complain. Service users and staff gave some evidence of possible verbal, physical abuse and neglect that some service users were subjected to by named staff members. They did not feel able to utilise the whistle blowing policy as there had always been perceived support for the perpetrators of these acts from management and proprietors. The examples given were mainly in relation to staff’s interaction with dependent service users. Incidents included shouting at them, rough handling, making them wait for assistance and leaving them to soil themselves. In general they reported an air of menace in the operation of the home, where all concerned were frightened to speak out. The decision to make the Commission aware of the concerns in the home appears to have been initiated because of changes in management posts. These are clearly matters of serious The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 15 concern to the CSCI who has referred these matters to ESSD under POVA procedures. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 19, 22 and 26. The home failed to provide specialist equipment to meet a service user’s needs. Nurse call systems were not fully operational. EVIDENCE: The assessed needs of one service user on a temporary stay at the home had not been fully addressed. In particular the impaired mobility of the service user had not been risk assessed to determine the most suitable method of transference. The provision of suitable aids and furnishings had also not been assessed, which resulted in the staff being unable to use a manual hoist to transfer the service user onto their bed, and instead had used illegal lifting techniques to carry out this task. This risked injury to both the service user and staff involved. Although the home’s management were aware of this issue and involved mobility suppliers in providing bed leg blocks to raise the bed, these were not the correct design and posed a more significant risk in their use. In conclusion the inspector found that inadequate steps had been taken The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 17 both prior to the admission of the service user and during their stay to rectify the issue. During a tour of the home the inspector noted that some nurse call buttons had been removed from bedrooms, and in other cases rudimentary repairs carried out to cords using cellotape. The deputy manager reported that the system was due for renewal, however there were no supplementary instructions to staff in how to monitor service users’ needs in the absence of call systems. In one room two beds were accommodated with only one nurse call available to one service user. Some bedrooms had strong odours and required deep cleaning in order to deal with the issue. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30. Staff files did not contain all the documentation required to reflect arrangements to protect service users from abuse. There was insufficient staff training and records relating to staff attendance were misleading. EVIDENCE: A sample of staff files was examined during the inspection and found to have missing documentation required by Care Homes Regulations 2001 (19) and Schedule 2. This included CRB and POVA checks for staff working in the home. The continued failure to carry out these checks does not protect service users from potential abuse. Staff training records did not match either personnel files or certification. When discussed with the deputy manager she was unclear how the training had been provided. In particular there was not regular updates of mandatory training such as medication, moving and handling, etc. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36. The management of the home does not provide leadership in good practice and positive attitudes to older people. The service is not operated to meet the best interests of service users. Staff were not appropriately supervised. EVIDENCE: Throughout the inspection the evidence provided through discussion with service users and staff indicated that the home’s management did not provide positive leadership models either through their deeds or instructions. In particular there was a failure to provide positive attitudes towards the service users in their care. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 20 From both discussions with staff members and staff files it was apparent that staff supervision did not take place, nor was there any guidance to staff in relation to their performance or evaluation of the standards of care provided. The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 1 1 x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x 1 x x x 2 STAFFING Standard No Score 27 x 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 2 1 1 x x 1 x x The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 22 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 OP4,OP7,O P8, OP37 Regulation 15 Requirement The registered person must ensure that care plans contain sufficient detail to instruct staff in how to meet the identified needs of service users, and that these are regularly reviewed and updated. Timescale for action 30/09/05 2. OP18 17,22 The registered person shall make 30/09/05 arrangements for the prevention of service users being harmed or suffering abuse. This relates specifically to the procedural statements contained within the Abuse Policy and provision of staff training. The registered person must ensure that the staffing levels are subjected to regular review against the assessed needs of service users. This standard was not assessed at this visit and will be reviewed at the next inspection. The registered person must ensure that staff are only employed following rigorous recruitment checks including two written references, CRB and POVA checks. 30/10/05 3. OP27 18 4. OP29 18,19, Schedule 2 30/09/05 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 23 5. OP30, OP4 18 The registered person must ensure persons employed in the home receive appropriate training to the work they perform, and that a planned programme of development is arranged. It is required that risk assessments are carried out on working practices and activities and that action is instigated which complies with current health and safety guidance. Specifically this relates to the moving and handling assessments. The registered person must ensure that staff receive regular line management supervision. The registered person must ensure that records required by Regulation are maintained. THE REQUIREMENTS SET OUT ABOVE ARE ALL REPEATED FROM PREVIOUS INSPECTIONS. 30/09/05 6. OP3, OP7,OP38 13(4)(5) 30/09/05 7. OP36 18(2), 21 31/12/05 8. OP37 17,12,13, Schedules 1,2,3,4 30/09/05 9. 10. OP3 14 The registered person must ensure that prospective service users needs are fully assessed prior to admission. The registered person must ensure that service users health needs are monitored and action taken to meet these included in care planning. The registered person must ensure that the recording, administration and management of medication adheres to the guidance provided by the Royal Pharmaceutical Society of Great Britain. 30/09/05 11. OP8 12,13,14, 15 30/09/05 12. OP9 12,13 (2) 30/09/05 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 24 13. OP10,OP18 ,OP32 12(4)(a), (5) The registered person must ensure that service users rights to be treated with dignity and respect are upheld by staff in carrying out their duties. The registered person must ensure that serivce users are provided with opportunities to exercise choice and control in their daily lives, including recreational, sprititual and social needs. The registered person must ensure that service users and staff are consulted about the operation of the home and that they are supported in complaining about the service. The registered person must ensure that nurse call sytems are maintained in working order. The registered person must ensure that specialist equipment is provided to meet service users assessed needs. The registered person must ensure that the environment is maintained free from offensive odours, and that adequate systems and equipement is in place to achieve this. The registered person should ensure that the management arrangements for the home adequately support the needs of the service. The registered person should ensure that the home is conducted in an open and inclusive manner. 30/09/05 14. OP12, OP14 12(2)(3)( 5), 16 30/09/05 15. OP16, OP33 12 (5),16,21, 22,24 30/09/05 16. OP19 23(2) 30/09/05 17. OP22 23,2(n) 30/09/05 18. OP26 16(j)(k) 30/10/05 19. OP31 8,12 30/09/05 20. OP32,OP33 12,(5) 30/09/05 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 25 21. OP32 26 The registered providor must conduct visits under Regulation 26 at least once a month, in accordance with the regulation. 30/09/05 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 home needs to ensure they are on target to meet the requirement for a minimum of 50 of care staff to hold a NVQ level 2 by 2005. The registered manager needs to hold a NVQ level 4 in management by 2005. The registered person must keep under review the provision of assisted baths in relation to service users assessed needs. 2. 3. OP31 OP21 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 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 The Lodge - Walton I56 - I05 S18013 The Lodge - Walton V244150 310805 Stage 4.doc Version 1.40 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!