CARE HOMES FOR OLDER PEOPLE
Abbeydale 182 Duffield Road Derby DE22 1BJ Lead Inspector
Steve Smith Unannounced Inspection 11th November 2005 02:30 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 DS0000002104.V263601.R01.S.doc Version 5.0 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. DS0000002104.V263601.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Abbeydale Address 182 Duffield Road Derby DE22 1BJ 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) 01332 331182 01332 344481 Willover Limited Pamela Margaret Slonimski Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places DS0000002104.V263601.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Abbeydale Nursing Home provides 41 places for Residents over the age of 65 years and is situated in a residential area of Derby city. The property was orginally a private dwelling that has been tastefully and extensively converted into the current nursing home. Residents bedrooms are located over 4 floors. All floors are accessed via a passenger shaft lift or staircase. Four shared bedrooms have ensuite facilities. The Home is close to a local park, churches and public houses. It is also on a regular bus route from Derby city centre that is not far away, which means that all the amenities of the city centre are within easy reach. DS0000002104.V263601.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place in just over 3.5 hours. Discussion was held with the Manager, two Residents, some of the Home’s records were seen, and the public areas of the Home were examined. What the service does well: What has improved since the last inspection?
Since the last inspection the Registered Providers and Manager have improved their Care Planning procedures, and so now all 6 monthly care plans were drawn up with and signed by the Resident or their Representative. Recording
DS0000002104.V263601.R01.S.doc Version 5.0 Page 6 had also improved within each Resident’s care plan. If senior staff asked other staff to monitor a Resident in the log records, the staff now acknowledged this request and noted down their findings. A record of Residents meals was now maintained by catering staff. The administration of medication had also been improved. The Manager now maintains a record of complaints, be they verbal or written complaints. Plastic covered armchairs are now appropriately covered to improve the comfort offered to Residents. Footrests are now always used when transporting Residents in wheelchairs to safeguard Residents. The Manager said that all new staff are now provided with copies of the code of practice set by the General Social Care Council What they could do better:
During this inspection it was found that the Registered Providers had not provided details of the physical environment Standards met by the Home. The Manager had not begun to record the way the Home had had to reduce a Resident’s right to choice, freedom and decision-making due to their progressing dementia. The Manager said that she discussed Residents wishes, following their death, only with their relatives, but she was recommended to discuss this with each Resident, if they were able to do so. As the Activities Coordinator was on long-term sick leave, the Manager needed to make alternative arrangements to meet the Residents need for social activities. The Manager was also required to ensure that staff knocked and waited to be invited into bedrooms occupied by able Residents. The Manager was encouraged to ensure that staff did not provide assistance to Residents in such a way as to leave the impression that they were always in a hurry. She was also encouraged to ensure that staff were able to respond to Residents calls for assistance to ensure that Residents were able to go to the toilet within a reasonable time. It was also suggested that she review the number of staff on duty in case this also contributed to slow responses from staff to requests for assistance from Residents. Residents needed to be included in discussions with GPs to ensure that the GP did not make recommendations, with respect to bedtimes, that did not meet Residents wishes.
DS0000002104.V263601.R01.S.doc Version 5.0 Page 7 The Manager was encouraged to introduce a Key worker system of care of Residents The Registered Providers were required to ensure that at the main meal of the day Residents were offered a choice of meal. The Registered Providers and Manager were encouraged to become aware of and respond to the contents of the Public Interest Disclosure Act of 1998. The Registered Providers also needed to repair the damaged doorways into Residents bedrooms. The bathroom door, by the lift on the first floor, needed repair or replacement. At the entrance area to the Home there was a noticeable odour, which may have permeated throughout the Home, that needed attention. Residents bedrooms needed to be supplied with all the necessary furniture listed within the Standards and Regulations. Bedroom doors also needed to be provided with locks, which Residents could operate from both the inside and outside of their bedroom. Staff also needed to be provided with master keys to Residents bedrooms. Radiator covers were also needed in many places throughout the Home. Staff were often found to work in the Home for as much as 13 hours each day, and the Manager was encouraged to address this to help safeguard Residents. The Manager had not as yet obtained her NVQ level 4 qualification in Management. As a result the target date within which she was now required to obtain this was changed from 31 December 2005 to 31 December 2006. The Registered Providers and Manager needed to provide quality assurance measures for the Home. The Manager was also required to provide risk assessment procedures for all staff on all working practice topics. She also needed to provide a written statement of the policy, organisation and arrangements for maintaining safe working practices in the Home. 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. DS0000002104.V263601.R01.S.doc Version 5.0 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 DS0000002104.V263601.R01.S.doc Version 5.0 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): Standard 1 The statement of purpose and Residents Guide were well completed, but did not provide Residents with all of the information necessary on the provision of services by the Home. EVIDENCE: During this inspection of the Home, the Manager gave to the Inspector copies of the Home’s statement of purpose and Residents Guide. These documents were well completed and provided almost all information required by the Regulations. However, they did not provide information to potential Residents on the physical environmental standards met by the Home. This information needs to be laid out in full in the statement of purpose and summarised in the Residents Guide. DS0000002104.V263601.R01.S.doc Version 5.0 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 the following standard(s): Standard 7 & 10. The care provided to Residents, according to Residents comments, was of a good quality. EVIDENCE: During the inspection of July 2005, it was found that the Manager had not provided opportunities for Residents or their Representatives to discuss, and for the Home to record the Residents rights to choice, freedom or decisionmaking in the Home. This will obviously vary depending on whether the Resident has a dementia condition. This issue had still not been addressed at the time of this inspection. Two Residents were spoken to about life in the Home. They said that staff were very good at listening to their views on how they wished to be cared for and always carried out their wishes. They said that their care needs were always met with dignity and respect. As a result, they said they felt very safe in the Home, and appeared to have a strong sense and appearance of well being. DS0000002104.V263601.R01.S.doc Version 5.0 Page 11 Both Residents were asked what plans had been made with the Home about their wishes following their death. They said that staff in the Home had not raised this issue. The Manager was later spoken to, and she said that relatives were asked about this. However, it was recommended to her that this issue should be raised with Residents early in their stay at the Home. DS0000002104.V263601.R01.S.doc Version 5.0 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 the following standard(s): Standards 12, 13, 14 & 15. Residents’ preferred lifestyles were respected by the Home. They were able to receive visitors and to exercise choice and control over their lives. Residents were given a wholesome and appealing diet, although no realistic choice of the main meal of the day was provided. EVIDENCE: The two Residents spoken to during the inspection said that they felt very safe in the Home. Staff respected their confidences and all their needs were met with dignity, respect and choice. However, one Resident said that although staff were very nice, they always seemed to be in a hurry. This Resident also said that assistance to the toilet often took at least 30 minutes to arrive, which left the Resident embarrassed due to the consequences. This Resident also said that said that she had to wait a considerable period to get up in the morning, as she needed full assistance from staff. Both Residents said bathing times were provided at weekly intervals and that they were happy with this. In general, both said that they could express their needs and that staff generally accepted and followed their wishes. In this respect, both Residents had a strong sense and appearance of well-being. DS0000002104.V263601.R01.S.doc Version 5.0 Page 13 Staff in the Home administered medication, and the Residents spoken to were pleased and satisfied with this arrangement. Neither Resident was aware of whom their key worker might have been. The Manager later said she intended to introduce key workers in the near future. One of the Residents said that ministers of religion visited the Home on approximately monthly intervals Entertainment on the Home was limited, which was commented upon by the Residents spoken to and supported by the Manager. She explained that the Activities Coordinator was currently on extended sick leave. Relatives and friends of the Residents were able to visit at any time, and the Residents said they could always be seen in private. One Resident said that staff always knocked and waited to be invited into her bedroom. The other Resident said that this varied according to the member of staff at the door. In her opinion, some staff knocked and waited to be invited in, while most others knocked, paused and entered. The Residents spoken to said that their mail was always delivered unopened, and said that as far as they were concerned the Home was a non-smoking Home. The Manager later explained that the Home would become totally nonsmoking in the very near future. When describing the meals provided by the Home Residents spoken to said that good meals were always provided. They said that a choice of breakfast was available and again a choice could be made at teatime. However, for the main meal of the day there was no choice. The Manager agreed that the only choice was linked to a Resident’s health needs or active dislike of a meal. The kitchen was examined during this inspection of the Home, and all was found to be in good order. The Manager later said that the kitchen was due to be refurbished during the next 6 months. DS0000002104.V263601.R01.S.doc Version 5.0 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 the following standard(s): Standards 16 and 18. The protection policies and procedures provided by the Home meant that Residents were well protected. EVIDENCE: The Residents spoken to said that if they had any issues of complaint they would take them to the Manager or to one of the senior staff on duty. They both showed that they had confidence in the staff to address any concerns they may have had. The Registered Providers had a good policy to protect Residents from abuse and the Manager was aware of the Derbyshire Adult Protection Procedures sponsored by the Local Authority. However, she did not have a copy of the Public Interest Disclosure Act of 1998. The Manager agreed that she would refer unsuitable staff to the Protection of Vulnerable Adults register, now that it was operational. The Home had polices and procedures for handling Residents money, which included a section preventing staff from benefiting from or assisting in the making of Residents wills. DS0000002104.V263601.R01.S.doc Version 5.0 Page 15 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): Standards 19, 20, 21, 22, 23, 24, 25 & 26. The Home was well maintained throughout, providing all Residents with a safe, comfortable environment in which to live. However, attention was needed in a number of areas to maintain Residents safety and comfort. EVIDENCE: A tour of the public areas of the Home was made. The Home was found to be maintained to a good standard, and was well decorated throughout, although some attention was needed, as listed below. The dining room, lounges, conservatory and public areas of the Home were inspected. The following areas needed attention within the Home: Many of the doorways to Residents bedrooms were badly damaged by wheelchairs and were in need of repair and redecorating. The bathroom door, by the lift on the first floor, was damaged and needed repair or replacement.
DS0000002104.V263601.R01.S.doc Version 5.0 Page 16 The following items were listed in the inspection report dated July 2005, but at the time of this report had not been fully addressed, although the Manager said that work had been started upon them. Residents’ bedrooms needed to be supplied with all of the furniture and items listed in Standard 24.2 of the National Minimum Standards. However, this was found not to be the case during the inspection of July 2005 and a visit of a very limited number of bedrooms during this inspection confirmed that this work had not been completed. Residents’ bedroom doors needed to be fitted with a lock that could be operated by each Resident, but accessed by master keys held by staff of the Home. The Registered Providers were required to address this issue in the inspection report dated December 2004, but this was still outstanding at the time of this inspection. Also outstanding since December 2004 was the need to provide covers on radiators where there may be a danger to Residents welfare, should they fall upon them. Full covers of the radiators were needed in Residents bedrooms and assessments of the risk to Residents for all radiators in public areas, but this had not been completed at the time of this inspection. DS0000002104.V263601.R01.S.doc Version 5.0 Page 17 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): Standard 27 & 30. The Registered Providers were found to be providing more than adequate staffing in the Home to ensure that Residents needs were met. EVIDENCE: Staffing provided in the Home was compared with the details provided by the Residential Forum. This showed that during the four weeks beginning 10 to the 31 October 2005, the Home was providing care staffing above that required by the Residential Forum for 18 Residents at the Medium Dependency level and 17 Residents at the High Dependency level. This was judged to be sufficient staffing for the resident group staying in the Home. These figures were calculated without the Manager’s working time included, as recommended by the Residential Forum. However, in three of the four weeks reviewed, 7 staff were found to have worked double shifts in one day of 13 hours and in the fourth week 5 staff worked double shifts of 13 hour. This does not encourage staff to meet the needs of Residents in a kindly, understanding and patient manner. Staff induction and foundation training was provided for all new staff that came to work in the Home. The Manager also said that all care and nursing staff were provided with at least three paid days training a year. All staff also had an individual training and development assessment and profile. DS0000002104.V263601.R01.S.doc Version 5.0 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): Standard 31, 33 & 38. Satisfactory management systems for the Home were established, thus Service Users benefited from a well run and managed establishment. However, quality assurance systems had not been put in place, to ensure the security of Service Users. EVIDENCE: The Manager said that as yet she had not started her qualification for an NVQ in Management as required by the Regulations. This issue was listed in the last two inspection reports. She also said quality assurance systems in the Home had not yet been addressed, although some work had been done to meet them. This item was raised with the Manager in December 2004, and it is disappointing to find it is still not completed addressed.
DS0000002104.V263601.R01.S.doc Version 5.0 Page 19 The training provided for staff was examined. This showed that Moving and Handling training was provided and was up to date. This was also the case for Fire training and Infection Control training. However, a number of staff were in need of First Aid, and Food Hygiene training. This latter point was included in the inspection report of July 2005. All accidents and injuries were found to be appropriately recorded in the Home. However, the Manager had not provided risk assessments on working conditions of staff; that is care staff, catering staff and domestic staff. This issue was first raised during the inspection of July 2005. The Manager had also not provided a written statement of the policy, organisation and arrangements for maintaining safe working practices in the Home. Again, this was first raised in the inspection of July 2005. DS0000002104.V263601.R01.S.doc Version 5.0 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 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 2 2 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 2 DS0000002104.V263601.R01.S.doc Version 5.0 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. Standard Regulation Requirement The Registered Providers must extend the statement of purpose by addressing the issues concerning the physical environment standards in the Home. This must also be summarised in the Residents Guide to the Home. The Manager must ensure that each Resident, or their representative, has had the opportunity to discuss their rights to choice, freedom and decision-making while staying in the Home. The outcome must be recorded in each Resident’s records. (This issue should have been addressed from the inspection report dated 6 July 2005) The Registered Provider and Manager must provide local, social and community activities in the Home. The Manager must ensure that staff are aware of the need to knock and await a response from Residents before entering their bedrooms. The Manager and
DS0000002104.V263601.R01.S.doc Timescale for action 1 OP1 4 06/01/06 2 OP7 17 Sch 3 31/05/06 3 OP12 16 31/01/06 4 OP12 12 06/01/06 Version 5.0 Page 22 5 OP15 16 6 7 OP19 OP19 23 23 8 OP24 23 9 OP24 12 10 OP25 13 care team need to decide which Residents this must apply to, given Residents differing abilities. The Registered Providers and Manager must provide a choice of at least two meals at the main lunchtime meal. The damage to the doorways to Residents bedrooms must be repaired and redecorated. The bathroom door, by the lift on the first floor, must be repaired or replaced Residents bedrooms must be provided with all of the fixtures and fittings outlined within Standard 24.2 of the National Minimum Standards. Where a Resident does not require any of these, or a risk has been assessed, this must be recorded in the individual plan. (This issue should have been addressed from the inspection report dated 2 December 2004) All bedroom doors must be fitted with a lock that can be operated from both the inside and outside of the room by the Resident. Each Resident must be provided with a key to their bedroom. Risk assessments must be carried out and recorded in the Resident’s file where it is considered by the Registered Providers that the Resident is not able to hold the key to their bedroom. (This issue should have been addressed from the inspection report dated 2 December 2004) Radiators throughout the Home must be risk assessed and any necessary protective measures introduced to prevent Service Users from being scalded or
DS0000002104.V263601.R01.S.doc 06/01/06 28/02/06 06/01/06 06/01/06 06/01/06 06/01/06 Version 5.0 Page 23 11 OP31 9 12 OP33 24 13 OP38 13 & 18 14 OP38 18 15 OP38 18 burned. (This issue should have been addressed from the inspection report dated 2 December 2004) The Manager must obtain a qualification at NVQ level 4 in Management by 31 December 2006. (This issue should have been addressed from the inspection report dated 2 December 2004) A quality assurance system as set out in Standard 33.1 to 33.7 of the National Minimum Standards must be developed. (This issue should have been addressed from the inspection report dated 2 December 2004) First Aid trianing must be provided once every three years for each member of care staff working in the Home. Food Hygiene trianing must be provided for each member of care staff and catering staff working in the Home. (This issue should have been addressed from the inspection report dated 6 July 2005) The Manager must provide risk assessments, for all staff, on all working practice topics in order to ensure that significant findings are recorded and acted upon. (This issue is outstanding from the inspection report of 6 July 2005) 31/12/06 31/03/06 31/03/06 31/03/06 31/03/06 DS0000002104.V263601.R01.S.doc Version 5.0 Page 24 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 Refer to Standard OP11 OP12 Good Practice Recommendations The Manager should arrange to discuss with each Resident (or their Representative if necessary) their wishes following their death while staying at the Home. The Manager should review and discuss with staff their style of assisting Residents to ensure that they are not always doing tasks ‘in a hurry’. The Manager should review with staff the length of time it takes them to attend to a Resident’s request for assistance. This is to reduce the occasions when Residents need assistance to visit the toilet, but are not attended by staff for an extended period. The Manager should also review staffing levels to ensure that there are sufficient staff on duty to attend to Residents needs in a timely fashion. The Manager should review staffing provision in the mornings to ensure that sufficient staff are on duty to get Residents up within a short time of Residents preferred chosen time. The Manager should introduce the key worker system of care in the Home in the near future. The Registered Providers and Manager should become aware of and respond to the contents of the Public Interest Disclosure Act of 1998. All care staff and domestic staff should be provided with master keys to Residents bedrooms. The Manager should review the length of time care staff are allowed to work in the Home, and where possible limit this to no more than one shift per day and 40 hours each week. The Manager should provide a written statement of the policy, organisation and arrangements for maintaining safe working practices in the Home. 3 OP12 4 5 6 7 8 OP12 OP12 OP18 OP24 OP27 9 OP38 DS0000002104.V263601.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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