CARE HOMES FOR OLDER PEOPLE
The Old Vicarage Residential Home Vicarage Road Tean Stoke On Trent Staffordshire ST10 4LE Lead Inspector
David Cowser Unannounced Inspection 27th February 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Old Vicarage Residential Home Address Vicarage Road Tean Stoke On Trent Staffordshire ST10 4LE 01538 723441 01538 723810 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) Mrs Patricia Ann Cope Mr Richard Cope Miss Lisa Marie Shaw Care Home 15 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (15), of places Physical disability over 65 years of age (4) The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th September 2005 Brief Description of the Service: The Old Vicarage is a residential home for older people, which is located in the small village of Upper Tean in Staffordshire. The property was built around 1859 as the local vicarage, and has been updated by the current providers to meet the national minimum standards. The property is two storeys, serviced by a shaft lift, and provides 15 single occupancy rooms, with 12 of these having an en-suite facility. Aids and adaptations are in place throughout the home to assist service users with restricted mobility, and there is an assisted bath on each floor, and ramp access to all external entrances. Bathrooms and toilets are close to bedroom and communal areas. There is a large lounge with small conservatory off, and a pleasant dining room, again leading to a small conservatory. All areas of the home are tastefully decorated and a homely atmosphere exists. Adequate laundry and kitchen facilities are provided. Adequate car parking is available at the front of the property, which is set in private grounds. A registered care manager and teams of care assistants provide care. NHS healthcare facilities and professionals are accessed when required. Local GPs, community nurses and a pharmacist service the home. The community is welcomed into the home, and family and friends can visit at any reasonable time. Transport is arranged for residents when required. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection was made on the 27 February 2006 at 11:00hrs. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The total time spent for the inspection, including pre and fieldwork, amounted to 5.5hrs. The registered care manager was in charge of the home; accompanied by two care assistants. A housekeeper was also on duty, and she undertook care duties while lunch was prepared and served. The homeowners were also present throughout the inspection. These staffing levels were adequate to meet the needs of current the 14 residents in the home. There were a total of 14 elderly service users in the home receiving personal care, two of which had a dementia related condition and others had needs associated with old age. The age range of service users was 78 to 98 years. The inspection included the following elements; a tour of the building, observation and inspection of records relating to provision of care, discussions with six residents, discussions with all the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, quality assurance and health & safety. Since the last inspection on 10 September 2005; there had been no changes to the management of the home, no complaints had been received, and no additional visits had been necessitated. What the service does well:
Residents and/or their representatives had been able to choose the home, following an assessment and an invitation to visit, prior to admission. Speaking to three residents and two visitors, and inspecting the admission documentation, confirmed this. The above aspects had ensured that each resident had been suitably placed, and that the home had the ability to meet their assessed needs. It was evident, from discussions with residents and staff, and an inspection of the relevant documentation, that the provision of health and social care had been addressed well. Two visiting community nurses spoke of the good links with the home and the high standards of care provided. Service user plans seen had been well completed and regularly reviewed. The plans were based
The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 6 on the community care plans completed by social workers, and agreed by residents/representatives. There was a good safe system in place for the receipt, storage, administration and disposal of medicines. No errors were noted concerning medicines, and residents asked said that they had their right medicines on time. Privacy, dignity and choice aspects for residents were seen being upheld during the caring process. When asked several residents and relatives said that they were very happy with the health and personal care being delivered by the home. During the past 12 months the number of accidents and reportable events in the home was low and this also reflected the good standards of care being delivered. Activities and entertainment had taken place, and were seen documented. Residents told the inspector that they had appreciated and enjoyed the recent events and activities, and that they were able to choose whether or not to take part. Two visitors confirmed that links had been maintained with them and links had also been maintained with the local community. Catering aspects were good and records seen showed that individual dietary requirements had been met. Residents spoke of choices and said that they were pleased with the food provided. The inspector observed the main meal of the day, which met all requirements and was well presented. Assistance was seen being given to people with dementia care needs to help them to make a choice, by staff who had knowledge of the residents likes and dislikes. All of the above had assisted the residents in their daily living and social activities. No incidents or reports of abuse of any kind had been received since the last inspection and policies and procedures seen covered these issues. No complaints have been recorded since the last inspection. Residents and relatives understood the complaints procedure. These aspects had contributed to the protection of service users. The home was fit for purpose, and provided a safe environment for the residents, staff and visitors. A very homely atmosphere had been created and the premised were clean, warm and tidy. Adequate areas for residents were provided including; communal space, dining/activity space, bathing/toilet facilities, and bedrooms. Services and facilities including catering and laundry were adequately provided. All residents asked stated that they were happy with the facilities and that they were comfortable with their surroundings. The registered care manager and teams of care staff provided care. Staffing levels and skill mix had been adequate to meet the assessed needs of the existing residents. Recruitment of staff aspects was good. Staff training had been given a high priority, with induction training being followed by NVQ training. Just over half of the care assistants employed were qualified to NVQ level 2 or above (54 ). In house training in relevant subjects was seen documented. These aspects had contributed to the high standards of care being provided by the home. The registered care manager is experienced and demonstrated the necessary skills and knowledge base to manage the home. The management of health
The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 7 and safety issues had been given a high priority and no shortfalls were noted. The documentation seen evidenced that the premises were adequately maintained. Records had been correctly filed and stored. Assurances were given regarding the positive financial viability of the home, and that suitable accounting/business procedures were adopted. The current public liability insurance certificate was seen. There was a safe system of accounting for residents day to day monies and the ledger (previously checked) had reconciled with the money held. All the above had contributed to the protection and well being of residents in the home. Throughout the inspection the people who use, or have contact with, the home expressed only positive views. Thank you cards and complimentary letters were seen from appreciative relatives. 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 Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Residents had been correctly placed in a home of their choice, which had the ability to meet their needs, following an assessment of their needs. EVIDENCE: The documentation seen, and a discussion with both residents and their representatives, evidenced that residents had been assessed prior to admission and they had been able to make a choice about the home. All had been given the opportunity to visit the home prior to choosing to stay. One resident spoken to had visited the home, and had a meal prior to deciding to stay, and this was seen documented within the care plan. A full assessment of each residents needs had taken place before admission and this was seen documented. The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within the service user plans. Residents asked confirmed that they had been fully involved and were in agreement with the assessments.
The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 10 All of the above had contributed to suitable placements and the residents needs being met. Intermediate care is not undertaken in this home. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Individual health, personal and social care needs, as identified and documented within care plans, had been adequately addressed with privacy and dignity afforded during the caring process. EVIDENCE: The service user plans and associated documentation seen were complete, reflected the current condition of residents, and had been regularly reviewed. Care aspects had been recorded and were seen cross referenced to associated documentation such as accident book and incident sheets. Entries seen were meaningful, and it was agreed that weekly summaries would be entered on daily evaluation sheets. Discussions with both residents and staff members evidenced that health and personal care needs were being well met. Several service users commented positively about the care being provided. A total of three care plans were examined in greater depth, with a check on all aspects of care starting at the pre admission/assessment stage. One daily evaluation sheet required follow-on observations, as agreed. The actual date of care plan evaluations should be entered, instead of the month, as agreed. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 12 NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, and these events were seen recorded. Local GP practices and a pharmacy service the home, and there is a good working relationship with them. Records of their visits and outcomes were seen documented. Two visiting community nurses spoke very highly of the home and the care delivered. Currently one resident had a pressure area (hospital acquired), which was being correctly dealt with by the district nurse. Community Psychiatric Nurses were accessed to meet the mental health needs of service users. The above were seen well documented. The medicines within the home, medication administration records, controlled drugs book and drugs returned book, were all checked and no errors were noted. It was observed that a safe system was in place, and that the comprehensive medicines policy documentation seen was being complied with. The documentation seen evidenced that only senior staff administered medicines, and that they had completed certificated training. No resident was ‘self medicating’, but locked facilities were available. During the inspection it was observed that privacy and dignity were being afforded to residents, and there was very good interaction with staff. Care staff were seen knocking on doors before entering. Two residents told the inspector that they were treated with respect, and that the staff were very kind. All of the above evidence satisfied the inspector that the individual health, personal and social care needs of residents had been addressed in the correct manner. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Social contact had been maintained and the daily activities, along with autonomy and choice, had contributed to the resident’s lifestyle experiences meeting their expectations. Catering/nutritional aspects were addressed and met individual needs and preferences. EVIDENCE: Several residents told the inspector that their views had been listened to, and that they had been able to influence some aspects of the running of the home e.g. mealtimes, menus. These comments had been documented along with the feed back from the resident/relatives questionnaires, and they had been acted upon. Contacts had been maintained, where possible, with relatives and friends and this was seen documented. Residents spoke of their visitors and their involvement with the home. One visitor attending the home during this inspection, told the inspector of the good links and communication with her. A member of staff coordinates and records the activities and entertainment provided. Several residents commented that this work had been appreciated. The record of activities book was seen completed.
The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 14 Several residents spoke of their satisfaction with the meals and choices offered. The menus and catering records were examined and evidenced that the dietary requirements of residents were met, including residents’ needs with diabetes, and special diets. The menus had been changed with input from the residents and staff knowledgeable of their likes and dislikes. The homeowner when asked said that fresh good quality food from local suppliers was delivered on a weekly basis, the records seen confirmed this. Adequate supplies of fresh vegetables and fruit were also seen. The care staff spoke with each resident on a daily basis to establish his or her choice of food for the day, and this was seen documented. The inspector observed the mid day meal and it was well cooked and presented, meeting all requirements. Two residents said that an alternative to these would be provided if requested. The inspector saw residents being assisted by staff who were knowledgeable of their likes and dislikes. Residents were also seen being discretely assisted to eat in an unhurried manner. All of the above aspects had ensured that the daily living and social aspects of care had met the residents expectations and needs. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 An open culture existed where complaints or grumbles are listened to and acted upon. Residents are protected from all forms of abuse. EVIDENCE: An examination of the complaints records, the relevant policy and procedure documentation, and a discussion with staff and residents, evidenced that complaints and grumbles were listened to and dealt with. No complaints had been received since the last inspection. No additional visits to the home were necessitated. Many ‘thank you’ and complimentary cards were seen from appreciative relatives. No incidents or allegations of abuse of any kind had been recorded or brought to the attention of the CSCI. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen also evidenced that all the above issues had been discussed at length during staff induction, training and on-going supervision. All of the above had contributed to the protection of service users. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 the following standard(s): 19,26 The home was clean, pleasant and hygienic, and provided a suitable and safe environment for the provision of care. EVIDENCE: A tour of the buildings, and a check on the maintenance documentation, evidenced that the premises were fit for purpose, clean warm and tidy, and were being maintained. The kitchen and laundry facilities were compliant. The duty rosters evidenced that adequate ancillary staff were employed. Staff when asked had knowledge on infection control, and referred to the relevant documentation. Adequate hand washing facilities, including hand gel, were available throughout the home. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 17 The records evidence that maintenance of the premises was being given a priority. The redecoration of the home is continuing , as programmed. The grounds and gardens were seen to be adequately maintained and were appreciated by residents spoken to. Hot water temperature checks, and emergency lighting/fire alarm tests were seen up to date and correct. Risk assessments were seen in place. There are no outstanding issues known from the Fire Prevention or Environmental Health departments. All the above had contributed to the comfort, safety and well being of service users. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 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 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): 27,28,29,30 Adequate numbers of suitably trained and experienced staff are correctly employed to meet the assessed needs of residents. EVIDENCE: The registered care manager was in charge of the home; accompanied by two care assistants. A housekeeper was also on duty, and she undertook care duties while lunch was prepared and served. The homeowners were also present throughout the inspection. These staffing levels were adequate to meet the needs of current the 14 residents in the home. The duty rosters seen, and a discussion with the manager and the staff, evidenced that adequate numbers of care staff had been on duty to meet the needs of the existing service users. Staffing levels were being maintained as at 1st April 2002 and following a discussion with the manager it was agreed that the shift cover was adequate for the existing residents needs. Staffing rosters were checked and were in order. An examination of the rosters evidenced that, in addition to the homeowners, the following care staff had been maintained or exceeded for the 14 residents: The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 19 Morning – one senior care assistant one care assistant Afternoon – one senior care assistant one care assistant Night time – two care assistants (awake on duty) Several residents asked stated that care staff were available when they wanted them, and that the staff were capable. The records seen evidenced that 15 care assistants were employed, of which eight (54 ) were trained to NVQ level 2 or above. The home is working towards further increasing this number. The homes recruitment policy, procedures and documentation were examined and recruitment issues had been handled correctly. Staff had been subject to POVA/CRB comprehensive checks, and these were seen recorded. Staff asked stated that they had job descriptions and contracts of employment. Training had been given a high priority and the training records of individuals were seen. The records evidenced that care assistants had benefited from ‘in house’ and external training, which had covered the needs of the registered client group. Staff told the inspector that they had been afforded the time off and encouraged to study. The records seen and a discussion with the staff evidenced that, individually and collectively, they had the necessary experience and skills to meet the assessed needs of the current service users. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 20 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): 31,33,35,38 An experienced care manager is managing the home in the best interests of service users, and in an open an inclusive atmosphere. The home is on a sound financial footing and managed well, with safeguards for the health and wellbeing of residents’ staff and visitors. EVIDENCE: The registered care manager is well experienced and is currently studying for the Registered Managers award. An open, positive and inclusive atmosphere was observed during the visit and confirmed to the inspector by service users, staff and relatives. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 21 From observations made, discussions with service users and staff, it was evident that the home was being run in the interests of service users. Quality assurance, including feedback from residents and their representatives, was being developed. Documentation seen evidenced that the views of visiting professionals had also been established, and included in the review process. Staff supervision sessions, six times per year, had all been completed and documented. A check on the records and a discussion with both residents and representatives evidenced that all service users had the opportunity to handle their own finances and residents and families had chosen to do so. Day to day monies of residents and the associated records were not checked, but previously had been found correct. Inventories of valuables and belongings brought into the home were seen recorded. No health and safety issues were noted during this inspection, including a tour of the home. Not all documentation for the servicing of plant and equipment was examined during this inspection. The documentation seen for checks and examination of plant and equipment was correct and up to date. All of these documents will be checked in full during the next inspection. The homeowner gave assurances that the home was financially viable and that suitable accountancy and budgeting procedures were adopted. The current public liability insurance certificate was seen up to date and correct. All of the above had contributed to the protection of service users. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 22 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 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 4 3 3 3 The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP7 OP7 OP31 Good Practice Recommendations Follow-on observations made should be recorded within the care plan daily evaluation sheets, as agreed. The actual date of care plan evaluations should be entered, instead of the month, as agreed. The care manager should complete her studies, currently being undertaken, for the Registered Managers Award. The Old Vicarage Residential Home DS0000005022.V282941.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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