Inspection on 31/07/07 for Hall Grange

This inspection was carried out on 31st July 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

Hall Grange 27/09/06

Hall Grange 07/02/06

Hall Grange 28/10/05

Hall Grange 14/02/05

Hall Grange 10/01/05

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

CARE HOMES FOR OLDER PEOPLE Hall Grange 17 Shirley Church Road Shirley Croydon Surrey CR9 5AL Lead Inspector Jon Fry Key Unannounced Inspection 10:35a 31st July, 13 August & 18 September 2007 th th 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 Hall Grange DS0000025787.V348322.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. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hall Grange Address 17 Shirley Church Road Shirley Croydon Surrey CR9 5AL 020 8654 1708 020 8654 4982 home.shi@mha.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged 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) Gloria Carol Smith Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Hall Grange DS0000025787.V348322.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 only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old Age, not falling within any other category - Code OP The maximum number of service users who may be accommodated is 36. 27th September 2006 Date of last inspection Brief Description of the Service: Hall Grange provides care for up to 36 older people. It is run by Methodist Homes for the Aged (MHA). The home is situated in a pleasant residential area of Shirley close to local shops and transport links. Accommodation is provided over two floors with lift access. Rooms are single and some have the added attraction of overlooking the extensive garden and grounds. A copy of the service’s Statement of Purpose and User Guide can be obtained on request. Fees for the home at the time of writing range between £509.00 and £587.00 per week. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent fifteen hours in the home over three separate visits. We spoke to ten people who live at the home, the manager and five staff members. We looked at records and documents, including three people’s care plans and the home’s User Guide. Completed surveys were received from nine people living at the service and two relatives or friends of individuals. The home completed an Annual Quality Assurance Assessment (AQAA) to tell us about the service provided, how it makes sure of good outcomes for the people using it and any future developments being planned. What the service does well: What has improved since the last inspection? What they could do better: We are concerned that there has been a continued failure to meet minimum standards in important areas such as care planning, medication and recruitment. These are the same issues that were raised in the September 2006 inspection report. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 6 Enforcement action had to be taken by the CSCI to get the home to improve its practice around medication following our second visit to the home in August 2007. We saw that action had been taken in this area by the time of our third visit in September 2007. An effective quality assurance system needs to be in place to check that the service is improving in key areas. 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. Hall Grange DS0000025787.V348322.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 Hall Grange DS0000025787.V348322.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 and 4. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory information is available to prospective users of the service. Assessments are completed before people move in but these are not currently being reviewed and updated satisfactorily. EVIDENCE: 67 of people who returned surveys said that they had received enough information to make a decision about moving in. 33 said ‘no’ to this question. Comments from people living at the home included “I came and had a look before I moved in”, “I chose the home as it was convenient” and “my Doctor chose it for me”. We saw that a guide is available which tells people about the home and the service it offers. This is currently only available in normal type and we have Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 9 recommended that it be made available in other formats such as large print, pictures and audiotape. There is an admissions procedure and full assessments should be completed prior to anybody moving in. Once an individual comes to live there, a care plan can then be written based on these assessments. We looked at the information kept for three people and only one of these individuals had a fully completed and up to date assessment on file. The home told us that they were in the process of moving over to new documentation which was why some of the assessments were blank or part completed. 60 of people who responded in surveys said that they had received a contract. We saw that the service has written contracts in place that are provided to people and / or their representatives on admission. We recommend that contracts be made available in large print and other formats as required. Hall Grange DS0000025787.V348322.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. People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements for the handling, storage and administration of medication were poor but action has been taken to improve this area. Care planning needs improvement to make sure that individual needs are being met. EVIDENCE: The majority of people we spoke to said that staff treated them with dignity and respect. Comments included “everyone is kind” “lovely staff” and “very pleasant”. One person felt that younger staff were not so helpful and “can be rude”. 78 of people who completed surveys said ‘usually’ when asked if they received the care and support they needed. 22 said ‘always’. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 11 We looked at the care plans for three people. These were mainly blank and contained little or no quality information for staff to use when providing care and support. As stated previously, new care documentation was being introduced and this had begun in March 2007. We think that this process is taking too long and action needs to be taken quickly to make sure that everybody living there has a detailed care plan in place. Risk assessments we looked at were also sometimes not completed or had not been kept under review. It is important that areas such as risk of falls, developing pressure sores and nutritional intake are looked at regularly. We saw one instance where a person had fallen and cut their head. This had not been recorded properly and their risk assessment around falls was blank. 55 of people who completed a survey said that they ‘usually’ received the medical support they needed. 45 of people said ‘always’. Comments included “I go to the surgery to see my GP”, ”the Doctor visits” and “they call the Doctor for the least thing”. One relative or friend of an individual felt that improvements could be made in dealing with things such as broken hearing aids. On our first visit, we found three instances where medication had not been given to people but had been signed for on the administration record. A number of other instances were seen where the medication records were blank and one instance where medication had not been given as prescribed. We were very concerned about this and gave an Immediate Requirement to make sure that medication was given as prescribed with full records kept. We visited again on the 13th August 2007 and found that there had been little or no improvement in how the home was administering medication to people living there. We issued an Enforcement Notice to Methodist Homes for the Aged telling them to make improvements or the CSCI may prosecute for the homes failure to comply with the law. A compliance visit was made on the 18th September 2007 and we saw that the organisation had taken the necessary action to improve this important area. This included staff training, improved procedures and better checking of records. We still think that the home needs to look at reducing the quantities of medication it holds as this makes auditing much more difficult. Hall Grange DS0000025787.V348322.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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a good range of activities. There is scope to improve this by making sure there is a full social care plan for each person and involving all staff in delivering this care. People living there generally enjoy the food provided and mealtimes are a pleasant social occasion. EVIDENCE: People spoken with generally said that they enjoyed the food offered with comments including “beautifully cooked”, “always plenty”, “good” and “lovely food – sometimes a bit too much”. One person said they thought “tea was a little disappointing” and another person said they would like “more variety for vegetarians”. In completed surveys, 63 of people said they ‘usually’ liked the meals served. 12 said ‘always’ and 25 replied ‘sometimes’. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 13 We saw lunch being served on both days we visited. People were given a choice and were able to serve themselves where possible. Three people we spoke to said that meals were always late and this happened on the first day we visited the service. There is a good range of activities on offer to people living there. There is an activities co-ordinator who is employed for 25 hours per week. A weekly schedule is displayed throughout the home. Activities include religious services, art classes, exercise sessions and quizzes. Comments from people living at the home included “there is plenty going on”, “very good”, “as much as necessary” and “there are enough”. One person said they would like “more trips out” and another person said they would like “more activities in the evening”. Care staff spoken to said that they did not routinely provide activities and said that this was not really their role. We saw a number of instances where people were sitting in the lounges but staff did not seem to have time to chat or interact with them. We have strongly recommended that the service look at how care staff could be actively involved in the provision of activities. This may be important in developing a service that is person centred rather than task based. Hall Grange DS0000025787.V348322.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. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are protected from abuse. Improvements need to be made around how the home responds to concerns and complaints. EVIDENCE: The complaints policy and procedure is displayed in the home and is part of the guide for the people living there. Comments from people who live at the home included “no complaints”,“ I know who to speak to” and “nothing much to complain about”. 67 of the people who completed surveys said that they knew how to make a complaint. 33 of individuals said ‘no’ to this question. Records are kept of any concerns or complaints but these are not detailed enough. There was one instance where the home had not responded promptly to a concern. Another instance was found where the investigation into a complaint was inadequate. It is very important that clear outcomes are recorded for each issue and ‘lessons learnt’ recorded to improve practice when needed. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 15 Care staff have training that teaches them how to recognise and report abuse. There is a procedure available for staff to follow in the event of any allegations being made. Hall Grange DS0000025787.V348322.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, 21, 24 and 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home enjoy a comfortable and safe living environment. The home is generally kept clean and well maintained but would benefit from redecoration in some areas. EVIDENCE: People spoken to were generally happy with the environment. Comments from individuals included “my room is extremely nice”, “all nice”, “ok”, “my room is ridiculously small but I’ve accepted it” and “satisfactory”. We saw that the home generally provides a pleasant and well maintained place for people to live. The bathrooms are in need of updating and do not provide a nice environment for people to have baths or showers. We also saw that the first floor hallway carpeting is in need of replacement. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 17 The home was clean and hygienic at the time of this inspection. 45 of people who returned surveys responded ‘always’ when asked if the home is fresh and clean. 45 said ‘usually’ and 10 said ‘sometimes’. One relative or friend of an individual said they thought that the cleaning of bedrooms could be improved describing it as being ‘dusty’. Hall Grange DS0000025787.V348322.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. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are generally enough staff on duty to meet the needs of people using the service and individuals are happy with the care they receive. Staff recruitment practices and training need improvement. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “very helpful”, “very good”, “understanding” and “they are not perfect but they do their best”. 89 of people who returned a survey said that they thought staff listened to them and acted on what they said. One person said ‘sometimes’ in response to this question 75 of people who filled in surveys said that staff were ‘usually’ available when needed. 12.5 of individuals responded ’always’ and 12.5 said ‘sometimes’. We saw that care staff were very busy and needed to spend a lot of time with people in their rooms to support them with things like toileting, washing and dressing. This makes it seem like there are not many staff around at times. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 19 As stated previously, there is scope to look at the role of carers and make sure that social and emotional care is seen as an important part of their job. We saw a number of ‘missed opportunities’ where care staff did not sit with people and spend time with individuals. Two care staff we spoke to said they would welcome some training around dementia care as the needs of individuals in this area was increasing. We looked at training records for four members of care staff. These were not up to date and there was very little training recorded for 2007 with the majority having been carried out in 2006. The home needs to carry out a full audit of training attended by staff and make sure that individuals have had all mandatory courses such as Food Hygiene, Safeguarding Adults and manual handling. Training around dementia care and person centred care also needs to be provided to all care staff. It is recommended that the activities coordinator be offered some specialist training also to help develop the provision at the home. Staff recruitment records need improvement to make sure that all the required information is kept on file. We found one instance where a Criminal Records Bureau check was from a previous employer and a new one had not been obtained. This area was being addressed by the organisation by the time of our September 2007 visit. Hall Grange DS0000025787.V348322.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, 32, 33, 35, 36 and 38. People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A new manager is required. Organisational quality assurance practices need improvement. EVIDENCE: The registered manager left the service during the period we were inspecting the home. As stated previously, there has been a failure to maintain adequate standards in areas such as care planning, medication, staff recruitment and training. This also highlights a failure in quality assurance, as these shortfalls do not appear to have been either identified or addressed by the organisation. Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 21 We were satisfied that improvements had been made in a number of areas by the time of our visit in September 2007 and this work is ongoing. Temporary management arrangements are in place until a new manager is recruited for the service. A system for regular individual staff supervision needs to be put in place. Staff told us that they were receiving supervision with their line manager but this was not very regular. Health and Safety checks take place to make sure people are kept safe and generally good records are kept of these. A number of issues were however seen. Better checks need to be kept of fridge temperatures in the home. This was highlighted at the September 2006 inspection and needs to be properly addressed. A fire blanket was missing in the first floor kitchen area and records for recent safety checks of a hoist in use were also unavailable. One instance was seen where domestic staff had not locked cleaning materials away. Hall Grange DS0000025787.V348322.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 3 3 2 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 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 2 17 X 18 3 2 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 2 X 2 Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (2) Requirement In order to ensure that people’s individual needs are met, assessments must be fully completed and kept under review. The Registered Provider must ensure that each person living at the home has a full care plan that clearly details how all of their personal, health and social care needs will be met. (Previous timescale of 01/12/06 not fully met) 3. OP8 13 (4) In order to look after the welfare 01/12/07 and safety of people living there, the home must carry out risk assessments of areas such as falls, nutrition and pressure care. These must be kept under review particularly following any incident or accident. The home must keep a full 01/12/07 record of complaints detailing timescales and outcomes for each issue. Complaints must be fully Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 24 Timescale for action 01/12/07 2. OP7 15 (1)(2)(b) 01/12/07 4. OP16 22 (3) (8) investigated with records kept. This will make sure that any complaints are taken seriously and acted upon. 5. OP19 23 (2) (b) (c) The carpet in the first floor hallway must be replaced. This is to ensure that individuals are provided with a suitable and safe environment to live in. All communal bathrooms must be renovated in order to provide a pleasant and safe environment for individuals to bath or shower. The Registered Provider must ensure that a satisfactory Criminal Records Bureau (CRB) check is obtained for all new staff. This will help to protect the welfare of people living at the service. In order to make sure that people are supported by competent trained care staff, all individual training needs of care staff must be assessed. Mandatory training must be attended by care staff and refreshed as necessary. Training in dementia care and person centred care must be provided to all care staff. A permanent manager must be appointed for the home and an application for registration submitted to the CSCI. 01/02/08 6. OP21 23 (2) (b) (c) 19 (1) 01/03/08 7. OP29 01/11/07 8. OP30 18 (1) (c) 01/02/08 9. OP31 8 (1) 01/02/08 10. OP33 24 (1) This will ensure that people live in a home that is run and managed by a person who is fit to be in charge. The organisation needs to ensure 01/12/07 that an effective quality DS0000025787.V348322.R01.S.doc Version 5.2 Page 25 Hall Grange assurance system is in place for the home. This will help to make sure that the home is being run well and is successful in meeting its aims and objectives. 11. OP36 18 (2) (a) All care staff must receive supervision with their line manager at least six times annually (pro-rata for part-time staff) with full records kept. This is to make sure that care staff receive the supervision and support they need to do their jobs well. 12. OP38 12 (1)(a) To ensure the safety of people living at the home, cleaning products must be stored in a locked facility when not in use. (Previous timescale of 01/11/06 not fully met) 13. OP38 13 (4) To ensure the safety of people living at the home, the home must ensure that fridge and freezer temperatures are monitored, with records kept, on a daily basis. (Previous timescale of 01/11/06 not fully met) To ensure the safety of people living at the home, the fire blanket in the first floor dining room must be serviced and ready for use. 01/11/07 01/11/07 01/01/08 14. OP38 23 (4) (c) 01/10/07 Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 26 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 OP1 OP2 OP9 OP12 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as large print, audiotape or pictures. It is recommended that the home looks at making sure that contracts are in plain English and supplied in alternative formats as required. The home needs to look at reducing the quantities of medication it holds for individuals. The organisation should look at how care staff could be more involved in the provision of social and emotional care. It is strongly recommended that further training courses be made available to the activities co-ordinator and/or other responsible care staff. It is recommended that the home looks at staffing roles, shift patterns and routines in place to help support person centred care throughout the service. 5. OP27 Hall Grange DS0000025787.V348322.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Hall Grange DS0000025787.V348322.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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