Inspection on 21/02/08 for Astley Grange Nursing Home

This inspection was carried out on 21st February 2008.

CSCI found this care home to be providing an Excellent service.

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

Other inspections for this house

Astley Grange Nursing Home 08/02/07

Astley Grange Nursing Home 12/10/05

Astley Grange Nursing Home 18/04/05

Astley Grange Nursing Home 08/09/04

Astley Grange Nursing Home 21/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Astley Grange Nursing Home 288 Blackburn Road Bolton Lancashire BL1 8DU Lead Inspector Grace Tarney Unannounced Inspection 21st February 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Astley Grange Nursing Home Address 288 Blackburn Road Bolton Lancashire BL1 8DU 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) 01204 365435 01204 392687 astley.grange@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Mrs Barbara Jean Oakes Care Home 30 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (30), of places Physical disability (3), Terminally ill (3) Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 30 service users, to include: up to 30 service users in the category of Older People (OP), up to 7 service users in the category of Dementia over 65 years (DE(E)), up to 3 service users in the category of Terminal Illness under 65 years (TI) and up to 3 service users in the category of Physical Disabilities under 65 years of age (PD) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 8th February 2007 2. Date of last inspection Brief Description of the Service: Astley Grange is a two-storey property, situated on a main road on the outskirts of Bolton Town Centre. It is within easy reach of bus routes, shops, and other community facilities and is not too far from the motorway network. The home has 24 single bedrooms and 4 doubles. There is a lounge on each floor, a dining room on the ground floor, and bathrooms and toilets on both floors. The home is fitted with adaptations and equipment suited to the needs of the resident group. Equipment includes a passenger lift and ramped access. Outside, there is a small parking area at the front of the home, and an enclosed garden at the side. It is registered to care for people with mainly nursing needs and because of this 24 hour qualified nurse cover is provided. The Manager informed the inspector that the fees within the home ranged from £355.39 to £542 per week for those residents funded by local authorities or the primary care trust and £470.00 for private residents who pay for their own care Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 27/02/2008. A copy of the most recent inspection report is displayed in the entrance hall. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The home was not told that this inspection was to take place although many weeks before the inspection, questionnaires (comment cards) were sent out to the residents, their relatives and the staff. The questionnaires asked what people thought about the care and quality of the service provided. 9 were received from residents, 8 from relatives and 8 from staff. What they felt about the care and services provided is written in different sections throughout this report. Also before the inspection we (The Commission) asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we do. We spent 7 hours at the home and during this time we examined care records and medicine records to make sure that the health and care needs of the residents were being met. We also looked around the building at most of the bedrooms, bathrooms, toilets and sitting areas to check if they were clean, warm and well decorated. We also looked at the menus and looked at what the residents had for their breakfast, lunch and evening meal. We also checked how many staff were provided on each shift to make sure the residents needs were being met, and also looked at how management recruit and train their staff. How the home manages the residents’ spending money was also looked at. In order to get further information about the home we also spent time speaking to 3 residents, 3 visitors, the qualified nurse on duty, the administrator, the activities organiser and a nurse who was visiting the home. What the service does well: The Manager makes sure that the staff only care for those people whose needs they can meet. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 6 Residents feel that they are well looked after by the staff and residents and relatives made the following comments: • I am very pleased with everything they do. Its very helpful. • They have been very kind to me. • I am fully satisfied with the care. • Not only do they have the right skills but also the right attitude. The qualified nurses and care staff were extremely good at caring for the residents who were very ill and needed lots of specialised care. The staff made sure that all the necessary equipment needed for their care was available. Activities were considered to be a very important part of the residents’ day. The Company is making sure that the staff are properly trained and is providing the care team with the knowledge and skills they need to protect and meet the needs of the residents. Management make sure that they check care staff out properly and safely before offering them a job. Management are good at checking out the quality of care and the services provided for the residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff can meet their needs. EVIDENCE: Before any resident was admitted to the home a senior member of staff from the home undertook an assessment of their needs. The assessment looks at what help and support the prospective resident needs in all aspects of daily life. The 2 assessments looked at were detailed and gave a clear indication of the residents’ needs and what they could and could not do for themselves. Standard 6 does not apply. The home does not provide Intermediate Care. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 &10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care plans show what care needs the residents have and care practices ensure that their needs are met in a safe, caring and dignified way. EVIDENCE: Individual care plans were in place for each resident. The care plans of 2 of the residents were looked at. Both these residents had extensive nursing needs and the care plans contained detailed information about the care needed and the involvement of other health care professionals. The staff looked at whether or not there was any risk in relation to the residents developing pressure sores and also if they were at risk due to problems with their diet and fluid intake. They also looked at and they wrote down how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 10 The care plans were reviewed regularly so that any change in their condition could be identified and appropriate action taken. Management also confirmed this in the AQAA form that was sent to us. The care plans detailed the religious and cultural needs of the residents. At the time of the inspection there were no residents of any ethnic minority. Whilst at the home we were made aware that a GP was visiting one of his patients. We also spoke to a visiting nurse from the Primary Care Trust (PCT) who was there to assess some of the residents that were funded by them. The nurse felt that the care provided was very good. The following were some of the comments made by relatives and residents: • Knowing that they are efficient and caring puts my mind at rest when I am not there. • The staff are exceptionally nice and are very good at their jobs • They treat residents as individuals and try to meet their needs. • I think I get special treatment. They look after me so well. A safe system of medicine management was in place. The home does not have a separate medicine room. Medicines are kept in the nurses’ office in locked cupboards and in the medicine trolley. The medication keys were held securely and the trolley was secured to the wall when not in use. Controlled drugs were stored and recorded, correctly and safely. One resident commented: • The staff are very attentive and I get my medication on time. The following area needed putting right: • A handwritten instruction for medicines was not checked and countersigned. Signing and checking transcriptions protects the resident by reducing the risk of drug errors. Staff were discreet when providing assistance to the residents. Staff were seen knocking on bedroom doors before entering and speaking to residents in a quiet and respectful way. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. The residents looked clean and comfortable and were suitably dressed. One comment made was: • If people have accidents with toileting they are seen to promptly and cleaned with care. • The care of the residents is important to them. They are treated with respect and tenderness. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a choice in how they spend their day and find enjoyment with the activities available and the meals provided. EVIDENCE: The residents’ routines of daily living and their social interests were recorded in their care plans. One of the residents told us that she gets up and goes to bed when she wants to. Also she prefers to stay in her room for her meals and likes to watch her own television. The home employs an experienced activities organiser who works 20 hours each week and organises a programme of activities for the residents. A wide range of activities is offered at the home including table and floor games, knitting, crocheting and various arts and crafts. The activities were displayed on a notice board on the corridor. The activities organiser told us that she had changed her hours of working just for that week so that one of the residents could benefit from her 1-1attention at a certain time of the day. The majority of residents had a Church of England or Roman Catholic religious faith and staff told the Inspector that the clergy visit the home on a regular basis. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 12 Residents told us that visitors are always made welcome. One relative commented: • Being a small home I feel quite close to the staff and have regular chats with the carers whenever I visit. We spoke to a visitor who was not a relative but was acting as an additional support (advocate) for one of the residents. She told us: • I have nothing but praise for the staff. He is so well cared for. Staff told the inspectors that the residents are encouraged to bring personal possessions into the home. We saw that many of their bedrooms were personalised with pictures, photographs and ornaments. A 4 weekly menu was displayed in the hall. The menus looked varied and nutritious. We did not eat with the residents but saw what they were having for lunch. The residents have a choice of food at breakfast, lunch and teatime. The dining room was a very pleasant area and the tables were nicely set. Hot and cold drinks were served during the meal and throughout the day. The one thing of concern was that the residents were not given a plate for their biscuits when having a mid morning/afternoon drink. In view of the fact that, in the main they were drinking from mugs and therefore did not have saucers, this is not an acceptable practice. We did discuss this with the manager the following day who agreed to address it. Residents made the following comments: • I like the food its always good. • Very good food. • Meals are always the same every week. I would like a change. • The quantity and quality of food is excellent. • I dont like the chips. They are not the same as the chip shop. I used to make my own. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents. EVIDENCE: A detailed complaints procedure was in place and was displayed in the reception area. The complaints procedure was also included in the Service User Guide. It is easy to understand and gives an assurance that complaints will be responded to within 28 days. A record is kept of any complaint made and includes details of the investigation and any action taken. No complaints have been made to the CSCI since the last inspection. Residents made the following comments: • Yes I know how to complain but I dont find anyone that bad. • I would go to the top. A discussion with staff showed that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by staff and is ongoing. Records of training were kept on file. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 24 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in suitably adapted, safe and comfortable surroundings. EVIDENCE: The front porch and reception area are very welcoming with adequate seating for the residents and visitors. The reception area is where the administrators’ and the managers’ offices are situated. The corridors are wide with grab rails along the side to assist the residents with mobility problems. There is a lounge on each floor, a dining room on the ground floor, and bathrooms and toilets on both floors. Doors from the dining room lead on to an enclosed garden area. Both lounges and the dining room were clean, warm and suitably furnished. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were close to bedrooms and living areas. Each toilet and bathroom had Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 15 a lock on the door to ensure privacy and the facilities were clearly marked as such. One of the toilets on the top corridor however had no disabled assistance and was without a nurse call system. This was identified on the last inspection. We were told that this was a staff toilet. We had a discussion with the manager the following day who agreed to identify it as a staff toilet and keep it locked so that it is not used by residents. The bedrooms throughout the home were centrally heated with radiators that were suitably protected. They had a safety overriding door lock and a lockable space to store anything that is of value to the resident. They were clean and warm. Several had been redecorated, carpeted and newly furnished. Residents and relatives made the following comments: • Always clean. • The home is immaculate. • The home could be improved by extending the lounge. It can get crowded at times. The Inspector was told that thermostatic control valves were in place on immersion baths and showers. Radiators were suitably guarded to prevent any risk of accidents. The home was clean and free from odours. Hand washing facilities were in place in bedrooms, bathrooms and toilets. Clinical waste was handled safely. The laundry area was clean, well equipped and looked well organised. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by very experienced staff that are suitably trained and safely recruited. EVIDENCE: Comments from staff, residents and relatives indicated that there was just the minimum amount of staff on duty during some of the busy times during the day. The following were some of the comments made: They could possibly do with more staff on duty sometimes. At times they seem to be overstretched. • Improvements that would be a benefit would of course be more staff. • The staff levels dont always seem enough, especially when getting residents up and at mealtimes. • More staff are needed at times, due to the higher dependency of some of the residents. • I think there should be more staff on (carers) duty in the mornings as they are very busy getting residents up. During the inspection we saw that the residents needs were being met although the staff were continually busy. Management should keep the staffing levels constantly under review to ensure that the home is staffed according to the dependency and needs of the residents. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 17 • It was documented in the AQAA that management wanted to recruit more staff to cover for holidays and sickness. The information received from the AQAA document showed that over 50 of the staff had obtained their NVQ level 2 in care, and a further 4 staff had the NVQ level 3 qualification. This is good progress. The personnel files of 2 staff members were inspected. All were in order and these staff had been properly and safely employed. This helps protect residents from being cared for by unsuitable people. Induction training is provided for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. Also a wide range of appropriate and ongoing training in moving and handling, detection of abuse, basic food hygiene, fire safety and other relevant topics are provided to staff at the home. We saw that the training provided to individual staff is recorded in detail in their training file. Some of the comments made by staff were: • We have regular training keeping up to date with everything. • • • I found the induction period very useful and helpful. It helped me to get used to the residents and staff and the way the home was run. We have regular training sessions that cover all we need to know to do our jobs properly. I appreciate the training. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and practices ensure the safety and wellbeing of the people within the home. EVIDENCE: The manager is a Registered General Nurse (RGN) and has a lot of experience working within the private sector. She has worked at the home since 1997. She has a recognised teaching and assessor qualification and has also obtained the NVQ level 4 in management award. She keeps herself updated by attending various courses. On the day of the inspection she was not present in the home as she was on a training course. Some of the comments about the management of the home were: • We have quarterly meeting for relatives and on Wednesday you can ask the manager for one-to-one meeting. You are encouraged to ask questions or any queries are dealt with when need be. You are never DS0000005671.V359820.R01.S.doc Version 5.2 Page 19 Astley Grange Nursing Home made to feel troublesome when you ask questions or you may have a problem. They are always happy to help. • • She has the clients interest at heart. She has such a passion. We have regular appraisals and supervision sessions with the manager. These are useful as we can discuss any problems we have and the manager can let us know if she feels we need any extra training or improve the way we work. The company has its own Quality Assurance system in place and has achieved The Investors in People Award. The Manager has to do a monthly check of lots of things in the home. She has to check to make sure that there are no hazards around the building and also check the records about care, medicines and any accidents that have happened. Comment cards are also sent out to residents and their relatives every 6 months asking what they think about the care and services provided. The system for the safekeeping of residents’ money was good. Individual computer records are made of all transactions and balances. Receipts are held for any purchases made and receipts are given to relatives when they deposit any “spending money” for their relative. Regular weekly checking and testing of fire detection system, fire exits and emergency lights was undertaken and documented. The equipment and services within the home were serviced on a regular basis in accordance with the individual requirements. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x x 3 3 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 3 x x 3 Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 21 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 Refer to Standard OP9 OP27 Good Practice Recommendations To ensure the accuracy of a transcription, handwritten transcriptions should be checked with another member of staff, signed and countersigned. The staffing levels should be kept continually under review to ensure that the home is staffed according to the dependency and needs of the residents. Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Astley Grange Nursing Home DS0000005671.V359820.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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