Inspection on 26/01/06 for Silverdale

This inspection was carried out on 26th January 2006.

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

Silverdale 18/04/07

Silverdale 31/08/05

Silverdale 24/02/05

Silverdale 18/08/04

Silverdale 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Silverdale 20 Bents Avenue Bredbury Stockport Cheshire SK6 2LF Lead Inspector Kathleen Mcall Announced Inspection 10:00 26 & 30th January 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silverdale DS0000008572.V273804.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. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Silverdale Address 20 Bents Avenue Bredbury Stockport Cheshire SK6 2LF 0161-430 5010 0161 430 5019 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) Borough Care Limited Mrs Maureen Hayes Care Home 47 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (47) Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The ratios of care staff to service users must be determined according to the assessed needs of residents and in accordance with guidance issued by the Department of Health. The home is registered for a maximum of 47 service users to include: *up to 28 service users in the category of DE(E) (Dementia over 65 years of age) *up to 47 service users in the category of OP (old age not falling into any other category). *up to 4 service users in the category MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. 3. Date of last inspection Brief Description of the Service: Silverdale is a purpose built residential care home that is registered to provide care for up to 47 older people over the age of 65 years, including 28 residents who have a diagnosis of dementia and 4 residents with a diagnosis of mental disorder. Silverdale provides permanent residential care services and day care services. The home is one of 12 homes owned by Borough Care Limited. The registered manager is a Mrs Maureen Hayes who has been in post since the 1st April 2005. Accommodation comprises of 47 single bedrooms, 19 of which have en suite facilities. The home is divided into four units each has its own lounge, dining room and kitchen area. Several smaller seating areas are situated around the home and provide quiet private areas for service users and visitors. Day care facilities are available for up to five services users each day, Monday to Sunday. Day care service users have their own lounge and dining room facilities on the ground floor of the home. The building is suitable for wheelchair service users and has a passenger lift to assist service users to the first floor. There is a good-sized garden area with a pond and patio areas for service users use. Silverdale is situated in the Bredbury area of Stockport. It is close to the motorway network and public transport is easily accessible. There are a number of shops, post office, chemist and churches all within walking distance. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over the course of a day and a half. The registered manager and the deputy manager assisted the inspector throughout the inspection process. Care plans, assessment documentation, medication and its storage were examined. The inspector spoke with a number of residents in the home, a visiting relative and staff that were on duty at the time of the inspection. Twelve service user comment cards were returned; eleven cards indicated that residents like living at the home and one responded no that they did not like living at the home, however all twelve cards indicated that residents felt well cared for. Eleven residents said that staff treated them well and one resident said that sometimes staff treated them well; with all twelve cards indicating that residents’ privacy was respected. Eight residents indicated that they liked the food and four said that they sometimes liked the food. The inspector spoke to several residents all of whom said that the food provided at the home was very good and that a good variety was provided. Ten residents cards said that the home offered suitable activities, one said that sometimes suitable activities were provided and one responded no. Ten residents said they knew who to talk to if they had a problem, one responded no and one resident did not provide an answer to the question. One resident told the inspector, ‘I am very happy and comfortable’. Another said, ‘they look after you very well, they provide nice food and the home is very clean’. Seven relatives comment cards were returned; all seven indicated that they were satisfied with the overall care provided and none of them had made a complaint, however only six were aware of the home’s complaints procedure. All seven said that they were made welcome at the home at any time and that they were kept informed of important matters concerning their relatives. All seven cards indicated that they felt there was always a sufficient number of staff on duty. One resident did inform the inspector that her relative had written to Borough Care regarding the levels of staff on the first floor in the morning and breakfast period. Staff interviewed as part of the inspection also felt that staffing levels at the home had improved. Comments from relatives included, ‘I think the care is very good’. ‘My sister and I are very pleased with the standard of care and cleanliness at Silverdale’. ‘The home provides excellent care and the staff are always helpful and friendly’. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection care plans had improved and provided detailed information about a residents care and health needs and how these should be met. Residents told the inspector that they were very satisfied with the way in which the home met their needs. Day care facilities had been re-sited to the ground floor and day care service users told the inspector that they preferred to be on the ground floor and felt much more included in the day to day routine of the home. Staffing levels and staff rotas had been reviewed since the last inspection and both residents and staff reported that overall the staffing in the home had improved. Several residents told the inspector that in their opinion there was always a sufficient number of staff on duty. Temperatures in areas of the home where medication was stored were now monitored on a regular basis to see if there was a problem in these areas. Risk assessments for residents who preferred to manager their own medication had been put in place since the last inspection and these were reviewed on a weekly basis. Residents were enabled to make choices. Residents meetings were held on a regular basis and during a recent residents meeting, residents expressed a preference to sit together during mealtimes. Consequently the dining and Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 7 living areas on the first floor had been restructured according to service users preferred choices. A member of staff now had specific duties and responsibilities for laundry arrangements at the weekends. However this is only alternate weekends. Staff reported that they still had ironing responsibilities and they felt this kept them from delivering care to service users. The manager was aware of this and will continue to review the situation. A number of new employees had been recruited to the home to meet the increased number of residents; employment files contained all relevant documentation, which ensured that residents were protected. All care staff including casual staff now received regular supervision. 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. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 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 Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 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): 2, 3 and 4. Service users care needs were fully assessed before admission and they were satisfied with the care provided. EVIDENCE: Service users admitted to the home had a written contract which detailed the terms and conditions of their stay. Several new service users had been admitted to the home since the last inspection. As part of the inspection a selection of service user files were examined. These contained a sufficient amount of assessment information in respect of each service user. It was the practice of the home that service users were assessed prior to their admission. Assessments were obtained from social workers and health professionals if they had been involved in the admission and no service users were admitted to the home without their care needs having been assessed. Borough Care had its own assessment documentation called the “key-working together document”; which should be completed for all new service users. The inspector examined five such documents and found that three had not been Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 10 signed or dated by the service user or the member of staff completing the document. One file did not contain a key working together document and one was signed and dated by both the service user and the staff member. The registered manager advised the inspector that service users sometimes refused to sign the assessment. Service users told the inspector that they were quite satisfied with the way in which the home met their care needs. The needs and preferences of service users were recognised and met by care staff. Care staff demonstrated a good understanding of service users care needs. One relative told the inspector that he felt care staff had a good understanding of his wife’s care needs and that he was very satisfied with the standard of care provided. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 11 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 and 10. Service users health and personal care needs were identified in care planning and met by staff. EVIDENCE: At the last inspection the home had been given a requirement in respect to service users care plans. The registered manager was required to review all service user care plans and to ensure that the plan illustrated how the home was meeting all of a service users needs. At the time of this inspection is was observed that care plans had improved considerably and that all aspects of a service users care were addressed in the care plan including mental health and medication needs. Care plans were stored in one accessible folder along with risk assessments, moving and handling assessments, weight charts, daily records and a review sheet. Care plans were reviewed on a monthly basis and any changes needed were made. There was evidence that as far as it was possible care plans were drawn up with a service user and their relative. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 12 Silverdale had specialist equipment in place to meet the needs of service users living there. The home was fully functional to accommodate and meet the needs of 47 service users. At the time of the inspection 44 service users were resident at the home. Medication was provided in the monitored dosage system, this was stored appropriately and medication records were accurately maintained. The home had a secure dedicated refrigerator for the storage of medication requiring refrigeration; the temperature of this refrigerator was monitored and recorded on a daily basis. Medication was stored in two storage areas in the home, one on the ground floor and one on the first floor. At the previous inspection it was observed that the temperature of the ground floor storage area was extremely hot and it was recommended that the registered manager monitor the temperatures of both storage areas. Since the last inspection the deputy manager had put in place a chart to monitor the temperature of these areas and this will be reviewed on a regular basis. One service user at the home managed their medication. Since the last inspection the registered manager had put in place a new and detailed risk assessment of the service users ability to manage their medication and this was reviewed on a weekly basis. The home accommodated a number of service users who had a diagnosis of dementia. The majority of these service users were unable to comment in detail on the quality of care they received due to their levels of dementia. Consequently the inspector spent time observing the practices of staff and the daily routine of the home and observed that staffs approach towards service users was respectful, sensitive and caring at all times. Other service users who were able to comment on the care they received told the inspector that staff treated them well and they were very satisfied with the care they received. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The day-to-day routine of the home including mealtime arrangements was relaxed and informal and met service users needs and expectations. EVIDENCE: The day-to-day routine of the home was relaxed and flexible with some service users preferring to spend time in their rooms and others using the lounge areas. Service users said they could get up and go to bed at times that suited them and that the day was theirs to spend how they choose to. Staff encouraged service users to make choices about how they spent their time, whether they wished to join in activities or not and what they ate. Residents meetings were held on a regular basis to discuss issues in the home that affected them and as a consequence of one residents meeting the dining room and lounge areas of two units on the first floor had been restructured following consultation with service users who had requested to sit together for all meals. The registered manager intended to review this arrangement on a regular basis as a small number of service users told the inspector that they now preferred the former living arrangement. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 14 At the last inspection service users had expressed some dissatisfaction about not being able to access the garden areas of the home. Whilst this had not been tested since the last inspection due to weather conditions, the registered manager had re-sited the day care residents on the ground floor in a lounge that would provide direct access to the garden areas in the spring and summer months. Two day care service users told the inspector that they preferred the day care lounge being downstairs they felt there was more going on and felt included in the homes day-to-day activities. A member of staff was employed to organise activities within the home for day care service users and service users resident at the home. A structured activities programme was in place. At the time of the inspection service users were making valentine’s cards, music was regularly played for service users entertainment and stimulation and a game of skittles was taking place for service users on the first floor. Visitors were made welcome at the home and service users kept in touch with family and friends. Meals were served at regular intervals and were usually taken in the dining room areas. A hot meal option was offered at both lunchtime and teatime meals with the exception of Sunday teatime when a cold buffet tea was offered. Staff were on hand to help service users with meals. A number of service users told the inspector that they had enjoyed their lunch, one service user told the inspector that the variety and quality of meals offered was very good and that a good. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 15 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 and 18. Service users felt confident that their complaints would be taken seriously and acted upon. Staff had undertaken appropriate training in adult protection, which ensured the protection of service users. EVIDENCE: The home had a detailed complaints policy and procedure; there had been three complaints since the last inspection, two of which were substantiated and one which was partially substantiated. Complaints generally were about standards within the home. Several service users with whom the inspector spoke said that they knew who to complain to if they had a problem and all felt confident that the problem would be resolved in a satisfactory manner. The home had a procedure for responding to allegations of abuse. The majority of staff had completed training in adult protection, new staff completed training in adult protection as part of their induction programme. Staff had a clear understanding of their responsibilities with regard to reporting abuse and poor practice. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. The home was well maintained and provided comfortable living accommodation for service users. EVIDENCE: The home was well maintained throughout and provided comfortable accommodation. A programme of refurbishment at the home was completed in January 2005. The home had nineteen service users bedrooms that provided ensuite facilities. In addition to this there were six bathrooms and a shower room that service users had access to. The grounds of the home were well kept and attractive with a garden pond feature and garden furniture provided for service users use. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 17 occupants, with many of the service users being quite self contained in their own rooms. The home was clean, tidy, bright and airy throughout and was free from any unpleasant odours. The home met fire safety regulations. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The home was sufficiently staffed with a staff group that was trained to undertake their duties, and recruitment procedure ensured that service users were protected. EVIDENCE: At the last inspection a number of service users, relatives and care staff complained about inadequate staffing levels in the home. Care staff felt that the home had got busier since the numbers of service users had increased and that service users care needs were greater. Staff had identified the first floor area of the home as being a particularly busy area, which included day care service users. At the time of the last inspection the inspector observed that staff morale was low. One member of staff had complained that there was no laundry staff at the weekends and that laundry duties were the responsibility of weekend care staff, which took them away from caring tasks. The inspector had observed care staff rushing around and looking flustered. At the time of this inspection the inspector observed that the atmosphere in the home had improved considerably, the home was calmer with staff appearing to be relaxed whilst going about their working routines with service users. The registered manager had put a number of strategies in place to address the staffing issues identified at the previous inspection. Staff meeting were now held on a regular basis, the inspector saw evidence of minutes recorded from such meetings. Staff supervisions were regularly undertaken Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 19 and staff reported that they felt much more supported and that they felt the staffing situation in the home had improved since the manager had reviewed the staffing levels and the way in which staff were deployed around the home. A member of staff had been designated responsibility for laundry duties alternate weekends. Staff reported that despite this arrangement there were still some difficulties at the weekend and care staff had responsibility for service users ironing. The registered manager agreed to monitor the situation. One member of staff told the inspector that if there were problems in covering the units she felt comfortable about approaching the manager, she felt listened to and believed that the situation would be addressed. The reciting of day care service users to the ground floor had enabled staff on the first floor to satisfactorily meet service users needs. A number of new care staff had been recruited to the home since the last inspection; the registered manager had followed appropriate recruitment procedures with regard to newly appointed staff. Care staff on duty at the time of the inspection confirmed that they had undertaken further training to assist them in their role as carers and new staff had completed a period of induction at the commencement of their employment. 50 of the current staff group held an NVQ qualification. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36 and 38. The home was well managed for service users and care staff were appropriately supervised. The health and safety of staff and service users was safeguarded. EVIDENCE: The registered manager, Mrs Maureen Hayes has approximately 25 years experience in working in the residential care sector, she has been the manager at Silverdale since April 2005. She holds a BTEC Higher National Certificate Caring Services (Care Management), and has recently completed the Registered Managers Award. Care staff reported that the manager was approachable and that they felt they could discuss any concerns regarding service users with her. There had been no change to the way in which the home dealt with service users finances since the last inspection. The home did not have any Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 21 involvement with service user finances; these remained the responsibility of service users or their relatives. Small amounts of money were held for service users to purchase small items; systems were in place to ensure the safe handling and storage of service users monies. Staff received regular supervision to support them in their work and records of such meetings were made available at the time of the inspection. The home complied with the requirements of the fire authority and maintained records in respect of fire safety at the home. Staff had updated their training in safe handling and moving procedures, fire safety, food hygiene and health and safety. Certificates confirming the maintenance of the passenger lift, hoisting and lifting equipment, electrical and gas supplies to the home were seen on inspection. The home recorded information in respect of falls and accidents to service users. This information was regularly reviewed and monitored to see if patterns were evident and measures to address emerging patterns were put in place. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 2 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 X 3 Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No. 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. Standard Regulation Requirement Timescale for action 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 OP3 Good Practice Recommendations The registered manager should ensure that all assessments completed by care staff are dated and signed by both care staff and service users. Silverdale DS0000008572.V273804.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Silverdale DS0000008572.V273804.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. 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