Inspection on 24/11/05 for Aughton Grange Care Home

This inspection was carried out on 24th November 2005.

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

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

Other inspections for this house

Aughton Grange Care Home 21/11/06

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

CARE HOMES FOR OLDER PEOPLE Aughton Grange Care Home 26 Granville Park Aughton Ormskirk Lancashire L39 5DU Lead Inspector Vivienne Morris Announced Inspection 24th November 2005 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 Aughton Grange Care Home DS0000062646.V265345.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. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aughton Grange Care Home Address 26 Granville Park Aughton Ormskirk Lancashire L39 5DU 01695 423564 01695 423564 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) Aughton Grange (EMI) Care Home Limited Care Home 27 Category(ies) of Dementia (27), Mental disorder, excluding registration, with number learning disability or dementia (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (13) Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 27 service users to include: Up to 27 service users in the category of DE - (Dementia). Up to 13 service users in the category MD(E) - (Mental Disorder excluding learning disability or dementia) aged over the age of 65 years. One named female service user in the category MD - (Mental disorder, excluding learning disability or dementia) aged 61-65 years may be accommodated at the home within the overall total of registered places. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 19th May 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Aughton Grange is situated in the picturesque village of Aughton and is close to local amenities. The home provides 24 hour nursing and personal care for up to 27 elderly people who have mental health needs or a dementia related illness. Accommodation is provided mainly in single rooms; although two shared rooms are available for married couples, friends or people who prefer to share facilities. Some single rooms have en-suite facilities. Toilets and bathing facilities are located at intervals throughout the home. A separate spacious lounge and dining room are available. However, service users are able to dine within the privacy of their own accommodation, if they prefer. A large conservatory is constructed at the rear of the premises overlooking the pleasant garden and patio area. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection that took place over one day in November 2005. Two regulatory inspectors from the Commission for Social Care Inspection conducted the inspection. Due to the category of people living at Aughton Grange it was not possible to obtain a clear picture as to what life was like living at the home from the residents perspective. Therefore, alternative sources of evidence had to be gathered, including discussion with visitors to the home, the people who worked at the home, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on a small group of people living at the home. All records relating to these people were inspected along with the rooms they occupied in the home. However this was not to the exclusion of other people living at the home. Since the last inspection there had been one complaint received by the Commission for Social Care Inspection, in relation to cleanliness of the environment, personal hygiene and general care issues. A further complaint was investigated at the time of the inspection, which was in relation to general care issues. What the service does well: Policies and procedures were in place at the home to ensure the safe handling of medications. Those living at the home were treated with respect and their rights to privacy and dignity were upheld. Service users were able to exercise choice and control over their lives, as far as practicable. Representatives were involved in cases where service users were unable to make informed choices. Those living at the home received a wholesome, appealing balanced diet in a pleasant, relaxed environment. Policies and procedures were in place to adequately protect those living at the home from abusive situations. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 6 In depth induction and foundation training had been provided to ensure that the needs of those living at the home were adequately met. Service users’ financial interests were adequately safeguarded by the availability of secure facilities for the retention of money and valuables deposited with the home and the maintenance of clear records of any transactions made. What has improved since the last inspection? What they could do better: The home has failed to meet a number of requirements made during previous inspections. This is of concern as failure to do so could put residents at risk. Of most concern is that the recruitment procedures were not good enough. Failure to recruit staff properly to the home could place residents at risk. This must improve. The manager of the home should ensure that service users or their representatives are adequately consulted during the pre-admission and care planning processes so that those living at the home have the opportunity to be Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 7 involved in their care and are able to exercise choices about the planned programme of care. Those wishing to live at Aughton Grange should be informed in writing that the home is able to meet their assessed needs so that they are reassured that they will receive the care which they require. The registered person should demonstrate that the premises comply with any requirements made by the water authority to ensure the health and safety of those living at the home. A recorded system should be operated for calculating staff numbers to ensure that a sufficient number of staff are deployed to meet the needs of those living at the home. A minimum ratio of 50 of care staff with a relevant care qualification should be achieved to ensure an adequate percentage of care staff are appropriately trained to meet the needs of those living at the home. The registered person must make arrangements to send the monthly report conducted to the Commission for Social Care Inspection. Although appraisals were being conducted annually for all staff, there was no evidence to demonstrate that formal supervision for staff was conducted six times a year to ensure that staff were being adequately supervised. 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. Aughton Grange Care Home DS0000062646.V265345.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 Aughton Grange Care Home DS0000062646.V265345.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): No standards from this section were fully assessed on this occasion. EVIDENCE: Although no standards from this section were fully assessed on this occasion the inspectors established that two requirements from the previous inspection had not been addressed. The registered person must not provide accommodation to a service user unless, as far as it is practicable to do so, the service user or their representative has been consulted about the assessment undertaken prior to admission and they have been informed in writing that the home is able to meet their assessed needs. Aughton Grange Care Home DS0000062646.V265345.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): 9 and 10 Systems were in place to facilitate the safe handling of medicines, which were supported by the implementation of written policies and procedures. Those living at the home were treated with respect and their right to privacy was upheld. EVIDENCE: Although standard 7 was not fully assessed on this occasion the inspectors established that one requirement had not been consistently addressed from the previous inspection. The service user or their representative had not always been consulted about their plans of care to demonstrate that they had been given the opportunity to make some decisions about the care being provided for them. There were no people living at the home who self-administered their own medications. Qualified nurses were always responsible for the administration of all medicines to ensure safe procedures were in place in relation to the safe handling of medications. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 11 A payphone was available in a quiet area of the home, where disturbance would be minimal and mail received on behalf of service users was routinely passed onto their representatives unopened to give those living at the home a degree of privacy and autonomy. There were named, individual baskets in the laundry department, in which clothes of those living at the home were placed and laundry staff were responsible for ensuring that each persons clothing was put into their wardrobes and drawers to reduce the possibility of clothing being mislaid or used by others. However, comments received from relatives indicated that on occasions service users were seen wearing clothes which were not their own. The manager of the home is advised to ensure that correct laundry procedures are being followed to ensure that service users wear their own clothes at all times. The term of address preferred by the service user was clearly recorded in individual care records and the inspector observed staff using the preferred term appropriately, which demonstrated that service users’ choices were being respected. Recorded evidence was available to demonstrate that staff were instructed during their induction period on how to treat service users with respect at all times. The inspectors observed staff speaking with those living at the home in a respectful manner, demonstrating that the dignity of those living at the home was protected. Aughton Grange Care Home DS0000062646.V265345.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): 14 and 15 Service users were able to exercise choice and control over their lives, as far as practicable. Representatives were involved in cases where service users were unable to make informed choices. Those living at the home received a wholesome, appealing balanced diet in a pleasant, relaxed environment. EVIDENCE: At the time of the inspection there were no service users living at Aughton Grange who were able to handle their own financial affairs. The inspectors noted that appropriate information was clearly displayed within the entrance of the home in relation to advocacy services and leaflets were available to provide relatives with contact details, should they wish to utilize this service. Due to the category of service user living at Aughton Grange, staff had to facilitate services on their behalf, should it be deemed necessary. It was established that solicitors were acting on behalf of some service users to ensure that their financial affairs were adequately protected. The written information provided by the home confirmed that residents could access their own personal records and take personal possessions into the Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 13 home. This ensures they are then involved in decisions that may affect their care. A policy was in place in relation to the provision of nutrition, which included the involvement of external professionals. Evidence was seen to demonstrate that those living at the home were weighed regularly to ensure that health care needs in relation to nutrition were being met. Menus seen showed that a variety and choice of meals were provided. One service user told the inspector “We can get something to eat and drink at any time”. Service users were able to eat their meals within the pleasant dining rooms or within the privacy of their own accommodation, if they preferred, offering service users the choice of where they wished to dine. Liquidised meals and specialised diets were provided, which were attractively presented and service users were being given assistance with eating, when necessary in a discrete and sensitive manner in order to maintain appetite and nutrition in a dignified way. Service users were also seen to be eating their meals themselves with encouragement so that independent living was promoted. Although service users were not always able to make informed choices staff had a good understanding of service users’ individual preferences to ensure that they were provided with food and beverages, which they enjoyed. Sufficient time was allowed for service users to eat their meal in a relaxed environment so that they were not being hurried and so that they enjoyed meal times. The cook informed the inspectors that he is notified about special diets and preferences and it was evident that he had an awareness of individual service users’ dietary needs, demonstrating that appropriate diets were provided in accordance with individual requirements. One service user stated, “The food is very good” and another said, “The staff are lovely, they are very helpful”. Aughton Grange Care Home DS0000062646.V265345.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): 18 The policies and procedures of the home adequately protected those living there from abusive situations. EVIDENCE: Procedures for responding to suspicion or evidence of abuse or neglect, including whistle blowing were in place at the home in accordance with the Public Interest Disclosure Act 1998 and Department of Health (DH) guidance No Secrets, a copy of which was included with the written procedure to ensure that staff were aware of the correct procedures to follow, should an allegation of abuse be reported. A policy had also been implemented to provide guidance for staff on the management of physical and/or verbal aggression displayed by service users to ensure that those living at the home were adequately protected. The home had developed policies and procedures in relation to service users’ money and financial affairs, which included the safe storage of money and valuables in order to protect any money or valuables deposited with the home. Aughton Grange Care Home DS0000062646.V265345.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): None of the standards from this section were fully assessed on this occasion. EVIDENCE: Although none of the standards from this section were fully assessed at this inspection the inspectors established that all the requirements and recommendations from the previous inspection had been fully addressed, except for one recommendation. The registered person should be able to demonstrate that the premises are compliant with the Water Supply (Water Fittings) Regulations 1999 to ensure that the health and safety of those living at the home is adequately protected. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Service users’ needs were being met by the number and skill mix of staff on duty, although the ratios of care staff to service users was not being calculated in accordance with the dependency levels. The recruitment procedures were not robust enough to adequately protect those living at the home. Staff were appropriately trained to meet the needs of those living at Aughton Grange and were competent to do their jobs. EVIDENCE: Staff rotas were in place, which showed the number of staff on duty and the capacity in which they were employed; demonstrating an appropriate skill mix of staff was employed. The duty rota showed that registered nurses were on duty at all times to ensure that adequate supervision and advice was being provided for more junior staff and that service users’ nursing needs were being met. There were 24 people living at Aughton Grange at the time of the inspection. Although the dependency levels of those living at the home were established and care records demonstrated that on occasions additional staff were deployed to provided service users with 1:1 observation as required, there was no recorded evidence available to show that the staffing ratios were being calculated in accordance with the dependency of those living at the home to ensure that all needs were being fully met. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 17 The home had increased the domestic staff hours since the last inspection in order to maintain a clean and generally pleasant smelling environment. At the time of the inspection there were 13 care staff employed at the home, 4 of who had achieved a National Vocational Qualification at level 2 or above. Evidence was available to demonstrate that a further 5 care staff had commenced a National Vocational Qualification. However, the home should achieve a minimum ratio of 50 of care staff with a relevant National Vocational Qualification to ensure an adequate percentage of care staff are appropriately trained to meet the needs of those living at the home. Three staff files were examined at the time of the inspection. It was found that recruitment procedures were not being adequately followed in day-to-day practice. This must be improved as a matter of urgency to ensure adequate protection of those living at the home. Insufficient checks had been undertaken on staff prior to employment to ensure that the people living at the home were adequately protected. One referee had only known the employee for a period of two months, which was not sufficient to make a judgement on the suitability of the person to work in a care home with vulnerable adults and three other references were undated, so it was not possible to identify when these had been obtained. The Criminal Records Bureau disclosure on one file had been accepted from the previous place of employment. CRB disclosures are not portable. The POVA first checks on all three files examined had been obtained after employment commenced, which is not acceptable practice. A detailed induction programme for all newly appointed staff was in place, which had been extended to equip them to meet the assessed needs of service users living at the home. A lot of training for staff had been introduced, which demonstrated that staff were receiving appropriate training to look after the people in their care. Aughton Grange Care Home DS0000062646.V265345.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): 31 & 35 Service users’ financial interests were safeguarded. EVIDENCE: The home does not have a registered manager but the Commission has received an application that is being processed. However, the manager was aware of his need to complete some up to date relevant training. This is needed to demonstrate that he has undertaken periodic training to up date his knowledge, skills and competence whilst managing the home, including achieving a relevant management qualification to demonstrate that he has appropriate management skills. The inspectors established that monthly visits were being conducted and recorded by the General Manager to determine the quality of service provided. However, these reports were not being forwarded to the Commission for Social Care Inspection. The General Manager informed the inspectors that she would address this by sending her reports through on a monthly basis to demonstrate Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 19 to the Commission for Social Care Inspection that internal monitoring was conducted on a regular basis. Written transactions were maintained of service users’ monies deposited with the home and any withdrawals were recorded to ensure that any money handled by the home on behalf of service users was adequately protected. Secure facilities were provided for the retention of any service user’s money or valuables deposited at the home to ensure adequate protection. The home had developed policies and procedures in relation to service users’ money and financial affairs. These ensured that service users’ had access to their personal financial records and that service users had access to their personal allowances at all times. Although appraisals were being conducted annually for all staff, there was no evidence to demonstrate that formal supervision for staff was conducted six times a year to ensure that staff were being adequately supervised. Aughton Grange Care Home DS0000062646.V265345.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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Aughton Grange Care Home DS0000062646.V265345.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. 1 Standard OP3 Regulation 14(1)(c) Requirement The registered person must not provide accommodation to a service user at the care home unless, where practical, there has been appropriate consultation regarding the assessment with the service user and/or their representative. (Timescale of 01.12.04 and 30.06.05 not met) The registered person must not provide accommodation to a service user at the care home unless the registered person has confirmed in writing to the service user or their representative that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. (Timescale of 30.06.05 not met). The plans of care must be drawn up with the involvement of the service user or their representative, unless it is impractical to do so, in which case the reason for not doing so must be recorded. (Timescale DS0000062646.V265345.R01.S.doc Timescale for action 31/12/05 2 OP3 14(1)(d) 31/12/05 3 OP7 15(1) 31/01/06 Aughton Grange Care Home Version 5.0 Page 22 4 OP29 19(1)(b)(i )Sched 2 5 OP31 8 6 OP33 26(1)(2)( 3)(4)(5) of 01.12.04 and 31.08.05 not met) The registered person must implement robust recruitment procedures by obtaining relevant disclosures from the Criminal Records Bureau and the Protection of Vulnerable Adults register prior to the employment of any new staff members. Two written references in respect of every employee must also be obtained prior to employment. This must be addressed as a matter of urgency. (Timescale of 30.11.04 and 30.06.05 not met). The registered person must ensure that a registered manager is at the home at all times. The registered provider must make arrangements to supply a copy of the unannounced internal report to the Commission for Social Care Inspection on a monthly basis. 31/12/05 31/01/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP10 OP26 OP27 Good Practice Recommendations The manager of the home is advised to ensure that correct laundry procedures are followed. The registered person should be able to demonstrate that the premises are compliant with the Water Supply (Water Fittings) Regulations 1999. The ratios of care staff to service users should be determined according to the assessed needs of residents, and a system should be operated for calculating staff DS0000062646.V265345.R01.S.doc Version 5.0 Page 23 Aughton Grange Care Home 4 5 OP28 OP36 numbers required, in accordance with guidance recommended by the Department of Health. A minimum ratio of 50 of care staff with a relevant National Vocational Qualification at level 2 or above. should be achieved. Care staff should receive formal supervision at least 6 times a year. Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aughton Grange Care Home DS0000062646.V265345.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!