Inspection on 21/11/07 for Swallow Wood Care Home

This inspection was carried out on 21st November 2007.

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

Swallow Wood Care Home 12/12/06

Swallow Wood Care Home 03/01/06

Swallow Wood Care Home 23/03/05

Swallow Wood Care Home 06/10/04

Swallow Wood Care Home 18/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Swallow Wood Care Home Wath Rd Mexborough South Yorkshire S64 9RQ Lead Inspector Janet McBride Key Unannounced Inspection 21st November 2007 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 Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swallow Wood Care Home Address Wath Rd Mexborough South Yorkshire S64 9RQ 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) 01709 571477 01709 585505 swallowwood@schealthcare.co.uk www.southerncross.co.uk Trinity Care Ltd Leonie Shepherd Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability over 65 years of age of places (38) Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specific service user under the age of 65, named on variation V8248 dated 9th June 2004, may reside at the home One specific service user under the age of 65, named on variation V31609 dated 24th May 2006, may reside at the home 12th December 2006 Date of last inspection Brief Description of the Service: Swallow Wood Care home is registered to provide nursing and residential care and accommodation is registered with thirty-eight beds. The home was purpose built home and is part of the Southern Cross Healthcare group. The home is situated on the main Mexborough road within a residential area to the west of the town centre of Mexborough, shops and amenities are close by. Accommodation is provided on two levels, the upper floor being serviced by a shaft lift, and there are several lounges situated around the home on both floors. Swallow Wood is set in enclosed gardens, comprising of shrubs, mature trees, lawn and patio area which has suitable access for people either on foot or in wheelchairs. Car parking spaces are available at the front of the home. Fees range from Nursing Care £380:62 to £426:30 plus nursing band per week, as of November 2007. Additional charges are made for hairdressing, chiropody, optical, dental services, specialised toiletries, and magazines. For further information contact the home. Information about the service was available for people and their families in the Statement of Purpose and the Service User Guide. The home last published inspection report was on display on the homes notice board. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this Key Unannounced Inspection, which took place on the 21st November 2007 for seven hours. The home is registered for thirtyeight places, however double bedrooms are used as single therefore they only accommodate thirty-six people. Thirty-five people were receiving services at the home on the day. Prior to the inspection the manager submitted an Annual Quality Assurance Assessment this gives information about the home and services provided. Pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Three care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. A tour of the premises and direct observation of staff interaction with people who use the service was carried out throughout the visit. Information was gathered from as many different individuals as possible that had contact with people within the home, including individual interviews with the manager and six members of staff .Two relatives were spoken to and six people within the home who receive services. We sent out surveys prior to the inspection, eleven were sent to people who use the service, eight were received back. They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service needs were met. We would like to thank all the staff, relatives and people receiving services within the home for their co-operation in the inspection process. Any issues or concerns that were raised were discussed with the manager at the end of the inspection. What the service does well: Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 6 The home provided a welcoming and comfortable environment, with a very relaxed atmosphere. The home provides information for people and their relatives, who are invited to look around the home and spend up to a day there before being admitted. Discussion with both people receiving services and the activities co-ordinator confirmed routines were flexible and people focussed. People said they enjoyed the activities available, however some people choose not to participate in the activities but said they appreciated being read to by the activities organiser. Other people within the home said they liked to watch television and spend time in their bedrooms, books and daily newspapers were available. People also said they were encouraged to keep in contact with family and friends living in the community, they visit local shops, garden centres and meals out to local venues. Stable staff group which ensured continuity of care by staff that know the people who use the service, both male and female staff, to ensure people had a choice of who performed their personal care. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. Staff said all people were encouraged to make everyday choices, for example what to eat and what to wear. This promoted the choices and dignity of people living at the home. People said that staff listens and acted on what they said and all felt that staff supported them and care was excellent. What has improved since the last inspection? What they could do better: Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 7 Ensure that a correct supply of every medicine listed on the medication sheet for each person is in stock and available. Any returned medication should have signature from both the person returning the medicines and the person collecting the returns. The manager to provide a record to show they monitor the registered nurses pin numbers, to provide evidence of expiry dates and that they had been reregistered by the Nursing and Midwifery Council (NMC). Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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 Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People that use the service had information about the home and services provided. People were individually assessed prior to admission to ensure their needs would be met. EVIDENCE: The home offers nursing, residential and respite care but not intermediate care. All surveys received confirmed that people who use the service were provided with sufficient information before moving into the home. Records showed and discussions with people and families confirmed that they could visit before admission to assess the suitability of the home. One family commented that when they visited the manager and staff answered all their questions honestly. Surveys suggested that all people were issued with contracts/statement of terms and conditions of residency. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 10 The scale of charges was discussed with the manager and any extras that people pay for, are documented on page five of this report. Records showed that people who use the service were fully assessed prior to moving into the home, with other professionals involved if required. Discussions with people within the home and comments on surveys said people received the care and support they needed. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Care plans provided staff with sufficient information to meet the needs of people who use the service. Arrangements for dealing with health issues were met with support from health professionals. Medication policies and procedures were well managed, however staff must ensure that the correct supply of every medicine listed on the medication sheet is available, to ensure the safe administration of medication. EVIDENCE: Three care plans were checked these set out in detail healthcare, personal and social care needs in an individual plan of care. Including recording of religious beliefs, wishes regarding death were discussed when appropriate. These details ensured that staff delivered the care required and peoples needs were identified and met. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 12 Risk assessments were completed dependent on individual needs. People were nutritional assessed and weighed on a regular basis, and when weight loss had been highlighted they had been referred to a dietician. Records showed that staff document what care was given on a daily basis, and care plans were monitored and reviewed monthly, to ensure changing needs were identified. People had access to all health care services and other professionals when required. All surveys confirmed that people received medical care and support when needed. The company were carrying out an audit on administration of medication, on the day of the visit. Therefore it was decided that this would be shared with the inspector. One issue was highlighted regarding medication being out of stock for one person. These medicines should have been in liquid and only tablets were available, this was addressed immediately. Examination of records, storage and recording of medication was all found to be satisfactory, with the exception of when medicines were returned to the pharmacy staff did not always sign or got a signature from the person who collected them. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. Staff said all people were encouraged to make everyday choices, for example what to eat and what to wear. This promoted the choices and dignity of people living at the home. People said that staff listens and acted on what they said and all felt that staff supported them and care was excellent. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience Excellent outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People within the home were provided with stimulation and interesting activities. They were offered a wholesome and appealing balanced diet with a varied selection of food available to meet people’s tastes and choices. EVIDENCE: There was a very relaxed atmosphere and people said their daily routine was flexible and varied, they confirmed they were able to choose how they spent their day. Discussion with people receiving the services and the activities coordinator confirmed they enjoyed the activities available. Some people choose not to participate in the activities but said they appreciated being read to by the activities organiser. Some people said they liked to watch television and spend time in their bedrooms, books and daily newspapers were available. People were taking part in a quiz after breakfast and later in the morning a church service took place. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 14 People said they were encouraged to keep in contact with family and friends living in the community, they visit local shops, garden centres and meals out to local venues. Children come into the home from local schools especially at Christmas to sing carols, also the Salvation Army and local church visit on a regular basis. Two people said they went on a shopping trip yesterday with staff to Meadow Hall in Sheffield. People were encouraged to make choices, about many aspects of their daily lives, comments received were consistently positive for example,” Staff listen to what we say” and “any requests are acted upon.” Six people within the home were spoken to, all six said, “they enjoyed life in the home and that staff were always happy and kind to them”. Information is provided for people and families how to contact various external agents for example, advocates, Age Concern, dementia groups and social services. There was a varied menu, which was on display in the dining room for people to see. Food and mealtimes were discussed with the staff and people receiving the services. Dietary needs were discussed with people and likes and dislikes were recorded. Staff confirmed that people had access to food and drinks 24 hours a day. Observations at the lunchtime dining tables were set with tablecloths, cutlery and flowers in the middle of the tables. Staff served food from a hot trolley and people were offered seasoning and choice of drinks. Not all people were sat at dining tables, some people said they preferred to sit in lounge chairs with trays on tables in front of them. People made very positive comments about the food on offer at meal times for example, “I never finish or leave a clean plate as the portions are large”. “The food is excellent”. All surveys received back from people said they liked the food at the home and meals were always nice. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The complaints procedure was accessible and displayed within the home. Policies and procedures were in place on adult protection, this promoted and protected people who use the service. EVIDENCE: There was a comprehensive complaints procedure, which was on display in the home. People using the service and relatives said they were aware of the complaints procedure. The Annual Quality Assurance Assessment (AQAA) said they had received three complaints since the last inspection. Complaint records showed that these complaints had been recorded, responded and investigated in an efficient and thorough manner. Policies and procedures were in place regarding the protection of vulnerable adults. Staff confirmed they were aware of abuse polices and procedures, and staff were able to describe the action they would take on receiving any allegations. All people were made aware of their right to vote, and this is generally done by a postal vote, two people confirmed that they had used postal votes in the last general election. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. People who use the service experience Excellent outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who use the service live in a comfortable and wellmaintained environment. The home was clean and tidy and provided any specialist equipment people required to maximise their independence. EVIDENCE: A tour of the premises found the reception area of the home displayed the relevant insurance and registration certificate .The information board contained lots of valuable information for people and relatives including the menu for the day and activities that had been organised. Communal rooms included a selection of small lounge areas giving people a choice of sitting quietly, meeting family and friends in private or being with other people in the larger lounge. All communal areas were found to be clean and tidy and in good decorative order with ongoing general maintenance taking place. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 17 Bathrooms were well planned and the home looked at the needs of people. Refurbishment of the shower rooms was being completed today to make them into wet rooms. This will give a selection of bathing facilities and make them more accessible for people. There are all single bedrooms some with ensuite facilities. Bedrooms had been provided with furniture and furnishings in compliance with people’s needs and preference. They were all found to be clean and tidy, people were able to bring their own personal possessions and memorabilia as most had been personalised by the person using the service or their families. The home had purchased a number of new beds, divans for some people and specialist beds for people who need nursing care. Call system were in each bedroom, with cords left in easy reach of people. Laundry facilities remain the same, they had two washers and two dryers, the laundry room was well organised with plenty of clean linen available. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home; a stable staff group ensures continuity of care by staff that know the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Staffing structure within the home was discussed with the manager, who said dependency levels of people receiving care determined what staffing hours were needed. Observation and checking of duty rotas confirmed there were sufficient staff to meet the needs of people who use the service. Male and female staff were employed, this ensured people had a choice of who performed their personal care. Comments on the surveys said staff were available when you need them. There were recruitment and selection procedures including an equal opportunities policy. All the required employment checks have been undertaken prior to staff being employed, including Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks. This ensured people who Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 19 use the service were safe and protected. However one issue was raised verbal references on two of the files checked had not been followed up, with written references. This was discussed with the manager who addressed the issue immediately and informed us three days later that written references had been obtained. All registered nurses have to re-register their pin numbers with the Nursing and Midwifery Council (NMC). All were found satisfactory, however every personal file had to be checked. Suggested they had a record were all this information was kept together, to provide evidence that they monitor this practice. A number of staff had achieved National Vocational Qualification (NVQ) level 2 in care with other members of staff continuing to work towards attaining this qualification. Other training records indicated that a number of the staff team had accessed various courses for example, abuse, nutrition, challenging behaviour and dementia awareness. A number of staff confirmed they had received various training over the passed year. Two new staff members confirmed they were working through induction training and shadowing members of staff during this period. They also received a booklet about the homes policies and procedures. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who use the service were protected by management practises. The financial interests of people were safeguarded, good health and safety procedures ensured they were protected. EVIDENCE: The acting manager had only been in post since September 2007.She has started going through the process with the CSCI to be the registered manager. Discussion with the manager about her role and her own development, confirmed that she is a registered nurse and is responsible for the day to day running of the home. She also intends to continue to undertake periodic training to update her knowledge skills and competence whilst managing the home. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 21 Staff and people receiving care spoke freely and positively about the manager saying she was open and approachable. Quality assurance systems were in place and the manager could evidence they monitor the quality of care and services within the home. Thirty six surveys were sent out to relatives in September 2007 by the service to gain their views about the care and services provided. Sixteen were returned and their responses collated and are on display on the notice board. The company’s operations manager continues to carry out monitoring visits, and completes regulation 26 reports. These state what she found during her visit and who she spoke to. They are sent to the CSCI and a copy available at the home. Staff said they received supervision on a regular basis and that staff meetings are held with minutes taken. Discussion with the administrator and checking of records confirmed that people’s finances were recorded, receipts kept and audited on a weekly basis. Some people control their own finances, with the help of their families. Maintenance and service records were examined, these were up to date with current certificates. The required Health and Safety policies and procedures and the relevant notices were displayed throughout the home. Fire safety procedures were in place, records examined showed they were current and up to date. This keeps people living and working at the home safe. Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 X 3 X X 4 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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 OP9 Good Practice Recommendations 1) Correct supply of every medicine listed on the medication sheet should be in stock and available. 2) Returned medication should have signature for both the person returning the medicines and the person collecting the returns. A minimum ratio of 50 of staff must be trained to NVQ Level 2 or equivalent as soon as possible. Record should be kept to evidence that management monitor the practice of re-registering nurses pin numbers. The registered manager to achieve NVQ 4 in management. 2 3 4 OP28 OP29 OP31 Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Swallow Wood Care Home DS0000015875.V349771.R01.S.doc Version 5.2 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. 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