Inspection on 27/06/07 for Geel And Hitchen Court

This inspection was carried out on 27th June 2007.

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

Other inspections for this house

Geel And Hitchen Court 11/05/06

Geel And Hitchen Court 13/02/06

Geel And Hitchen Court 10/11/05

Geel And Hitchen Court 09/02/05

Geel And Hitchen Court 29/07/04

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

CARE HOMES FOR OLDER PEOPLE Geel And Hitchen Court Woodlands Road Aigburth Liverpool Merseyside L17 0AN Lead Inspector Mr Paul Kenyon Unannounced Inspection 27th June 2007 14:00 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 Geel And Hitchen Court DS0000025103.V346298.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. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Geel And Hitchen Court Address Woodlands Road Aigburth Liverpool Merseyside L17 0AN 0151 261 2000 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) Nugent Care Mary Bellmon Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Dementia over 65 years of age: Code DE(E) The maximum number of people who can be accommodated is: 24. Date of last inspection 2nd October 2006 Brief Description of the Service: The Geel and Hitchen Care Home is part of the Nugent Care Society and is a purpose built nursing home that offers single accommodation on a ground floor level. All bedrooms have hand wash facilities and there are several assisted baths, showers, and toilets. There is a large lounge, quiet room and a separate dining room. There are long corridors for residents to wander in. There is access to a patio area and secure garden. The interior and exterior of the home is well maintained. The home is set in grounds shared with another home owned by the Nugent Care Society, however, both homes have separate amenities and staff. Fees are currently charged at £476 per week. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection to be held this inspection year (April 2007 to March 2008). The inspection was unannounced and took place over two days. The inspection included a tour of the premises, examination of records relating to the care provided, interviews with two members of staff and observation of care practice. The nature of the disability of residents is such that it is not always possible to gain a view about their experiences about the care they receive. Observation of care practice assisted with this. Surveys to relatives have been made available yet none have been returned at the time of writing this report. Any returned surveys will be used in the continuous inspection process of the home. National Minimum standards were used to measure the quality of care provided. What the service does well: Prospective residents have their needs thoroughly assessed before they come to live in the home. Residents are treated in a dignified and respectful manner. Residents benefit from having a programme of activities to participate in if they wish and have their routines respected. Residents benefit from having continued contact with their families and have their independence maintained. The nutritional needs of residents are met. Residents and their relatives benefit from being provided with the information they need to make a complaint and residents are protected from abuse. Residents live in a well-maintained and hygienic environment. A well-trained and well-qualified staff team supports residents. A recommendation is raised in respect of the reviewing of staffing levels. Residents are protected through the recruitment process. The views of residents and relatives are taken into account and the health and safety of residents is promoted. ‘I like it, I have a lovely room and it is on one level no need to use the stairs’ ‘Food is good-you get a choice’ ‘Staff are good’ ‘I prefer it here’ ‘ I am happy here’ Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 6 ‘I feel well but I see the doctor if I am not’ ‘My daughter visits and I can see her where I want-I have a chat and I feel safe here’ What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to the service at present. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from having their needs thoroughly assessed prior to them coming to live at the home EVIDENCE: Assessment information was examined for three individuals who had been admitted into the service in the past few months. In all cases, there was evidence of an initial admission enquiry form, a pre admission risk assessment, medical and mental health assessment, medication assessment, dietary needs, pressure sore assessment, mobility assessment, clinical assessment, social needs assessment, continence assessment, manual handling assessment, risk of falls assessment and assessments covering personal hygiene and nutrition. In all cases, home assessments were accompanied by Local Authority Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 9 assessments for each person. All assessments were carried out prior to the person coming to live at the home. Geel And Hitchen Court DS0000025103.V346298.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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having a plan of care which outlines their needs and which in turn is reviewed regularly. The health needs of residents are met. Medication systems are now safe. Residents benefit from having their privacy and dignity promoted and maintained. EVIDENCE: Care plans for three individuals were examined. One care plan was dated May 2007. Evidence was available throughout of meetings with relatives to confirm their agreement with the contents of care plans given that residents are not always in a position to understand their contents. This care plan had been reviewed recently. Another care plan was examined and noted to follow a consistent format from the other one. Again there is a system in place for relatives to confirm contents of care plans through meetings. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 11 The third care plan related to a resident who had been admitted the day prior to the inspection. A basic care plan is in place yet it is too early for reviews to have taken place yet care plan is presented in the same format as others. All health needs are included within initial assessments and then are included within care plans. There is evidence of continence assessments, pressure care assessments and evidence of pressure relief equipment within the home for those who are susceptible as identified. There is evidence of general medical appointments in place such as visits by Doctors, opticians, chiropody, dentists and visits to consultants. There was also evidence during the inspection of a Doctor’s visit with action taken as a result of the outcome of such visits. The psychological health of residents is identified in care plans with Community Psychiatric Nurse visits where applicable. Weight monitoring on individuals is carried on a regular basis and nutritional assessments are also completed. No one self medicates at present although this is included within the initial assessment. A medication room is available with keys to this room retained by qualified staff at all times. Only qualified nurses administer medication and are subject to nursing codes of conduct. The medication room is locked when not in use and cabinets located inside the clinical room are also locked. Medication Administration Records are signed appropriately and an omission code is in place to ensure that all omissions are consistently recorded. The details of and a contract with pharmacy supplier are in place. Visits by the pharmacy supplier occurred last in May 2007. All medication is recorded when received by two individuals. A copy of the most recent medication guide (BNF) is in place. No controlled medications are prescribed at present. A refrigerator is in place for storage of medication and its temperature is checked daily. A monitored dosage system is used. A medication trolley is used to transport medication to residents during medication administration. All opened medication is labelled with the date it was opened. A disposal system for medication is in place and a sharps box is in use. The medication round was indirectly observed. The Nurse administering medication was noted to be administering medication in a supportive manner to residents ensuring that they are given the support they need in ensuring that medication is taken voluntarily. Staff interviewed were able to give an account of the way in which privacy is taken into account. No shared rooms are in use in the home and there was evidence of staff knocking on doors prior to them entering. Clothing in the laundry is marked discreetly. Privacy was also noted to be given to residents when being toileted by staff. One resident confirmed that they were able to receive visitors in private. All preferred names for residents are outlined in care plans. There were also numerous examples of staff discreetly ensuring that clothing was fixed and that the dignity of individuals was maintained. Geel And Hitchen Court DS0000025103.V346298.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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a programme of activities, which is individual and will be more tailored to their needs once the Manager’s proposals are implemented. Residents benefit from being able to maintain contact with families and friends and have their independence taken into account. Food provided meets the nutritional needs of residents. EVIDENCE: A board is on display outlining activities through the week. This orientation board for residents indicates the date, whether the day has some significance and weather outside. Each resident has an activity record, which outlines which activities they have undertaken and this provided evidence of those activities as well as those occasions when people do not want to join in. The dining room and conservatory area is available for activities. Routines in daily living are flexible. The morning inspection noted that some people preferred to rise later and were still able to have breakfast later on. The Manager provided evidence of her intention to develop activities. Each person has been assessed Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 13 into those who are willing to take part in activities and those whose disability is more profound. As a result a series of suggested activities has been identified for each group of people and this is linked to their dependency and their social preferences as identified in the initial assessment. Evidence was available through visitor’s books of significant visits from families and friends. It was confirmed through discussions with residents that they are able to receive such visits in private. There were examples of people able to go out with family and this is taken into account. There are links to local churches. A Eucharistic minister visited during one part of the inspection to give out communion. All religions of individuals are included within care plan with all being Christian but of different denominations. The home has a Roman Catholic ethos although most people are not catholic yet links to all Churches are fostered and religious preferences are taken into account. Many individuals are still independently mobile. The home is designed so that people can access all parts of the building and outside in the garden area although this is done safely with no risk to individuals. Residents were noted to be enabled to mobilise independently throughout the building with minimal staff intervention given for support purposes. Others are able to move around with the use of walking aids. Many rooms are personalised and this extends to the outside of the bedroom doors with many photographs of individuals when they were younger being on display. This provided evidence of personal belongings in place. The organisation is appointee for a handful of people while everyone else relies on family members given that they are unable to manage their own financial affairs. Where the home administers finances, this is done is an accountable manner subject to audit and is secure. Advocacy information is available and the manager has sought to gain more information on local advocacy groups. Nutritional assessments are completed on admission and included in each care plan. Some residents have diabetes and this is included in care plans and discussion with kitchen staff indicated that they are aware of these needs. Mainly individuals are able to eat independently although again evidence that some require softer of blended food to be provided to them in line with risk assessments. A dining room is available and meals are provided at flexible times. Kitchen staff employed and obtain stocks from external suppliers. The kitchen is a hygienic, well-equipped and organised facility. Food stocks are adequate. Menus are on display and indicate a choice of food. Residents were asked about food and stated that they liked it. Geel And Hitchen Court DS0000025103.V346298.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are provided with the information they need to make a complaint about the service and these are investigated. Residents are protected from abuse. EVIDENCE: A complaints procedure is on display in the hallway and around other parts of the building. These include details of the Commission for Social Care Inspection. Complaints records are in place and there have been complaints since the last inspection all dealt with by the home. Records indicate the nature of the complaints and there is evidence of investigation. There is also evidence that where complaints have been investigated, complainants are asked to sign to say whether they are satisfied with the outcome or otherwise. All complainants making recent complaints are satisfied with the outcomes. A Local Authority procedure for abuse reporting is in place, as well as a whistle blowing procedure, procedure in relation to gifts and wills and information on physical aggression. Staff interviews revealed that they have received training in abuse awareness and are aware of the whistle blowing procedure. No allegations of abuse have been received by the service. One resident has experienced alleged abuse in a previous residence and as a result the home Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 15 have provided support from care staff who are female and this is maintained and included within her plan of care. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well-maintained and home like environment, which in turn is clean and hygienic. Where offensive odours are identified, the Manager has taken steps to ensure that these are eradicated. EVIDENCE: A tour of the home was carried out. The home is secure with a coded lock to the front door. There is access for residents to the rear garden area. The home is single storey and is designed in such a way that residents can move freely in the building yet end up where they started from. The home is well decorated and includes a whole host of framed pictures and photographs in place, which relate to the Liverpool area in days gone by. Maintenance records are available and there is evidence that a refurbishment programme is ongoing. A new Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 17 carpet is to be fitted and grants have been applied for to ensure continued upkeep of the building. CCTV is in use but to the exterior for security reasons and does not impinge on the privacy of residents. The home employs domestic staff and they were evidenced throughout the building working to the cleaning programme throughout the visits. The home appeared to be clean and hygienic. An offensive odour was noted mainly in main lounge. The manager has identified the need for an air conditioning system in this area and provided evidence that funding had been secured for this. A laundry facility is in place separate from food preparation and storage areas and laundry staff are employed. The laundry has a sealed floor and washable walls, contains industrial appliances and has separate clothing storage to ensure that clothing is not mixed up. The laundry is clean and organised. A clinical waste system is in place and there is a plentiful supply of protective clothing in place. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being supported by a staff team that has a mix of skills although it is recommended that the staffing levels be reviewed to ensure that they meet the dependency levels of residents. Residents benefit from being supported by a well-qualified staff team who in turn have been recruited appropriately and receive regular, relevant training. EVIDENCE: Interviews with two staff members were held; one with a care assistant and one with a qualified nurse. They were asked if they considered that there was enough staff on duty to carry out their tasks. In both cases, stated that they considered that this was not the case and that one more care staff would assist. Information was noted on a monthly visit report by a representative of the organisation. This identified, through staff discussion, about the need for one more member of staff. The intended action outlined in this report stated that this would be looked in to. It is recommended that staffing levels be reviewed in line with the dependency levels of residents. A staff rota is available and this noted that there is a mix of care and ancillary staff in place. The rota includes designations of staff. Qualified nurse cover is maintained throughout the day and night. A staff allocation list is in operation Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 19 and this outlines the areas and residents that members of staff should be supporting during their shift. NVQ qualification records are available to suggest that almost all care staff had attained NVQ Level 2 at least and figures suggested that this represented 75 of care staff. This exceeds national minimum standards. Interviews with staff covered training. Care staff training has included: first aid, protection of vulnerable adults, NVQ Level 3, mandatory training and dementia awareness. The interview with the qualified nurse suggested that the organisation had assisted her in maintaining her registration as a nurse. Five personnel files were examined and these provided sufficient information held to suggest that recruitment has been done robustly with an emphasis on references and police checks. All information is securely stored. There is evidence that qualified staff have current registration as verified by their personal index numbers. All files examined related to newer starters. Training for qualified member of staff includes mandatory training, dementia care, abuse awareness, food hygiene and first aid. The individual considered training to be good. Other training records and certificates are available and these suggested that training included those topics relevant to the role of the individual. The Manager has had training relating to management issues such as supervision and time management. Other training for staff included: first aid, food hygiene, manual handling, abuse awareness, risk assessments, dementia awareness, challenging behaviour and fire training. A training plan is in place outlining that training that has been undertaken and what training is planned for the future. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from receiving a service managed by an experienced and qualified individual who has been approved by the Commission for Social Care Inspection. The views of residents and relatives are taken into account and the service has a number of methods for assessing the quality of care it provides. The health and safety of residents is promoted. EVIDENCE: Since the last inspection, a new Manager has been registered with the Commission for Social Care Inspection and has had her registration approved. Comments from staff made that they ‘she works very hard’ Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 21 Representatives of the organisation undertake monthly visits and these occur and copies of reports are made available to the manager. Surveys have been completed although it is recommended that the results are made available to relatives and other stakeholders. Relatives meetings have started with the first one being held on the evening of the first visit to the home. Requirements raised in last reports have been addressed. The Inspector was able to conduct the inspection with the co-operation of the home and enabled to speak with residents in private. Further quality assurance systems are in place linked to the national minimum standards for older people. A proposal has been made by the Manager to use a recognised method (known as SOFI) to observe residents care to be included within monthly visits. Training in mandatory subjects was confirmed through staff interviews as well as certificates and training plans. Fire detection systems are checked regularly as well as fire alarms and emergency lighting. Fire fighting appliances are checked, accidents are recorded appropriately, service certificates are in place for hoists and health and safety statements from 2007 are on display. General risk assessments are up to date for 2007, control of substances hazardous to health assessments are in place, portable appliances have been tested as well as certificates for gas and electricity systems. A certificate of registration is on display as well as insurance certificate. The manager is aware of responsibilities notifying the Commission For Social Care Inspection of untoward incidents and submits these as a matter of course. Water temperatures are checked regularly and other notification information is in place. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP27 OP33 Good Practice Recommendations The service should review staffing levels in line with the dependency levels of residents The service should make the results of quality assurance surveys available to all. Geel And Hitchen Court DS0000025103.V346298.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 - 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!