Inspection on 02/02/06 for Royal Court

This inspection was carried out on 2nd February 2006.

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

Royal Court 28/09/09

Royal Court 07/10/08

Royal Court 25/09/07

Royal Court 13/02/07

Royal Court 15/05/06

Royal Court 16/06/05

Royal Court 23/11/04

Royal Court 19/05/04

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Hawkhills

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Royal Court Rock Mount King Street Hoyland Barnsley South Yorkshire S74 9RP Lead Inspector Mrs Jayne White Unannounced Inspection 2nd February 2006 08:45 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 Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 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. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Royal Court Address Rock Mount King Street Hoyland Barnsley South Yorkshire S74 9RP 01226 741986 01226 741986 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) Healthmade Limited Mr Neil Bennett Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total persons who can be accommodated at the home cannot exceed 40 Persons accommodated shall be aged 60 years and above Staffing levels will be determined using the Residential forum for Care Staffing in Care Homes for Older People. 16th June 2005 Date of last inspection Brief Description of the Service: Royal Court is a care home providing personal care and accommodation for 40 older people. The home is a purpose built single storey building. Royal Court is located in Hoyland within the Barnsley area and is close to the shopping centre and a doctor’s surgery. All bedrooms are for single occupancy and have en-suite facilities. An enclosed garden area is provided. There are car-parking facilities at the front of the building. The homes registered owner is Healthmade Limited. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven and a half hours from 8:45 to 16:30. Opportunity was taken to make a partial inspection of the premises, inspect a sample of records, observe care practices and talk to residents, relatives, staff and two directors of the company. The majority of residents and staff were seen during the inspection and the inspector spoke in more detail to four of the staff on duty about their knowledge, skills and experiences of working at the home, six residents about their views on aspects of living at the home and two relatives. The manager who had commenced on 1 August 2005 had resigned from his post. Also, since the last inspection, the CSCI have approved an application, submitted by the home, to vary their registration so that only residents requiring personal care will be admitted. What the service does well: What has improved since the last inspection? Care plans were in place for residents residing at the home. Liquid soap, paper towels and toilet paper were consistently provided in all toilet areas. Staff were having supervision. On the whole fire extinguishers were wall mounted on brackets. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 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 Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The outcomes for standards 1 and 2 were inspected. The service user guide did not contain all the required information for prospective residents’ to have the information they need to make an informed choice about where to live. Permanent residents were provided with the details of the terms and conditions of their stay, but this did not contain the fee to be paid and bedroom to be occupied. Short stay residents were not given a contract/terms and conditions. EVIDENCE: The home did have a service user guide and contract for residents; however, they did not contain sufficient information for prospective residents’. Permanent residents had been provided with the terms and conditions of their residence, but the fee continued not be identified and the bedroom number. The directors informed the inspector terms and conditions/contract were not given for people who stayed at the home on a short-term basis. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 9 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): The outcomes for standards 7, 8, 9 & 10 were inspected. All residents had an individual plan of care where their health, personal and social care needs were identified, but omissions, inaccuracies and lack of detail were evident. Documentation identified residents were provided with access to health care services to meet their health care needs, but the hygiene needs of some residents were not met in a timely fashion. The detail of administration and recording of some medication required improvements to ensure that the administration details and records reflected accurately what had taken place. There were occasions when the privacy and dignity of residents were compromised. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 10 EVIDENCE: One resident’s plan of care was inspected. The care plan pack provided an initial guide of residents’ needs and contained some comprehensive information, however, the detail was not consistently added to the care plan, reviewed appropriately and updated and the records of action taken to meet the resident’s needs did not always correlate with the care plan and other records. For example, review of the falls risk assessment, the care plan saying weigh weekly which contradicted with information in the nutritional risk assessment and insufficient information being recorded for when supplement drinks should be provided. One resident’s medication was inspected on a sample basis. An audit of the medication was unable to be carried out as medication carried forward from one month to another had not been consistently carried forward and did not correlate with medication remaining. In addition, there was some medication that was being recorded as refused but this was not an accurate reflection of what happened, likewise, for the administration of that medication. Medication requiring refrigeration was securely stored. There was a resident who selfadministered their own medication and this was securely stored. There were areas where the privacy and dignity of residents was respected, for example, knocking on residents’ doors before entering and closing toilet doors when in use, however, there were times when the personal hygiene needs of residents were not met in a timely fashion and this compromised the dignity and respect of those residents. In addition, a resident and a member of their family identified they weren’t always spoken to appropriately by members of staff. See also complaints and protection. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 11 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): The outcome for standard 12 was inspected. Residents’ spoken with who were able to make judgements about choices and decisions said they were enabled to do so and that they were generally happy with their lifestyle within the home. EVIDENCE: Comments made by residents and/or advocates about the lifestyle at the home included “staff very obliging”, “staff very attentive and pay you good attention”, “it’s been much better since the new manager”, “we’ve had lots of things going off and trips out” and “it’s not like being in prison – you can do what you like”. Residents’ spoken with described how they could choose to spend their day and confirmed that they could choose what time to get up and go to bed. Residents seemed inspired and motivated by social events and the improvement in food since the new manager had been appointed. This was described by them and noted in the newsletter for residents and their families introduced by the manager and included events such as bonfire night, going to the Xmas market and Elsecar Heritage Centre, celebration of birthdays, Xmas Fayre and entertainers including a brass band. The majority of residents were observed to spend time in the lounges with the television on, but there were others who spent time on their own in their own room. Personal items and furniture were brought into the home by residents to personalise their rooms. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 12 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): The outcomes for standards 16 and 18 were inspected There were complaints and protection of vulnerable adults policies in place, but it was clear that there were some practices operated by staff that did not uphold the principles and values of those policies. EVIDENCE: The complaints procedure identified in the service user guide was resident friendly, comprehensive, but did not include the telephone number of the CSCI. There had been no record of any complaint since the last inspection. An adult protection policy was in place and the home had copies of both Barnsley and Rotherham’s local multi agency procedures for the protection of vulnerable adults. Staff spoken with had, had training in protection of vulnerable adults and were able to describe how they would report abuse if they became aware of it. On recruitment, staff were appropriately checked against the’ Protection of Vulnerable Adults Register’. The directors said there had been no allegations of abuse. Residents spoken with did not express any complaints as such but one resident identified they didn’t like living at the home because of how some staff spoke to them. The words used were humiliating for the resident and did not demonstrate the resident was treated in a respectful manner. In addition, there were times when the personal hygiene needs of residents were not met in a timely fashion, which was humiliating and degrading for the residents involved and did not fully respect the residents dignity. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 13 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): The outcomes for standards 19 and 26 were inspected. The building and its environment were generally clean, but housekeeping of the environment needed to improve, together with some of the furnishings and fittings. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 14 EVIDENCE: Room’s sizes met the minimum recommended and all accommodation was provided in single rooms. There were sufficient rooms for activities to take place. There was appropriate storage space for aids and equipment. The home had sufficient baths, showers and toilets and these were close to bedrooms, lounges and dining areas. There were appropriate aids and adaptations e.g. raised toilet seats, grab rails, bath hoists. The furnishings and fittings were on the whole domestic in character, but there were areas that were not of an adequate standard, for example, the main lounge area had areas where pieces of wallpaper had been torn from the wall, the entrance carpet was marked and stained, all chairs except the settee in the smoking area were either marked, frayed, torn or had sponge protruding from them and occasional tables were worn and stained. Housekeeping arrangements needed attending to as a bath had not been rinsed out after use and on the side of the bath was a toothbrush, shaving brush, nail brush, loofers and cushions piled behind a plastic chair. Continence wear and dressings had been left on resident’s bedroom floors. Laundry facilities were situated away from all food preparation and storage areas. Liquid soap and paper towels were consistently available in all toilet areas. Carers were observed using gloves and aprons, which would assist with the control of infection. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 15 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): The outcomes for standards 27, 28, 29 and 30 were inspected. The residential staffing forum calculation, the method used to calculate staff hours, identified the staff hours provided were sufficient to meet the assessed needs of residents. Comments made by residents and observation by the inspector identified there may be times when this is not appropriately distributed or the level of dependency used in the calculation is not accurate. Although there had been improvements in the recruitment information obtained for new staff it remained insufficient to adequately protect the welfare of residents who lived at the home. The minimum ration of 50 of care staff trained to NVQ Level 2 in Care or equivalent had been achieved and there was staff training to equip staff with the knowledge and skills for their roles within the home. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 16 EVIDENCE: The application to vary registration had been approved to include a condition of registration to use the Department of Health’s recommended staffing forum guidance for staffing levels. The directors’ were not familiar with the current dependency and so the last calculation completed by the manager on 23 December 2005 was amended to accommodate residents in hospital. The total care hours recommended was 625.38. The staffing rota for the week was calculated at providing 609 hours. Resident comments about staff and staffing levels included “staff very obliging”, “breakfast could be earlier”, “worst thing is shortage of staff – worse on a morning”, “staff all right – good girls”, “pay good attention to you, very attentive”, “if you use buzzer, they’re there straight away” and “staff lovely – can’t do enough”. The home employed ancillary staff, but there was only a cook on duty until 14:00, therefore carers were responsible of kitchen duties at tea and supper time. Inspection of one staff file identified there had been improvements in the recruitment procedure, however, it still did not contain all the information required by the regulation and standards including documented evidence of a full employment history with written explanation of gaps in employment, confirmation of qualifications obtained and that the General Social Care Council Code of Conduct had been provided. Fifty per cent of staff had obtained NVQ Level 2 in Care or equivalent. Discussions with staff and inspection of training records identified they had, had a range of training including essential skills for health and care, food hygiene, emergency first aid, basic medicines, moving and handling, infection control, tissue viability, NVQ 1 Cleaning and Support Services, health and safety and fire safety and awareness. Staff’s training records did not include dates of when training was completed and the content of the training. See also management and administration. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 17 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): The outcomes for standards 33, 35, 36, 37 and 38 were inspected. The manager employed by the home on 1 August 2005 resigned from their position on the 23 January 2006. Observations of care practice, housekeeping and the furnishings and decor demonstrated a manager was required to run the home on a day-to-day basis to meet its stated purpose and aims and objectives. Methods to consult residents and relatives for them to express their views on the home and for the home to measure their own success in meeting their aims and objectives identified in the statement of purpose had been established, but needed refining to include the action taken to meet the findings. Systems were in place to deal with monies/valuables held by the home on behalf of residents’ that safeguarded residents’ financial interests. Staff were having supervision. Resident’s rights and best interest could be placed at risk by the homes failure to maintain all records adequately. Some areas relating to health and safety issues required attention, in order to maintain the safety and welfare of both residents and staff. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 18 EVIDENCE: The manager employed by the home on 1 August 2005 resigned from their position on the 23 January 2006. Observations of care practice, housekeeping and the furnishings and decor demonstrated a manager was required to run the home on a day-to-day basis to meet its stated purpose and aims and objectives. As an interim arrangement the two directors’ said they would be managing the home on a day to day basis until a manager has been appointed. The manager had completed work on methods to consult residents and relatives for them to express their views on the home and for the home to measure their own success in meeting their aims and objectives identified in the statement of purpose had been established. These included resident and relative meetings, resident and relative questionnaires, newsletters and a suggestion box in the entrance hall. Minutes of residents’ meetings and questionnaires identified where the residents and relatives were not satisfied with the service but the action taken to meet the findings was not identified. Discussions with staff confirmed supervision took place. The directors stated they did not act as appointees for residents, they only held monies given to the home for safekeeping by residents. Monies held by the home for two residents were inspected. Monies withdrawn/deposited correlated with records kept. The procedure for dealing with any monies consisted of two signatures when financial transactions were made and audited and receipts. Records of residents’ possessions were kept. Secure facilities were provided for the safekeeping of money and valuables kept on behalf of residents’. A sample of the records that the home was required to keep was inspected. Comments and requirements with reference to these are made throughout this report. Maintaining the required records and keeping them up to date and accurate demonstrates how residents’ rights and best interests are being maintained. Not all resident records were stored securely, which compromised residents’ confidentiality. There were appropriate measures in place to ensure the security of the premises and prevent intruders. Inspection of the building identified fire exits were free from obstructions and when a sample of fire training and drills for staff were inspected they were noted to have been completed. Fire extinguishers, the gas system, hoist and fixed wiring had been serviced. The residents’ safety and welfare were not wholly safeguarded as although staff training records identified staff had undertaken moving and handling training they were observed linking arms with residents and moving residents by putting their arms underneath their shoulders. These are not safe working practices. Portable electrical appliances had not yet been completed but the director demonstrated a person had been trained to do this and a kit to complete it had been bought. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 19 Servicing of the emergency lighting was out of date. Recorded water temperatures identified that since 18 October 2005 the water temperature had not been close to forty-three degrees centigrade the recommended temperature for hot water. Creams and steradent were found insecurely stored in residents’ rooms, which could compromise the health and welfare of residents. The creams did not belong to the resident who occupied the room. In addition, the medical room was found left open. Sharps disposal and residents’ records were on the work surface and cupboards did not have locks and held creams and dressings, which were also not stored in an orderly manner. This did not promote the health and welfare of residents and maintain their confidentiality. Notifiable incidents were reported as required. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 20 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 2 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 3 2 1 Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 21 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 OP1 Regulation 5 Requirement The service user guide must contain all the information required by the regulations. Previous timescales of 31/03/05 & 31/10/05 not met. All residents who stay at the home must be provided with a contract/terms and conditions of their stay including the fee to be paid and who will pay the fee. Care plans must accurately reflect the care that is to be provided, including the action to be taken by staff to meet the residents’ health and personal care needs and remain up to date. Residents’ personal hygiene needs must be met in a timely manner. Staff must always speak to residents in a respectful manner. All residents must be asked about how they are spoken to by staff and the results documented. The outcome of those findings must be acted upon and reported to the CSCI. DS0000006497.V281460.R01.S.doc Timescale for action 30/04/06 2 OP2 5 & 17 30/04/06 3 OP7 OP8 15 30/04/06 4 5 6 OP10 OP8 OP18 OP10 OP16 OP18 OP10 OP16 OP18 12 & 13 12 & 13 12, 13 & 24 30/04/06 30/04/06 30/04/06 Royal Court Version 5.1 Page 22 7 OP9 13 8 9 OP19 OP19 12, 13 & 23 16 & 23 10 OP29 19 11 12 OP31 OP33 8 24 13 14 15 OP37 OP37 OP38 17 17 13 16 OP38 13 17 18 OP38 OP38 12 & 13 13 The recording of the administration of medication must accurately reflect what happens in practice. All parts of the home must be left clean, tidy and safe. The main lounge area must be redecorated. The entrance carpet must be replaced. All chairs in the smoking area must be replaced. Recruitment of staff must comply with regulation requirements. Previous timescale of 31/08/05 not met. A manager must be appointed to manage the home. The methods used to identify stakeholder’s satisfaction of the service, must include the findings of those consultations and how any improvements required will be met. All records holding information about residents must be securely stored. Records as required by the regulations must be maintained, up to date and accurate. Safe moving and handling procedures must be undertaken at all times. Previous timescale of 31/08/05 not met. All electrical appliance equipment must be appropriately tested. Previous timescales of 31/08/03, 01/09/04 & 31/08/05 not met. Water temperatures must be maintained close to 43 degrees centigrade. All hazardous equipment and substances must be securely stored. 30/04/06 30/04/06 30/09/06 30/04/06 30/06/06 30/06/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 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 Refer to Standard OP27 Good Practice Recommendations That the accuracy of the dependency of residents and/or the distribution of staff hours allocated using the staffing forum calculation are readdressed. Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Royal Court DS0000006497.V281460.R01.S.doc Version 5.1 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!