Inspection on 16/10/08 for Hetton House Residential Care Home

This inspection was carried out on 16th October 2008.

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

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

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hetton House Residential Care Home Hetton House 62 Station Road Hetton-le-hole Houghton-le-spring Tyne And Wear DH5 0AT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea Goodall     Date: 1 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Hetton House Residential Care Home 62 Station Road Hetton House Hetton-le-hole Houghton-le-spring Tyne And Wear DH5 0AT 01915172496 01915172496 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Maureen Anderson Type of registration: Number of places registered: Gradestone Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 22 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: Old Age, not falling within any other category, Code OP - maximum number of places 15 Dementia Code DE, maximum number of places 15 Physical Disability, Code PD, maximum number of places 4 Date of last inspection 15 0 4 Over 65 0 15 0 Care Homes for Older People Page 4 of 29 Brief description of the care home Hetton House is a converted older building near the centre of Hetton-le-Hole, which is a former mining village on the outskirts of the Sunderland area. The home was first registered in 1991, and can provide personal care for up to 22 older people. In June 2008 the home was registered to a new provider, Gradestone Limited. The home is relatively small and offers cosy, comfortable accommodation. There is level access into the home at the front entrance, and wheelchair access around the central corridors. There is a small run of steps at one end of the building on both floors, so there are 4 bedrooms that can only be used by people with good mobility. The home has bedrooms, bathrooms and lounges on both floors. A passenger lift serves the accommodation on the first floor. The home is on a main road through the village and is close to public transport routes. It is a short distance from local shops, library, health centre and churches. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last visit on 2nd August 2007. We looked at how the service dealt with any complaints & concerns since the last visit. We looked any changes to how the home is run, for example since the last inspection a new Provider has bought the home. We made an unannounced visit on 16th October 2008. This is the first inspection of the home since the new Provider bought the home. During the visit we talked with people who use the service, relatives, staff, the manager and visitors. We joined residents for a meal and looked at how staff support the people who live here. We looked at information about the people who use the Care Homes for Older People Page 6 of 29 service and how well their needs are met. We looked at other records which must be kept. We checked that staff had the knowledge, skills & training to meet the needs of the people they care for. We looked around the building to make sure it was clean, safe & comfortable. We checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: There were no requirements made at this inspection. A small number of good practice recommendations are made. For example, it would be better if assessment records are signed and dated, and that care records included Care Homes for Older People Page 8 of 29 some of the information that is in the monthly reports. It would be better if baths are replaced as part of the homes on-going programme of refurbishment. When the number of residents increases then staffing levels should also increase, and the manager should have enough time to carry out the management tasks. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are fully assessed before they make a decision whether to move here so that they know their needs can be met at the home. Evidence: Since the last inspection Hetton House has been purchased by a new provider. The information pack about the home (called a service users guide) is currently being revised to show this change. In the meantime the manager is giving out the old information packs with separate details of the new owner, so that people still have good information about the home before they decide whether to move here. It was clear from discussions with a visiting relative that the manager encourages people to come and have look around the home before they make any decisions. One relative said, We chose this room for him before he came here and they kept it for him. Care Homes for Older People Page 11 of 29 Evidence: If a persons care is funded by the local authority, a care manager assesses whether the person needs residential care. The manager of the home then carries out a preassessment of any prospective resident before they move here. This enables the manager to know whether the home can meet an individual persons needs or not. The assessment records of recent residents show that their physical, health, emotional, social and spiritual needs are all taken into account. A review is held after a six-week trial period to see if the home is still suitable for each new resident. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall people receive good support with their personal care so that their needs are well met. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example, how to help people with their mobility, diet, and emotional well being. The care plans at Hetton House have continued to improve over the last year and these provide staff with better guidance about how to support each person with their individual needs, and show how the resident would like to be supported. Some information about how to support people has been written in the wrong part of the care plan (e.g. it has been recorded in the evaluation reports rather than the action plan) and this means it might not be seen by all staff. For example one person can become upset and angry when being encouraged to have a bath. Staff have recorded how to respond in the best way to support the person but it is in the Care Homes for Older People Page 13 of 29 Evidence: evaluation reports, not the action plan where all staff would see it. Otherwise the care plans are easy to follow, reviewed monthly and are up to date. The plans are written in a respectful way and include details of peoples abilities to still do some things for themselves. For example which parts of their own care they can manage themselves, like brushing their teeth and whether they are able to choose their own clothes. The care records also show that peoples health care needs are assessed and regularly checked for example their mobility, nutrition, and risk of falling. Again some records are kept up to date but in the wrong place for staff to see. For example one person has a nutritional assessment but the records of her dietary intake are only in the daily records with no review in the care plan. This recording point is probably due to the fact that there are rarely any changes of staff and all the staff are very familiar with the needs of the people who live here. Residents are supported to access local community health care services that are brought into the home, including GPs, district nursing service, opticians, chiropodists and dental services. The manager seeks the advice of health and social care professionals to ensure that residents receive the right care. At this time three people have input from psychiatric care services. It was stated that if a resident had the capability to manage their own medication they would be supported to do so. At this time all residents medication is managed by the home. Most medication is supplied in blister packs by a pharmacy so that it is easy for staff to administer. It is stored in a locked trolley in a locked cupboard. At the time of this visit some unused medication that was to be returned to the pharmacist was in a cupboard that, for a short period, was not locked. Senior staff are responsible for managing the medication and they have all had certificated training in safe handling of medication. Records about medication were up to date and in good order. Staff are friendly and helpful towards residents. They support people in an unhurried way with tasks such as eating, walking and washing. All the residents and visitors who took part in this inspection commented very positively about the supportive attitude of staff. One resident said, Im well looked after here. Theyre all canny to me. A visiting relative said, All the girls are very nice - they look after him well. They keep him nice and clean. Its much better than the other home he was in. If residents choose to spend time alone in their rooms this is respected by staff. All bedroom doors are lockable and residents are offered a key. If residents have declined Care Homes for Older People Page 14 of 29 Evidence: a key or been assessed as unable to manage one, this is recorded in their care file. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good opportunities to make choices about their own daily routines so they lead a lifestyle that matches their own preferences. Evidence: This home continues to encourage people to lead their own lifestyle and to spend time in whichever areas of the home that they wish. During this visit some people were spending time in the conservatory, one person was enjoying a late breakfast after a lie-in, and other people were watching television in the lounge. One relative said that they specifically chose this home because of the individual care that people get and the flexibility of the home that means people can do what they want. They said, I really like the fact that people can get up or go to bed when they want, just like they would in their own homes. At this time there are only 7 people living here so activities tend to be very individualised to each residents tastes. For example, one person likes to play dominoes with staff, a couple of people enjoy games of bingo and reminiscence chats with staff, and one person likes to go out with friends and family. One visitor said, Care Homes for Older People Page 16 of 29 Evidence: Hes very comfortable here. Hes got his own books and he enjoys watching television. The home has a very local community feel as most resident and staff are from the local area. The home has good links with local shops and services. Visitors and relatives had several positive comments to make about the friendly atmosphere in the home. One visitor said, It feels like its the residents home. Its very friendly and the staff are so relaxed - it makes it feel really laid back. Meals are served in the pleasant dining room at the front of the home. Residents said that the quality of the meals remains very good. Residents are offered a range of traditional dishes that suit their tastes and expectations. Meals are wholesome, nutritious and appetising. People are asked if they would like the main dish or an alternative just before the meal so that they can make an informed choice about what they fancy at that time. For example todays main lunchtime meal was pork casserole with vegetables, another person chose to have fishcakes and chips, and one person had an omelette. In this way people can make their own decisions about what to have for their meals. One resident said, The meals are very good, you cant fault them. We get nice lunch and a hot tea as well if you want it. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have clear information so they would know how to make a complaint. The staff have had suitable training so they know how to protect residents from abuse. Evidence: All residents have information about how to make a complaint. This information is in the service users guide which is is currently being revised to show the new providers address and details. In the meantime the complaints procedure and the providers details are on display in the hallway where it can be seen by residents and visitors. There have been no complaints received by the home or by CSCI about this service since the last inspection. Residents and their visitors also have opportunities to discuss any concerns with the manager or staff. Relatives commented that they would feel comfortable about talking to the manager if they wanted to mention anything. One visitor said, We can ask the manager anything and shell sort it out. The home uses the safeguarding adults arrangements that are promoted by the City of Sunderland. These are robust procedures for dealing with suspected abuse. The manager has had training in the safeguarding adults processes and so she is familiar with her responsibilities in this area. All staff have previously had good training in Care Homes for Older People Page 18 of 29 Evidence: protection of adults. Arrangements are being made for all staff to receive updated training in safeguarding adults. In this way staff are clear about how to protect the people who live here. It is good practice that the manager has also had training in the Mental Capacity Act and in the deprivation of liberty. She and the new provider are now developing a policy about how each persons capacity can be assessed to ensure that residents are supported to make their own choices, wherever their capabilities allow, whilst living in this home. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 good improvements to the building mean that residents live in good quality, safe, comfortable accommodation that upholds their dignity. Evidence: Since the new provider took over the running of the home a few months ago there have been many good improvements to the standard of accommodation. Previously this home had suffered from significant wear and tear which meant that, although the home was safe and comfortable, it was not good quality accommodation for the people who live here. Over the past few months the provider has ensured that all windows have been replaced and double-glazed throughout the building. Every bedroom has been redecorated, refurnished and recarpeted. All bedrooms have also been fitted with new vanity units. The lounges have been redecorated and fitted with good quality woodeffect, non-slip flooring. All corridors and hallways have been recarpeted and redecorated. The lighting has been replaced so that it is much brighter in hallways and in bathrooms. New flooring has been provided to bathrooms, the laundry and the kitchen. All woodwork throughout the house has been repainted. It was clear from discussions that residents and their relatives are delighted with Care Homes for Older People Page 20 of 29 Evidence: improvements. One resident said, Its much better now. Its nice and bright. Ive had my bedroom completely done out. It is good that all the bedrooms now have matching furniture, curtains and bedding. The provider has plans for continued improvements including the possibility of altering the car parking area at the back of the home to make a sheltered, private garden for residents. Bathrooms have been repainted and the lighting is much improved. However the old baths and chair hoists are still showing signs of wear, and there are still no cupboards in these rooms so some personal equipment is on display on shelves. The manager anticipates that these matters will be addressed as the homes occupancy begins to rise. The home was clean and odour control was generally very good. There is one communal toilet that does have occasional odour problems. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 provides competent, well-trained, suitable staff to ensure that the people who live here are protected and that their needs are met. Evidence: The staff team consists of the manager, a deputy manager, nine care staff (including senior carers), two domestic staff and two catering staff. All the staff are experienced, mature and many have worked at the home for several years. It is clear from observations and discussions with residents that the long-serving staff have a very good knowledge of the care needs of the people who live here. Residents are very comfortable in the presence of staff and like to spend time chatting with them. Due to the current low occupancy in the home the new provider has temporarily reduced the staffing hours provided. There are currently 7 people living in the home. The minimum staffing levels provided by the home are two care staff on duty at all times, one of whom is either the manager, deputy manager or a senior. During the night there are also two care staff, one of whom is a senior. This meets the needs of the current people who live here, but any changes to the number or needs of residents would mean that the home will have to increase the number of care staff. There are also a domestic staff on duty in the morning and a catering staff on duty for Care Homes for Older People Page 22 of 29 Evidence: the morning and early afternoon. It was evident from the good standard of cleanliness and the quality of the meals that this is sufficient to meet the current number and needs of the people who live here. The home has always enjoyed a low turnover of staff and this has always supported the good continuity of care of the people who live here. There have been only two changes to staff in the past year (due to maternity leave and sick leave.) The home is an equal opportunities employer. The manager uses appropriate recruitment and selection processes to ensure that only suitable staff are employed. All necessary checks are taken up, including a CRB disclosure (police check), before a new member of staff starts working here. In this way the people who live here are protected. It is good practice that all 10 care staff have a care qualification (called NVQ level 2). It is excellent practice that all senior care staff have achieved the advanced qualification NVQ level 3, and three staff have also attained the management qualification, called NVQ level 4. It is also excellent practice that all the care staff have completed good training in dementia care. In this way staff are very well trained to provide the care and support of the people who live here. All staff have previously completed mandatory training in health & safety matters such as infection control, fire safety, first aid, and food hygiene. The manager is fully aware that staff now require refresher training in some of these areas, particularly moving & assisting, and this is arranged for the near future. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the home remains well run so that the best interests of residents are upheld. Evidence: The registered manager has been responsible for the day to day running of this home for several years. She is experienced and qualified, and fit to be in charge of a care home. She has demonstrated that she has kept up to date with her knowledge by attaining NVQ level 4 and the Registered Managers Award, which are suitable qualifications for managing a care service. Hetton House was purchased by a new provider in June 2008. Due to the current low occupancy the new provider has made some reductions to staffing. This means that the manager is carrying out the role of a senior care for much of her time. There are currently no supernumerary management hours so she also has to try to fit in the many managerial, supervisory and administrative tasks involved in managing care service. Whilst this has not yet had a significant impact on the running of the home, Care Homes for Older People Page 24 of 29 Evidence: this can only be a short-term arrangement before it effects the management and supervision of staff. A representative of the new provider visits the home frequently to check on its progress. At this time the reports of their visits (called regulation 26 reports) were not available within the home. There are no formal Residents Meetings at this time as there are only 7 residents and so they have opportunities to comment and make suggestions about the home on a daily basis. The manager indicated that the provider is likely to use surveys as part of its quality assurance processes towards the end of the first year of its operations. The home encourages residents (or their representatives) to manage their own financial affairs. At this time the home does not take responsibility for any residents monies. Health & safety checks are carried out regularly, and there were no health & safety issues noted to the premises at the time of this visit. The temperature of hot water is checked to make sure it is a safe temperature for residents to use. At the time of this visit the records of hot water to baths was not available. It was evident from records that contracted professional servicing takes place for utility systems, fire systems, and the lift. Records also show that all staff receive inhouse fire instruction at the required intervals so that they are regularly reminded of the action to take in the event of a fire. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 When the new service users guide is ready a copy should be given to each of the current residents so that they have information about the new provider. It would be better if the pre-admission assessment records are signed and dated to show when the assessment was carried out. It would be better if details about how to support people were in the action plan of the care plan not in the evaluation records. It would also be better if the full date was recorded on evaluation records. It would be better if the plans about peoples nutrition included what action the home would take if there was a significant change in someones weight. Any cupboards used to store medication should be kept locked at all times. Consideration should be given to replacing the baths, in line with the homes programme of refurbishment and improvement. Consideration could also be given to providing cupboards into these rooms so that personal care equipment is not on display. More steps could be taken to address odour control within Page 27 of 29 2 3 3 7 4 8 5 9 6 21 7 26 Care Homes for Older People the communal toilet on the ground floor. 8 9 28 31 Staffing levels should be reviewed and increased as the number and needs of residents increase. As the occupancy increases there should be sufficient supernumerary management hours built into the rota to allow the manager to carry out the many assessment, supervisory, review and administrative tasks involved in the management of the home. It would be better if copies of the provider-visit reports were available in the home for reference. 10 33 Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!