Inspection on 25/03/08 for Grange Court

This inspection was carried out on 25th March 2008.

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

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

Grange Court 05/03/09

Grange Court 04/09/07

Grange Court 09/08/06

Grange Court 28/02/06

Grange Court 08/09/05

Grange Court 02/03/05

Grange Court 11/02/05

Grange Court 20/12/03

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

CARE HOMES FOR OLDER PEOPLE Grange Court Station Road Baildon Shipley West Yorkshire BD17 6HS Lead Inspector Lynda Jones Key Unannounced Inspection 25th March 2008 10:00 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 Grange Court DS0000001244.V361104.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. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Court Address Station Road Baildon Shipley West Yorkshire BD17 6HS 01274 531222 01274 531222 stevewiggins@btinternet.com 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) Michael Stephen Berry Anita Anne Berry Belinda Cook Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (30) Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th September 2007 Brief Description of the Service: Grange Court is a family run concern, providing care and support for thirty older people. It is situated on the outskirts of the village of Baildon, Shipley West Yorkshire. Grange Court is a former coaching inn, with parts of the building dating to the fifteenth century and it still retains many of the original features. Over the years various alterations have been undertaken to make the home more accessible. All bedrooms are located on the first and second floors, the upper floors can be reached by passenger lift. There is a mix of double and single rooms available with disabled access via a ramp to the front of the building. The weekly fees range from £397 to £477. There is a different price for different rooms. Fees cover the costs of full accommodation, care and laundry facilities, but do not include chiropody, hairdressing, personal copies of newspapers and other personal requirements. People may bring in furniture and electrical items, though appliances are inspected for safety before use. All meals can be served in bedrooms or in the dining area. Support services are in place with a choice of General Practitioners, chiropodist, dentist and optician. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was our first visit to the home since the last key inspection in September 2007. This inspection took place to assess the quality of care provided to people living at the home. The visit was unannounced and was carried out by two inspectors between 10.00am and 4pm. As part of the inspection process we also looked at all the information we had received about the service since the last key inspection. We talked to people who live there and to the manager and staff on duty. We observed care practice, looked at various records and looked round the home. We were accompanied on this visit by an “expert by experience” from the organisation Help the Aged. An “expert by experience” is a person who, because of their shared experience of using services, is able to help us get a better picture of what it is actually like for people living in the home. The feedback she gave us has been incorporated into this report. What the service does well: People are always assessed before they move into the home to make sure that all of their needs can be met and it is the right place for them. People are receiving health care from a range of people such as doctors, district nurses, chiropodist and opticians. People look well cared for. Medication is well managed. This means that people receive their medication as it is prescribed. The home is comfortable and well maintained throughout. Bedrooms are personalised and people can take personal possessions with them when they move in, if they wish. Staff recruitment procedures are good, all staff are checked before starting work to ensure that they are suitable and people who live there are safe. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 6 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. Grange Court DS0000001244.V361104.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 Grange Court DS0000001244.V361104.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): 1, 2, 3 & 5 (standard 6 does not apply) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People receive information about the home before they move in and they can visit to see if the service can meet their needs. People are always assessed before they move in to make sure that all their needs can be met at the home. EVIDENCE: The statement of purpose and service user guide is available from the home. These documents give people lots of information about the home. We saw some of them in the bedrooms we looked at. The home offers a 5 day room reservation policy allowing people time to view Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 9 other potential homes before making a final decision about which home will best suit their needs. The manager told us that people are always given a contract when they move in. We looked at some of the care plans and we saw that people are assessed before they move in. This is done to make sure that the home is the right place for them and that all of their needs can be met. The home does not provide intermediate care. Grange Court DS0000001244.V361104.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 & 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The care plans do not always contain enough information about people’s needs. This means that people’s health, personal and social care needs are not always being met. Medication is well managed, which means that people are receiving their medication as it is prescribed for them. EVIDENCE: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet these needs. We could see from the plans that people are receiving health care from a range of people such as doctors, district nurses, chiropodist and opticians. We noted Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 11 that relatives, and wherever possible people living at the home, are now being involved in care plan reviews. This is an improvement since our last visit. Throughout the day we observed staff treating people with dignity and providing personal care in private. When we talked to staff, they demonstrated a good understanding of what people like and dislike; they know about preferred routines and how people like to spend their time but this information is not always recorded. They tend to pass this information on verbally. The care plans should provide staff with information about people’s needs and tell them what they must do to meet their needs. We did not think it would be possible to care for anyone living there based only on the information in the plans alone. We felt that the plans we looked at needed to be more detailed. These are some of the points that we fed back to the manager at the end of the inspection: • Some people with dementia are not being adequately supervised. We found evidence of one person entering other people’s bedrooms at night, which places vulnerable people at risk. Another person walks around the house during the day often entering other people’s bedrooms. Our Expert by Experience was talking to two people in their rooms when this occurred, the occupants saw this as an intrusion and said they do not like this happening. There is nothing in the care plans to offer guidance to staff about how to manage these situations and the staff seem to be too busy to offer these people additional supervision. This means that people’s needs are not being met and people’s right to privacy is not being upheld. Assessments are in place in the plans but they are not being used as indicators of risk. According to the records we looked at, one person lost 10lbs in weight in one month. A pressure ulcer assessment was carried and a score was determined, but there was nothing on the assessment tool to indicate what the score meant i.e. the level of risk of developing an ulcer. This person subsequently developed a pressure sore. Treatment was appropriate, but it is possible that this could have been prevented. People are being weighed in pounds and stones but the risk assessment tool is in kilograms, which could lead to confusion about weights. Moving and handling plans do not contain enough detail to ensure that people are always being moved safely and consistently. For example, although plans state whether one or two staff are required to support people but they do not say what support is required. • • • Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 12 • Continence plans indicate how many pads a person needs but there is no information about when these are to be used. This means that people’s needs may not always be met. People are not always receiving the care that is set out in their care plan. We looked at a plan that told us about one person who needed to wear support stockings and also needed to use a hearing aid, neither of which were in evidence. Some staff couldn’t get the support stockings on, so this person had to wait until there was a member of staff who could assist them. When we asked staff about this they didn’t seem to where the stockings and hearing aid were. The records told us about a person whose weight fluctuated, concerns about this were noted in the plan and food charts were in place to monitor dietary intake. When we looked at the charts we found that they were not being completed with any regularity which means that this person’s health care needs are not being met. The care plans are not always being updated to reflect changes in people’s abilities. One person had a broken wrist, the care plan indicated that this person was able to dress and undress without assistance. It had not been reviewed since the injury was sustained. • • • Medication is well managed and safely stored. The records show that people are receiving their medication at the times prescribed by their GPs. Medication records are up to date, signed appropriately and all medication could be accounted for. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are given the opportunity to take part in activities within the home and staff respect people’s preferred daily routines. Some of the practices at mealtimes are unsafe and are not respectful. EVIDENCE: Since the last inspection an activities organiser has been recruited. We were told that some form of activity now takes place each day but we could find little evidence in the records we looked at to indicate what sort of things take place. Some records we saw simply said, “participated in daily activities”, nothing else was recorded. We mentioned this to the manager at the end of our visit. There are a number of people with dementia living at the home. Several people are unable to make their needs known which means that it is very important that their relatives are consulted about their past lives. This Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 14 information is useful because it helps staff understand something about people’s backgrounds, families, work experiences etc. It also helps staff to make conversation with people. Some care plans we looked had some good information about people’s backgrounds and hobbies. This is an improvement on what we found when we last visited, but it is not clear from the records whether this information is being put to use by providing activities that are in keeping with individual interests. In the morning there was not much of a staff presence in the lounge where people were sitting. The staff were busy, involved in various tasks in other parts of the house. When they passed through the lounge they were pleasant and talked to people. The rear lounge felt warm and stuffy, we checked the temperature and it was between 26 and 28 degrees Centigrade. This, combined with a lack of stimulation, was probably why all seven people were asleep in this room by mid morning. We asked the manager to monitor the temperature. The Expert by Experience talked to staff and she told us there had been an Easter party at the weekend which relatives had been invited to join in. She said the activities organiser was enthusiastic about putting on more themed parties. She told us that most people she talked to do not go out, because they cannot walk and need assistance and she wondered whether there were enough staff available to take people out. The home has access to a mini bus which they share with another home owned by the same provider. Religious services were said to take place every month. One person said she had fairly regular visits from her church. In the afternoon, after the Expert by Experience left we saw several people taking part in a game of bingo, which they seemed to enjoy. Throughout the day visitors arrived to see people, they were made welcome by the staff. There are two dining rooms, one tends to be used by people who need assistance from staff, people who are more independent use the other, smaller dining room. The Expert by Experience joined people for lunch in the large dining room. She told us that people who needed assistance were helped by a member of staff. Drinks were served and people were encouraged to drink this before their meal was served. They then waited for about 15-20 minutes for their meals to arrive. She said “One member of staff was attempting to tend to two people at the same time. The amount of food on their forks was huge – by my standards. It appeared to me that one person did not want to eat like this, and it appeared Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 15 that she did not want her lunch. However when the member of staff went to get a sweet for the other person at her table, she proceeded to eat her lunch in small mouthfuls. When the member of staff gave her the sweet, she began again feeding her large mouthfuls. I don’t eat large mouthfuls of food – ever, and I think that I would be distressed and hungry if this ever happened to me. Menus were not put on the dining room tables until everyone had left the tables after breakfast. There was a set meal and no alternative main choice, with one menu advising of a requested alternative available. How can an alternative be requested in time for lunch when no-one was aware of what was for lunch at breakfast time. Apart from the cook being aware of the exact number of lunches required. The meal I had was very nice, and cooked well”. We do not find it acceptable for a member of staff to be assisting two people to eat at the same time and when people require help with their meals, they must be given manageable portions, at a pace that suits them. This is unsafe practice and could result in someone choking, it also demonstrates a lack of care and respect for people. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are not properly protected and safeguarded from abuse. Safeguarding issues are not being reported in line with adult protection procedures. EVIDENCE: There is a complaints procedure, details of which are in the service user guide. A log of complaints is held but this needs to include some information about the outcome of investigations. At the last inspection in September 2007 some relatives said they had raised issues with senior staff but felt their concerns were “trivialized”. People must have confidence in the complaints procedure so that they are able to raise concerns about the service and know that they will be listened to. One person contacted us with a complaint in January 2008, which was investigated by the provider. It was not about the care provided at the home, it was about the way a particular situation had been managed. The complainant was not satisfied with the way the provider dealt with the issue. The provider said it was dealt with in accordance with the homes complaints procedure. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 17 We were told that the manager and staff have had adult protection training and they know about their responsibility to safeguard people in their care but we found evidence that people are not being fully protected. The records show that several times one person had walked into the wrong room at night and on one occasion, in a state of confusion, got into bed with someone else. This was no longer happening by the time we visited. These incidents were not reported to ourselves or to the adult protection unit in Bradford. We talked to the manager about this and asked her to do this after our visit. We now have confirmation that this has been done. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 18 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, 23, 24 & 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is comfortable, safe and well maintained providing a pleasant place for people to live. EVIDENCE: We looked round all parts of the home when we last visited so did not feel it necessary to do this again on this visit. The home is well maintained and there is a programme for redecoration and refurbishment. We were told bedrooms are always redecorated when they become vacant. The bedrooms we saw were clean and there was evidence that people had personalised them with photographs, ornaments and pictures. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 19 The shared areas are clean and comfortable and the dining room is bright and pleasant. Outside there is a pleasant patio area with outdoor furniture for people to use when the weather is fine. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are not enough staff on duty at weekends to meet the needs of the people using the service and this could have an impact on their welfare. Recruitment practice is good, this means that staff only start work in the home when all checks have been carried out to make sure they are suitable. EVIDENCE: When we visited there were 26 people living at the home. The manager told us there are usually three care staff on duty, including one senior, during the day up to 5pm. In the evenings between 5pm and 9pm there are three staff on duty and during the night there are two staff available. Additional staff are employed to carry out domestic and catering duties. At weekends there are three care staff and one senior on duty throughout the day. There is no domestic cover at weekends which means that care staff have to carry out essential cleaning tasks, this means that they have less time to focus on people who they need to care for. This providers need to review this to make sure that people’s needs can always be met. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 21 There is an increasing number of people with dementia now living at the home, they are very dependent upon staff to meet their needs. Some people are not able to say what they want, which means that staff have to be very patient and spend time with people to determine their needs. The current staffing levels do not always permit this. We were told that on one Sunday recently there had only been two staff plus a senior on duty to provide care and carry out domestic duties. This is not safe, it leaves people without the support and supervision that they need. The providers must review the staffing at weekends and make sure that people’s needs can always be met. We looked at records relating to two recently recruited staff to see if they were appropriately checked before they started work at the home. We found that recruitment procedures are good, references are always taken up and checks are always made with the Criminal Records Bureau to ensure that new staff are suitable to work with older people. This means that people who live there are being appropriately protected. We asked about staff training and we were told that various courses had taken place but it was not possible to find the evidence for this while we were there. We talked to the manager about creating a training matrix, which would show “at a glance” what training had been undertaken and whether any training needed to be updated. We were provided with the information we requested following our visit, which told us that training had been undertaken in fire safety, moving and handling, adult protection, food hygiene, health and safety and infection control. We were also provided with details of further training that is scheduled to take place throughout this year. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The providers visit the home regularly to make sure that it is being managed effectively and that people who live there are safe. EVIDENCE: The manager is registered with us and has several years experience of caring for older people. She is supported by an effective administrative team. Since the last inspection, one of the providers has been carrying out monthly visits to the home reporting on the way the home is being run. We have not Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 23 been sent copies of these reports but they were available when we requested them. Relatives of people who live at the home are given feedback questionnaires so that they can say what the home does well and what areas can be improved. The questionnaires are issued to 25 of people every quarter so that there is continuous feedback on the performance of the home. We were told that 10 surveys had been sent to people in January but only 2 had been returned so far. People are also asked for their opinions at residents/carers meetings. We were told these had taken place in November07 and in January and February 08. The home does not hold money on behalf of people who live there. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 24 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X N/A X X 2 Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15 Requirement Care plans must be reviewed to make sure they a) Contain up to date information about people’s needs. b) Indicate clearly the action that staff need to take to meet people’s needs. This will make sure that individual needs are met appropriately. (This requirement was first made on 04/09/07) 2. OP15 12 (1) People who need assistance to eat must receive support on a 1:1 basis from staff. This is to ensure that they receive their meals safely and in a dignified manner. Adult protection issues must be promptly followed up and fully documented. This is to make sure that people are protected and safe from harm. 01/05/08 Timescale for action 30/06/08 3 OP18 13 01/05/08 Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 26 4. OP27 18 Staff must be available at all times in sufficient numbers to meet the assessed needs of people who live at the home. This is to make sure that the needs of each person will be met. (This requirement was first made on 04/09/07) 31/05/08 5. OP27 18 Weekend domestic cover must be reviewed to make sure that it is sufficient to ensure that the home is kept clean and hygienic at all times. 31/05/08 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 OP30 Good Practice Recommendations It would be useful to create a staff training matrix so that staff training needs can be readily monitored. Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Grange Court DS0000001244.V361104.R01.S.doc Version 5.2 Page 28 - 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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