Inspection on 29/09/05 for Markfield Court Care Centre

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Markfield Court Care Centre 18/09/08

Markfield Court Care Centre 20/06/07

Markfield Court Care Centre 16/11/06

Markfield Court Care Centre 23/06/05

Markfield Court Care Centre 14/02/05

Markfield Court Care Centre 27/07/04

Markfield Court Care Centre 17/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Markfield Court Ratby Lane Markfield Leicestershire LE67 9RN Lead Inspector Mrs Gillian Adkin Unannounced Inspection 28th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 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. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Markfield Court Address Ratby Lane Markfield Leicestershire LE67 9RN 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) 01530 242595 01530 244287 Markfield court@ashbourne.co.uk Ashbourne Life Ltd Vacant Care Home 85 Category(ies) of Old age, not falling within any other category registration, with number (85), Physical disability over 65 years of age of places (85) Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To be able to admit the named person of category PD as identified in correspondence with the previous registration authority dated 5th July 2000. To be able to admit the named person in variation application number: 48891 of category DE (E) into the home. To be able to admit a named person in category DE (E) (a person with dementia over the age of 65) application number V11239. 23rd June 2005 Date of last inspection Brief Description of the Service: Markfield Court is a care centre with provision for nursing and personal care. It is registered to accommodate up to eighty-five service users falling within Older Persons (OP) or Physical Disability (PD) Category over 65 years of age. The home is a traditional building which was formerly the nurses’ accommodation for the old Markfield hospital. It is located close to the A 50 and M1 junction 22 on the outskirts of Ratby and Markfield and is close to the towns of Coalville and Loughborough Leicestershire. It is easily accessed by public transport from the City of Leicester. The Care centre is an attractive and distinctive centre set in very large attractive and mature grounds of approximately five acres. The care centre has a custom designed woodland walk which is accessible to mobile service users. Grounds are mainly lawn and woodland and a retirement village, which has a bus service, further enhances the centre. Accommodation is located on three floors, which can be accessed by a shaft lift. The home has forty-five single bedrooms and twenty double bedrooms many are ensuiteand some open directly onto the garden. The home offers numerous lounges and dining rooms and specialised bathing facilities are available throughout the three floors of the home and it has access to the facilities of a social centre attached to it which is shared with the retirement village complex. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected against the Regulations as in the Care Standards Act 2000. This was an unannounced inspection, which took place over one day and commenced at 9.30 am on 29/09/05.The inspection took 8 hours. The nurse in charge facilitated the inspection in the manager’s absence. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they received through review of their records, discussion with them, and their relatives, care staff and observation of care practices. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. During this inspection a tour of the accommodation occupied took place and the inspector viewed internal records, and care plans. The inspector spoke to residents, nurses, care and ancillary staff, and relatives. Comments were received from seven residents including those selected for case tracking. Additional comments made by residents about the service were mostly positive. What the service does well: A homely environment is provided for service users. Staff are provided with training, which is relevant to residents needs. Residents are fully supported in maintaining spiritual needs, regular church services are held in the home. All staff working in the home are friendly and appear professional in their approach towards service users. Residents and visitors spoken with spoke highly of the staff employed at the home. Visitors also said they felt welcome at the home and could visit at anytime. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 6 The inspector observed interactions between staff and residents and found these to be positive and respectful. Staff spoken with demonstrated a good understanding of their roles; they possessed very caring attitudes and were obviously working towards serving the best interests of the residents. Service users are encouraged to attend activities in the social centre which is part of the retirement village, this includes a weekly get together in the bar and on the day of the inspection many service users attended a tea dance. What has improved since the last inspection? What they could do better: Discussions with the maintenance person indicated that he would welcome discussion with senior managers when they visit the home where he could express views directly regarding maintenance and health and safety issues. A more regular programme of activities and a full time activities organiser would improve the outcomes for service users. Discussions with care staff indicated that they would benefit from training in relation to mental ill health and behaviour management. The security of service users personal possessions could be improved by locking of bedroom doors when the individual is in hospital. The outcomes for service users and staff could be improved by the releasing of the top windows (which are stuck due to being painted) to allow more ventilation. The outcomes for service users could be improved by ensuring that where a service user is nursed in bed they are able to see their television and that where required appropriate furniture/fittings are put in place to elevate the TV i.e. wall brackets. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 7 The outcomes for service users could be improved by ensuring that their TV’s are adjusted to ensure that the pictures are as clear as possible. 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. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents have their needs assessed prior to moving into the home, this ensures that residents needs can be met. EVIDENCE: Four service users were selected for case tracking. Three out of four care records included all relevant assessment information including risk assessments. Where applicable social worker assessments and care plans were in place. One assessment was however noted to only be partially completed. It was therefore difficult to ascertain if the care plan was accurate. A new moving and handling policy was seen and staff had signed to state they were aware. One service user stated that the manager “came to see me in hospital” Two of the four-service users case tracked could not remember being assessed prior to admission (due to their medical condition) one service user was in hospital. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10 Resident’s health, personal and social care needs were being met. Safe medication administration procedures were in place, therefore risk was minimised. EVIDENCE: Care plans for four service users were inspected; these appeared to address most assessed needs. Care plans tracked were fully audited by night staff on 18.09.05. Assessments were in place for the risk of falls and for developing pressure sores. Records were seen of GP and community nurse visits. Daily records and wound management plans were reflective of care given and outcomes Administration records for the four case tracked residents were seen and appeared to be in good order. Discussion with staff demonstrated that they were fully aware of care needs and were kept up to date by trained staff at handovers. Two staff stated that if they needed to know anything they would look at the care plan. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 11 Residents spoken with said that staff administered their medication accurately and on time. Residents praised the staff employed and felt they were treated with respect and their privacy and dignity maintained. Although concerns were raised by a relative regarding certain aspects of care provided, these were discussed with the manager who agreed to action after the inspection. Medication is administered by qualified nurses and trained care assistants; the acting manager or senior sister assesses their competency, although due to the managers absence during the inspection training records were not seen. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Service users are satisfied by routines which enable them to maintain control and experience a lifestyle which matches their expectations and best interests. EVIDENCE: Two-service users case tracked were able to voice their opinions regarding the lifestyle they experienced in the home. Overall residents appeared to be happy and content with the systems and routines of the home. Residents indicated that staff were friendly and professional and that they had key workers to help with personal issues such as shopping etc. One service user said she “gets on well with the manager who is very pleasant” A new service user said” staff are very kind” At the time of the last inspection the activities programme had been reduced due to the activities organiser being on long-term sick leave. A part time organiser undertakes activities three days per week and external entertainers occasionally visit the home. Service users can take part in activities connected to the retirement village such as bowls or the tea dance, which was taking place on the day of the inspection. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 13 The activities programme is on display in the foyer this details activities by staff on Weds and Thurs each week. Staff spoken with stated that they are not able to do activities due to the dependency and needs of service users for whom they are caring. An activities questionnaire had recently been circulated and completed by service users detailing their preference of activities. Discussions with service users regarding the current programme indicated that although external entertainers and trips were arranged few could participate in them. A number of residents indicated that external trips were limited due to lack of drivers for the bus. Service users spoken with confirmed that their visitors were always made welcome and visiting was unrestricted Three of the four service users tracked did not take part in activities and one was in hospital. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 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 inspected at least once during a 12-month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18 Complaints are taken seriously and acted upon. Staff have a good understanding regarding the prevention of abuse, this ensures that service users live in a safe environment and are protected from possible abuse. EVIDENCE: Robust complaints and adult protection policies in line with national guidelines were in place. Complaint records were up to date information received indicated that all had been satisfactorily resolved. Robust adult protection policies and procedures are in place, which are included in the initial induction and foundation programme for staff. When questioned about reporting alleged abuse, staff were aware of the whistle blowing policy and procedure. One service user case tracked was in hospital and it was noted that her bedroom door was unlocked the home were advised to locks doors whilst the occupant was not in the home. Service users and visitors spoken with said they would to complain to the home’s manager or a senior member of staff if they were unhappy about any aspect of the service. The company complaints procedure was displayed on the home’s notice board. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19.20.24.25 Overall the home is warm, clean and comfortable and premises are satisfactorily maintained resulting in a satisfactory living environment for service users. Appropriate action to maintaining recommended water temperatures would ensure comfort when bathing. EVIDENCE: Discussion with the maintenance person and observation of records indicated that routine checks are undertaken according to Ashbourne maintenance policy and procedure. Records seen were up to date although water temperatures were recorded regularly below the recommended 43 degrees Centigrade at point of delivery. Jacuzzi baths were recorded at between 35-38 degrees Centigrade. Three fire drills have taken place during 2005 and staff and service users including a new service user indicated that they were aware of when the fire alarm was tested and the correct procedure to follow. Observation of information supplied by the registered provider indicates that all service contracts and testing are up to date. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 16 An inspection of accommodation took place in particular regarding those service users case tracked. Although some of the rooms occupied were smaller than other, rooms were noted to be clean and well maintained and contained items of personal furniture and possessions. One service user tracked was nursed in bed, observation of this room identified that due to the use of bedrails he was unable to see his television satisfactorily as it was situated on a low bedside locker. A number of service users were noted to be watching television in their rooms. The TV picture was snowy on all sets and it was indicated by them that the picture was always unclear. Communal areas and individual bedrooms were found to be clean and comfortable although one service user stated that she found her room (which was very large) to be rather cold at times. Staff commented on the temperature on the upper floors and considered that the working environment would be much better if the windows, which were stuck with paint, could be released to allow better ventilation. The manager has ordered new bedding and curtains for bedrooms and communal areas and two dining rooms have been redecorated and carpeted since the last inspection. Some minor decoration was still required to paintwork (middle floor) and flooring in the middle floor toilet had not been either repaired or replaced as discussed at the last inspection. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12-month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27.29 A thorough recruitment and induction process and sufficient numbers of suitably skilled and trained staff ensures that the needs of service users are fully met. EVIDENCE: The duty roster for the week in which this inspection took place was inspected. At the time of this inspection sixty-three residents were living in the home. At least two qualified nurses are on duty during the day, there were nine care staff on duty during the morning, six care staff in the afternoon/evening and four care assistants at night. The acting manager is supernumerary and the residential manager has one supernumerary day per week. Staffing hours calculated indicated that the home was meeting the minimum staffing hours as recommended by the previous registration authority, however suggested hours as detailed in the Residential Forum Guidelines recommended that a higher level of staff may be required particularly when considering the layout of the building and the dependency levels of service users accommodated Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 18 After this calculation took place the home appear to have a deficit of approximately 9.42 hours per day. Staff said there were regular shift shortages it was however indicated that the manager and senior nurses are usually successful in covering from within internal staff. The location of the home is a factor in staff recruitment. Staff indicated that there was little time on a shift to talk to service users or provide anything other than basic care needs. Residents spoken with felt that staff responded to their needs in a satisfactory and timely manner. It was suggested at the last inspection that two domestic staff at weekends would ensure the home remained adequately clean. Rosters seen indicated that only one domestic was working on Saturdays and Sundays to cover all of the three floors. This is considered inadequate considering the size and layout of the building. Discussion with domestic staff indicated that it was very difficult to complete work when only one person was working at the weekend. Four Staff files were inspected all essential documentation was noted to be in place. Although two members of staff recently appointed were unable to obtain two references the home had put in place a work based assessment to satisfy themselves of the person’s suitability. This is in accordance with company policy, which was inspected. All staff files contained evidence of induction. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33.35.37.38 The health, safety and welfare of service users are protected by systems and procedures being in place. The home is run to ensure that the best interests of service users are safeguarded. EVIDENCE: Good evidence was found to suggest that service users views are sought regarding the running of the home, discussion with service users indicated that the manager regularly visits them and asks their opinions and a survey was found regarding activities and service user views on improving them. Minutes were seen of a recent staff meeting and service users meeting both held in September. The administrator said that an annual survey is completed but to date this had not been undertaken this year. Discussions with the administrator took place regarding the management of service user finances and it was evidenced that an internal non profit making Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 20 system is in place where service users may deposit money. Records seen were appropriately managed and service users who were involved stated that money was available to them when required. Policies and Procedures require that money held is reconciled two weekly records demonstrated this was happening The service user guide fully details roles and responsibilities regarding storage of money and valuables but does not detail management of risk associated with service users who wish to keep money on their person. Most service users case tracked either managed their own finances or a family representative assisted. Staff spoken with indicated that they were aware of the policies and procedures regarding their involvement in personal affairs of service users. Discussion with the maintenance person and observation of records indicated that routine checks are undertaken according to Ashbourne maintenance policy and procedure. Records were noted to be stored on each floor in offices, which although having doors were not locked and therefore not appropriately stored in view of the confidential nature of their contents. Three fire drills have taken place during 2005 and staff and service users including a new service user indicated that they were aware of when the fire alarm was tested and the correct procedure to follow. Observation of information supplied by the registered provider indicates that all service contracts and testing are up to date. All staff spoken with had received manual handling training during induction; moving and handling practises were observed and appeared to be safe. Nine staff have a first aid qualification. Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 3 X STAFFING Standard No Score 27 2 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? 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 OP2727 Regulation 18 Requirement The registered provider must review the current numbers of ancillary staff at weekends to ensure that numbers provided are suitable to ensuring the environment is sufficiently clean. The registered provider must revisit current staffing levels provided to ensure that staffing of the home is appropriate to the needs of individuals currently accommodated. Additional staff must be provided where it is considered that insufficient staff are rostered to meet needs. Service users moving and handling needs must be assessed and documented within at least 24 hours after admission or as directed by company policy The registered provider must make suitable arrangements to ensure that records are kept securely on each floor i.e. facilities to lock the office where they are stored Timescale for action 17/11/05 2 OP2727 18 17/11/05 3 OP33 14 17/11/05 4 OP3337 17(1)(b)( a) 17/11/05 Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP18 OP25 Good Practice Recommendations It is recommended that bedroom doors be locked when a service user is in hospital or away from the home in consultation with the individual. It is recommended that suitable arrangements are made to ensure that water temperatures in baths and at hand basins are sufficient to be warm enough to take a wash/bath at a comfortable temperature which does not exceed the recommended guidelines. It is recommended that attention be given to television sets to ensure that service users have a reasonable picture when in their own rooms. It is recommended that attention is given to the siting of televisions where service users are nursed in bed with bedrails and cot bumpers to ensure they can see appropriately and that TV’s are in the optimum position for viewing. It is recommended that Records relating to the management of service user finances, including the service user guide fully detail the roles and responsibilities relating to persons who wish to keep money on their person. It is recommended that the registered provider provide the staffing hours as recommended by the Department of Health Residential Forum and considers the size and layout of the home when making these considerations. 3 4 OP20 OP20 5 OP37 6 OP27 Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 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 Markfield Court DS0000001917.V252845.R01.S.doc Version 5.0 Page 25 - 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!