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Inspection on 25/08/05 for Charlotte James Nursing Home

Also see our care home review for Charlotte James Nursing Home for more information

This inspection was carried out on 25th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Charlotte James is a home specialising in the care of older people with physical disabilities and as such, the environment, staffing levels and training, along with care planning are all organised to meet the needs of highly dependant residents. Written information provided to residents prior to admission was of a very good standard and a thorough assessment procedure was in place. The home offers its residents the opportunity to experience a good quality of life, with flexible daily routines and a wide range of social activities. The health and personal care needs of residents were being met appropriately and each resident had a written care plan, a sample of which were examined and found to be very satisfactory. All care plans were written legibly in black ink, dated and signed in line with NMC requirements. All risk assessments were in place along with long and short-term problems, which were reviewed monthly or more frequently if required. Competent trained staff met wound care needs. The home have had many successes in healing some large hospital acquired pressure sores. The staff maintain comprehensive care planning notes, up to date, reflecting the current condition of each resident. The staff in the home actively seek out further training, to enhance their skills and continue to strive forward and improve standards throughout the home. Residents and staff alike complimented the choice and quality of meals. All care staff had received robust documented formal supervision every two months and this formed the basis of staff development and continues to improve the standards of care delivered in the home. Observations of staff conduct throughout the day, along with several discussions with staff at different levels, confirmed to the inspector that staff were competent and caring.

What has improved since the last inspection?

Ongoing, significant training and updating of staff competencies continues throughout the home. This forms the basis and infrastructure of delivering excellent standards of care. The dedication and determination of the care manager, ensures that she maximises the quality of life for all residents when in the care of Charlotte James nursing home.

What the care home could do better:

No requirements were made following this statutory inspection. One recommendation was made to increase the activity organiser hours as she has been undertaking many of her duties in her own time. The home continues to meet all services and facilities available, which are presented by the home in their Statement of Purpose and Service Users Guide.

CARE HOMES FOR OLDER PEOPLE Charlotte James Nursing Home Oakhurst Snobnall Road Burton On Trent Staffordshire DE14 2BB Lead Inspector Sue Mullin Unannounced 25 August 2005 11:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Charlotte James Nursing Home Address Oakhurst Shobnall Road Burton On Trent Staffordshire DE14 2BB 01625 417800 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Four Seasons Healthcare (England) Ltd Mrs Pamela Dawn Worthington CRH 28 Category(ies) of PD(E) 28 registration, with number of places Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 28 beds - PH (Physical Disability) - Minimum age 60 years on admission 2 3 beds - PD (Physical Disability) - Minimum age 55 years on admission. Date of last inspection 4 October 2004 Brief Description of the Service: Charlotte James Care home is a 28-bedded establishment providing personal care and nursing care to service users suffering with a physical disability over the age of 65 years.The building dates around 1901 with a later extension added on. The home is located off the main road in a rural setting with very pleasant country views. The home is situated just outside Burton On Trent, with local amenities nearby.Ground and first floor accommodation is provided, accessed via a passenger lift. There are single and double bedrooms available and some of these are en suite. There is a selection of communal areas and a Victorian conservatory overlooking the pleasant gardens. There is adequate parking space. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place on the 25th of August 2005. It found that all of the standards assessed were fully met. The Registered Manager and all her staff on duty throughout the period of the inspection provided assistance. Several residents were consulted throughout the day and made positive comments on the high standards of care delivered in the home. The environment of Charlotte James provides a homely atmosphere. Communal areas are very spacious and comfortable. Most bedrooms are for single occupancy and have a washbasin. Some rooms have ensuite facilities. The attractive rural gardens that surround the property are very pleasant, enabling residents to enjoy the outdoors. Staffing levels provided at Charlotte James were found to be satisfactory. Staff training is given high priority and NVQ training was progressing well. The registered manager has been in post now for seven years and once again during this inspection, it was noted that the staff team was working very agreeably together. Effective and productive teamwork was evident throughout the inspection. Staff were sure of their roles and duties and carried them out with minimum direction. All routines and regimes were well understood by all staff working in the home. Residents were the primary focus of the 24-hour period and staff were seen to administer care with diplomacy, empathy and professionalism. What the service does well: Charlotte James is a home specialising in the care of older people with physical disabilities and as such, the environment, staffing levels and training, along with care planning are all organised to meet the needs of highly dependant residents. Written information provided to residents prior to admission was of a very good standard and a thorough assessment procedure was in place. The home offers its residents the opportunity to experience a good quality of life, with flexible daily routines and a wide range of social activities. The health and personal care needs of residents were being met appropriately and each resident had a written care plan, a sample of which were examined and found to be very satisfactory. All care plans were written legibly in black ink, dated and signed in line with NMC requirements. All risk assessments were in place along with long and short-term problems, which were reviewed monthly or more frequently if required. Competent trained staff met wound Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 6 care needs. The home have had many successes in healing some large hospital acquired pressure sores. The staff maintain comprehensive care planning notes, up to date, reflecting the current condition of each resident. The staff in the home actively seek out further training, to enhance their skills and continue to strive forward and improve standards throughout the home. Residents and staff alike complimented the choice and quality of meals. All care staff had received robust documented formal supervision every two months and this formed the basis of staff development and continues to improve the standards of care delivered in the home. Observations of staff conduct throughout the day, along with several discussions with staff at different levels, confirmed to the inspector that staff were competent and caring. 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. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 The home has very detailed pre admission assessment procedures and was able to demonstrate that the needs of residents were being met appropriately. EVIDENCE: Charlotte James has a very detailed pre admission assessment procedure that is well supported by comprehensive written records, samples of which have been examined and found to be satisfactory. Needs are identified and a plan of care is established which is developed further, as the period of assessment reveals more information of individual needs and how these are to be effectively met. Pre admission visits are encouraged, to allow all parties the opportunity to meet other residents, staff and become more familiar with the layout of the home. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 10 Care planning was maintained at a very good standard. The health and personal care needs of residents were being met appropriately. The home had policies and procedures in place for the management and administration of resident’s medication. Residents were treated with respect and their right to privacy was being up held. EVIDENCE: A sample of care plans were examined during this inspection and the inspector was satisfied that a good standard of care planning was being maintained. All care plans were written legibly in black ink, dated and signed in line with NMC requirements. All risk assessments were in place along with long and shortterm problems, which were reviewed monthly or more frequently if required. Competent trained staff met wound care needs. The home have had many successes in healing some large hospital acquired pressure sores. The staff maintain comprehensive care planning notes, up to date, reflecting the current condition of each resident. The staff in the home actively seek out further training, to enhance their skills and continue to strive forward and improve standards throughout the home. Discussions with staff and residents confirmed that good standards of health and personal care were provided at Charlotte James. An examination of daily entries into the care plan also confirmed a thorough approach. All NHS entitlements were available and made through the referral process where necessary. Due to the high dependency of residents at Charlotte James, none self medicate. All medication is managed and administered by qualified nursing staff. The care manager confirmed that the home continue to have a good working relationship with the dispensing pharmacy. Throughout the period of the inspection, the Inspector observed several very positive interactions between staff and residents, which confirmed that residents of Charlotte James are treated with respect and afforded privacy. The Inspector observed residents being consulted about a variety of things and staff were demonstrating patience and sensitivity. Discussions with staff confirmed a positive and respectful manner. Consultation with residents equally conveyed a feeling of mutual respect that exists between residents and staff. Throughout the day staff were observed to be knocking on bedroom doors before entering and promoting privacy when assisting residents to transfer and in a variety of other personal care Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 11 situations. It was very pleasing to witness the banter and genuine fondness apparent between residents and staff alike during the visit. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Charlotte James provides an excellent range of social, religious and recreational activities and opportunities. Contact with families is promoted. Residents are extensively consulted and encouraged to make choices that determine personal routines and activities for daily life. The quality of meals continues to be of a good standard. EVIDENCE: The home employs an activity organiser for 12 hours each week, at the time of the inspection the activity organiser was on annual leave. One recommendation was made to increase the activity organiser hours as she has been undertaking many of her duties in her own time. Residents engaged in conversation confirmed that a good variety of social activities and recreational opportunities were being provided, including one to one activities to meet individual assessed needs and group activities. Musicians and entertainers visit the home on a weekly basis and the residents and staff alike enjoy this immensely. Regular outings are also planned very regularly and the home hires a tailgate bus for this activity. Two residents engaged in conversation recalled their last mini bus adventure which had occurred the previous week. One said ‘ when we return to the home after our Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 13 trip and as we approach the turn to the home, she (my friend) always sayswe are home’. The home advertises planned events in the home. Evidence of spontaneous activities was also apparent with staff encouraging residents to sit and walk in the garden in order to enjoy the good weather. Consultation with residents confirmed their satisfaction with the range and level of activities provided at Charlotte James. Another resident stated ‘ the staff are so good and patient – I feel as if I belong here’. Spiritual needs are met and there is an organised service once a month in the home. For those residents wishing to worship elsewhere, the home would try to accommodate this. From observations made during this inspection it was evident that residents are appropriately consulted and encouraged to make choices in their day-today lives. As well as observing direct examples of this, discussions with residents also confirmed this good practice. The Inspector joined the residents at lunchtime, which was tarragon chicken with fresh vegetables, followed by fresh fruit and cream. Alternatives were available if preferred. The meals were very appetising and were well presented. Lunch was a social event with much laughter and camaraderie evident. Copies of menus were on display in the main lounge, which confirmed variety and choice of meals. Comments from several residents confirmed their satisfaction with the quality, quantity and choice of meals provided. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Charlotte James has a robust complaints procedure. There are written policies and procedures in place in respect of protecting residents from abuse, along with associated staff training. EVIDENCE: Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 15 A comprehensive complaints procedure was on display in the home and included all details of CSCI. Charlotte James has received no complaints during the past 12 months either to the home or via CSCI. The home has comprehensive policies and procedures, including ones on the protection of vulnerable adults. All staff receive specialist training in abuse awareness and associated guidelines. The home must be commended for its application to staff training and abuse awareness. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,25,26 The home is well maintained, comfortable and safe. The feel of the home and its grounds enable residents to benefit from countryside living. The environment throughout was found to be very clean and hygienic. EVIDENCE: Charlotte James provides an accessible, safe and well-maintained environment that meets the needs of residents. There is a rolling programme of decoration and maintenance intended to ensure high standards are maintained. Several windows opening on to the garden were open allowing through ventilation for residents within. Observations on the day of the visit confirmed that the environment was clean and hygienic and staff were following infection control guidelines. Robust policies and procedures were in place for the control of infection and appropriate hand washing facilities and disposable gloves/aprons were provided throughout the home. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staffing levels and skill mix provided at Charlotte James were satisfactory. Staff training is given a high priority. NVQ training was progressing well. All staff were deemed competent to do their jobs and provide a seamless service. EVIDENCE: Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 18 As this is a care home that provides nursing home the staffing levels and skill mix are maintained as South Staffs Health Authority agreed them in March 2002. There is always a qualified nurse on duty throughout a 24-hour period. Additionally there are 4 care staff on the early shift, on the late shift there are 3 care staff. On the night shift there are 2 care staff. All staff are waking staff. The care manager is fully supernumerary and has not only met all the national minimum standards inspected on this occasion but has maintained a commendable level of training and updates for herself and her staff. There were 26 residents in the home on the day of the inspection 23 (nursing) and 3 (residential) with 2 vacancies. The staffing levels and skill mix were found to be in line with minimum requirements on the day of the inspection and duty rotas are created in plenty of time to ensure the appropriate continuance of the skill mix and level of care staff. Catering, domestic and laundry hours are sufficient. There is an administrator who works 25 hours per week, this appointment has been very successful and allows time for the care manager to meet all care standards as outlined in the statement of purpose. The home also employ an activity organiser for 12 hours a week and it was recommended that her hours are increased to keep up with the demand from the residents and fulfil her duties. There is a part time handyman employed this amounts to 30 hours. There are adequate first aiders employed in the home as well as qualified trained nursing staff. Observations of staff on duty throughout the inspection confirmed that staff were competent and caring in their conduct. The Inspector was particularly impressed with the positive rapport and friendliness towards both residents and visitors to the home. At the time this inspection a good percentage of staff had achieved NVQ level 2 or above. Training is ongoing, a commendable commitment by management. Charlotte James has well established recruitment procedures. All staff in post have had suitable POVA and CRB checks, prior to employment being offered. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 19 Manual handling and all other mandatory training was completed and documentation seen. Records of training were up to date robust and easily accessible. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 A very competent caring experienced nurse manager directs the care delivered in the home. The home is run entirely on the best interests of the residents. The health, safety and welfare of residents and staff were promoted by extensive policies and procedures and implemented safe working practices. EVIDENCE: Effective and productive teamwork was evident throughout the inspection. Staff were sure of their roles and duties and carried them out with minimum direction. All routines and regimes were well understood by all staff working in the home. Residents were the primary focus of the 24-hour period and staff were seen to administer care with diplomacy, empathy and professionalism. All care staff had received robust documented formal supervision every two months and this formed the basis of staff development and continues to improve the standards of care delivered in the home. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 21 Observations throughout the day confirmed that safe working practices were in operation. Comprehensively written policies and procedures were in place and staff were being provided with an ongoing programme of health and safety training. Fire tests and maintenance of fire equipment was seen and up to date. Fire drills were undertaken in line with Fire Authorities requirements. Emergency lighting and hot water testing were undertaken and the records inspected, no anomalies were found. All mobile and bath aids were maintained 6 monthly. Wheelchairs and cot sides were checked regularly for any faults. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 4 4 4 4 x x 4 x 3 Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? 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 Regulation Requirement none made 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. Refer to Standard 12 Good Practice Recommendations A recommendation was made to increase the activity organiser hours as the post holder has been undertaking many duties in her own time. Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Charlotte James Nursing Home E51-E09 Charlotte James (OP) UI 25.08.05 S49239 v.246063 Stage 4.doc Version 1.40 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. 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