Inspection on 26/04/07 for Cromwell House

This inspection was carried out on 26th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Cromwell House 29/09/05

Cromwell House 14/01/05

Cromwell House 10/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Cromwell House Cecil Road Norwich Norfolk NR1 2QJ Lead Inspector Maggie Prettyman Key Unannounced 26th April 2007 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 Cromwell House DS0000027269.V337578.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. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cromwell House Address Cecil Road Norwich Norfolk NR1 2QJ 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) 01603 625961 01603 660581 home.nor@mha.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged Mrs Elizabeth Janet Pitcher Care Home 38 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (38) of places Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Thirty-eight (38) Older People may be accommodated. Four (4) service users over the age of 65 years with a diagnosis of dementia may be accommodated. Maximum number not to exceed thirty eight (38). Date of last inspection 29th September 2005 Brief Description of the Service: Cromwell House is a residential care home and is one of a number of care homes operated by Methodist Homes for the Aged, which is a registered charity. It offers accommodation and personal care for up to thirty-eight people and is sited in a residential area of the city of Norwich close to local amenities and the city centre. The home stands in its own grounds and is on two floors with a passenger lift to the first floor. All bedrooms are single and thirty-seven bedrooms have ensuite facilities and the remaining one bedroom has a private bathroom next to it. There are two communal bathrooms and two toilets on each floor and those living at the home have communal use of a large lounge, two small sitting rooms with tea making facilities, a large dining room, conservatory and chapel for daily prayer and worship. The current range of weekly fees is £465 - £519. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days during which a tour of the premises and grounds was undertaken and people living in the home, their relatives and staff working there were consulted about their views. Prior to the inspection a pre inspection questionnaire was completed by the manager with supporting information provided. Pre inspection questionnaires were received from 4 relatives, 2 health care professionals and 8 people who live in the home. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the provider, some residents and their relatives as well as other who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and current judgements for each outcome group. What the service does well: Cromwell house is a home that provides a service that is specific to the needs of the people who live there. One person said “I lived in another home before this and they did not give me the spiritual support that I need like they do here.” Regular religious observance is part of the homes daily routine. Visitors to the home are welcomed and supported and people are helped to remain part of their community. The home asks people about what they would like to do and how they wish to live their lives. Staff are kind and caring and have the knowledge and skills to support and protect people. The environment is safe, clean and well maintained. The manager is competent and has the best interests of people who live in the home at heart. One person said “There is no place like home, but this is the nearest I could possibly get.” Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The implementation of new care planning and medication systems has not been a smooth process and many shortfalls in these systems were found. Some other requirements and recommendations have also been made. Requirements: • • • • • • • • • • • • Care plans must be consistently recorded and reviewed The use of handover books with individual care notes must be discontinued All treatment assessed as being needed must be recorded and action taken MAR charts must be accurate and consistently completed Controlled drugs must be accurately recorded and witnessed Homely drugs must be securely kept and only those approved by the GP used Soaps toiletries and clothing must be individually labelled Food charts must be kept confidentially People must be able to consult the GP in a private and suitable area Adequate numbers of staff must be on duty Cleaning products must be safely stored Safe steps must be provided in the medical room Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 7 Recommendations: • • • • Complaints, comments, suggestions and compliments should be audited The large number of notices around the home should be reduced Bathrooms should be kept clear of surplus equipment Consideration should be given to the suitability of using two male night carers at the same time 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. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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 Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who plan to use the service have an assessment before they move in to make sure that the home is able to meet their needs. EVIDENCE: Inspection of individual files demonstrated that the manager makes an assessment before they come to live at the home. This assessment is made at the person’s home when possible, and involves both the person and their family or representatives if appropriate. Residents spoken to confirmed that their assessment helped them to give details about themselves and the needs that they wanted the home to meet. The manager confirmed that the home does not provide intermediate care. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 and 11 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Poor recording and maintenance of medication systems means that people living in the home do not always consistently receive the levels of health and personal care required by the standards. Significant improvements have been made since the last inspection with regard to recording peoples’ wishes relating to end of life care. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 11 EVIDENCE: Inspection of service user files showed a large variation in standards of recording. The home is implementing a new care planning system and it is clearly causing difficulties for staff. Old care plans were consistently completed and reviewed. New records are more detailed, but entries are sporadic and incomplete in some cases. A requirement has been made in this respect. This problem is compounded by the use of handover books which compromise data protection and cause records not to be duplicated into peoples’ files. A requirement has been made in this respect. An example of a Doctor’s visit and resulting changes in medication not being recorded in a persons’ care plan and medication sheet was found. Care records demonstrated that people receive visits from health professionals as required. Evidence of pressure area and nutritional risk assessments was seen in individual files. Unfortunately the home does not always fully meet the standard as records and action plans are not always fully recorded in peoples individual care plans. A Requirement has been made in this respect. Inspection of the medication system revealed some shortfalls in its administration. MAR charts detailed many drugs that had, in fact, been discontinued. One person had a controlled drug listed, but this had never been entered into the register and the home could not demonstrate when or why this had been discontinued and destroyed. Eye drops were found in the fridge that had not been administered, and no record could be found about when they had been prescribed. MAR charts had gaps in completion and the controlled drug register was not completed in full. An unlocked cupboard contained a variety of homely remedies, some of which had not been approved by the GP. Requirements have been made in respect of this standard. People living in the home reported that they feel treated with respect and that their dignity is upheld. The home demonstrated some good standards in the way that people are generally treated and spoken to. Some areas would benefit from improvement such as making sure residents’ soaps and toiletries in communal bathrooms are identified and that items of clothing are properly labelled. Some food consumption charts were left out in the dining room. In addition a GP remarked that residents are often given medical consultation in an extremely small downstairs room with a clear window to the car park. Requirements have been made in respect of this standard. Evidence in people’s individual files showed that the home has worked hard since the last inspection to discuss peoples end of life wishes with them and to make detailed records and care plans in this respect. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their lifestyle and the spiritual, social and recreational activities meet individuals’ expectations. The home is working to improve the standard of food provided. EVIDENCE: Feedback from questionnaires completed by people who use the service and their relatives as well as discussion with people during the inspection demonstrated that people are happy with the way the home works to meet their social and spiritual needs. The home has worked hard since the last inspection to provide a variety of social and entertainment activities. An activities worker has been trained to provide appropriate and enjoyable group and individual activities. Each person is given a written list of activities and a large board displays the days’ events and the menu. The manager is aware that this board is not always completed at weekends and plans to rectify this. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 13 People living in the home confirmed that their daily routines are flexible and that their spiritual needs are met. Religious observance took place during the inspection and people referred to the existence of small prayer group meetings as well. During the inspection relatives and friends were seen freely visiting the home and being warmly greeted and kindly supported by staff. Tea bars on each floor mean that people can have refreshment as they wish when visiting. Some people said that they go to activities and groups outside the home. Records showed that choirs and community groups come to the home. People living in the home confirmed that they have choice and control in their lives. The access to records policy and information about advocacy services are displayed in the hall. Records demonstrated that residents meetings are held and that action is taken in response to requests for change. The manager plans to further increase the input of people, particularly around the planned refurbishment of the home. Relatives confirmed that they are involved in meetings at the home and a “Friends” group exists to raise additional monies. Inspection of the kitchen demonstrated that good standards of food hygiene are maintained. The hom’s kitchens have recently been awarded a 4* rating by the environmental health officer. Feedback from questionnaires and some comments during the inspection as well as resident meeting records showed that people are not always happy with the quality and quantity of food provided. The home is working toward rectifying these issues. The head cook has developed a food choice questionnaire which he intends to discuss with each person living in the home to help make menus more appealing to people living there. A new quality assurance process has been developed to monitor the quality of food provision. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, have access to a complaints procedure and are protected from abuse. EVIDENCE: The home has recorded three complaints since the last inspection. People who live at the home feel that their complaints are listened to and taken seriously. Inspection of staff files demonstrated that not all serious complaints are recorded as such. A requirement has been made in this respect. Complaints of a minor nature as well as comments, suggestions and compliments about the service are not recorded and audited. A recommendation has been made in this respect. Information about Adult Protection services and whistle blowing is displayed in the hall and staff areas. Records and discussions with staff demonstrated that adult protection training is in place and that staff are aware of the signs and symptoms of abuse. The home is aware of the process of referral of unsuitable staff for POVA listing. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment. Some areas of the home are in need of refurbishment. Storage could be improved and the number of notices displayed should be reduced. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 16 EVIDENCE: A tour of the premises showed that the home is accessible and records demonstrated that a good system of maintenance and compliance with environmental and fire regulations is in place. Décor is pleasant and homely and the gardens are equally pleasant and accessible. The general appearance of the home is diminished by many notices giving information and instruction. The need for information needs to be balanced with maintaining a homely and domestic environment. A recommendation has been made in this respect. Bathrooms are routinely used to store surplus equipment. This means that people bathing are surrounded by unnecessary equipment and items. A recommendation has been made in this respect. Communal areas had a variety of social facilities, and a room is set aside for spiritual observance and social activities. The dining room is in need of refurbishment, and this is planned for the near future. The gardens are well maintained and accessible with plenty of seating available. Feedback from pre inspection questionnaires raised the problem of the lift becoming crowded before mealtimes. The manager is trying to address this issue. A tour of the building demonstrated that it is clean, pleasant and hygienic. Preinspection questionnaires raised issues about a lack of cleaners at weekends. This has been caused by staff shortages, which the manager said have now been rectified. The laundry has adequate equipment and sluices are available. Training records and discussions with staff demonstrated that people are trained in infection control and the safe and effective handling of cleaning materials. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are properly recruited and trained to support the people who use the service. Staff shortages have continued to affect aspects of the quality of service provided. EVIDENCE: Discussion with people in the home as well as feedback from pre-inspection questionnaires demonstrated that there have been staff shortages due to vacancies or unplanned absence of staff. Most of this shortfall has been in domestic, laundry and catering staff and the use of care staff to cover may have led to the use of agency staff on care rotas. A repeated requirement has been made in this respect. During the inspection it was drawn to the inspector’s attention that on some occasions only male staff are on duty at night, and that this may not meet the needs of some people living at the home. A recommendation has been made in this respect. The manager confirmed that at least 60 of staff are trained to level 2 NVQ which exceeds the requirments of the National Minimum Standards in this respect and the home is commended on the commitment to this training. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 18 Inspection of four staff files demonstrated that the home meets the standards in its recruitment processes and that necessary checks such as written references and CRB checks are being undertaken. Staff spoken to confirmed that they feel trained to do their jobs. Records of induction and training were seen on staff files. The manager is in the process of inputting this information into a training matrix to give an overview of training needs. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 19 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): Standards 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and quality assurance systems are being developed by a qualified manager. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 20 EVIDENCE: During the course of the inspection the manager demonstrated that she is a caring and knowledgeable person who has the best interests of people living at the home as a focus of her practice. She has NVQ level 4 in care management and has regular training updates. Evidence of independent quality assurance was seen during the inspection. Outcomes from this process are put on notice boards for people to see. Further quality assurance processes are in the process of being implemented. Monies held on behalf of people living in the home were checked and found to be properly accounted and correct. During the tour of the premises cleaning products were found unsecured in a bathroom. A requirement has been made in this respect. Shelves routinely used in the medical room are too high for many staff and district nurses to reach and no safe step was available. A requirement has been made in this respect. With these exceptions the home was found to be run in a safe way. The maintenance person maintains records of safety checks. Staff reported that they are trained in health and safety matters and this was supported by evidence in staff files. Risk assessments are in place and accident reports are completed. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 21 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 2 8 2 9 1 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 2 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 Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 22 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 OP27 Regulation 18.1 Requirement The registered person must ensure that adequate staffing levels are available at all times to ensure that people have enough staff to meet their needs. Care plans must be consistently recorded and reviewed to ensure that services provided match peoples current needs. The use of handover books recording specific information must be discontinued to ensure that a consistent and individual record of care is provided. All treatment assessed as being needed must be recorded and action taken to ensure that people’s health care needs are met. MAR sheets must be accurate and all medicines dispensed recorded to ensure that people receive the medication that is prescribed for them. Controlled drugs must be fully and accurately recorded and witnessed to ensure that these drugs are held safely. DS0000027269.V337578.R01.S.doc Timescale for action 31/07/07 2. OP7 15, 17 30/06/07 3. OP7 12.4 (a) 30/06/07 4. OP8 15, Schedule 3 13 Schedule 3 13 Schedule 3 30/06/07 5. OP9 30/06/07 6. OP9 30/06/07 Cromwell House Version 5.2 Page 23 6. OP9 13 Schedule 3 12.4 (a) 13.3 7. OP10 8. OP10 12.4 (a) 9 OP10 12.4 (a) 10. OP16 22 (3) 11. OP38 13.4 12. OP38 23. 2 (c ) Homely remedies must be kept securely and be those approved by the GP to ensure that people only receive medication that is suitable. Soaps and toiletries and peoples clothes must be individually labelled to ensure that people only use items which belong to them. Charts relating to peoples food consumption must be stored securely so that the information remains confidential. People must receive medical consultation in their own rooms or in an area that is suitable and ensures privacy. All complaints of a serious nature must be treated as such and appropriate action and reporting take place to ensure that people’s complaints have appropriate action taken. All cleaning products must be securely stored to ensure that people are safe from potentially harmful substances. A suitable step must be provided in the medical storage room so that staff can access shelves safely. 30/06/07 30/06/07 30/06/07 30/06/07 30/06/07 30/06/07 30/06/07 Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP16 OP19 OP19 OP27 Good Practice Recommendations All complaints, comments, suggestions and compliments should be recorded and audited. Notices and information should be kept on notice boards only to ensure that the homes environment is homely. Bathrooms should be kept free of spare items of equipment so that they are homely and comfortable to use. The home should try to ensure that two male waking night staff are not always on duty at the same time. Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Cromwell House DS0000027269.V337578.R01.S.doc Version 5.2 Page 26 - 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!