Inspection on 20/11/06 for The Meadows

This inspection was carried out on 20th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

The Meadows 16/12/08

The Meadows 06/01/06

The Meadows 12/07/05

The Meadows 20/01/05

The Meadows 10/09/04

The Meadows 09/12/03

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Meadows 88 Louth Road Grimsby North East Lincs DN33 2HY Lead Inspector Theresa Bryson Unannounced Inspection 20th November 2006 09:00 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 The Meadows DS0000002822.V320991.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. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Meadows Address 88 Louth Road Grimsby North East Lincs DN33 2HY 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) 01472 823287 Shire Care (Nursing and Residential Homes) Limited Mrs Marilyn Robinson Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2006 Brief Description of the Service: The Meadows is a 30-bedded care home providing care for people with general problems of old age. It is situated on one of the main roads into the fishing town of Grimsby, in a residential area, with access to local amenities. The accommodation is on ground floor level and many rooms have en-suite facilities. There are adequate numbers of bathroom and toilet facilities. The home has a large communal dining room and several other sitting areas. There are gardens around the home and adequate car parking facilities. Staff working in the home have their own rest area and the manager her own office. There is also a kitchen with storerooms and a purpose built laundry area. The home has the advantage of belonging to a small local group of homes, with the support of other managers, who are also professionally trained nurses, as is The Meadows manager and a Director of Operations who is also a nurse. Information about the home is on display in the main entrance and will also be sent to prospective service users. The home borders two local authority catchment areas and will accept those funded by them and also privately funded service users. The fee levels range from £329 to £376, with extra payments for such items as hairdressing, chiropody, papers and magazines. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection site visit took place over one day in November 2006 and was unannounced. Prior to the inspection the events log held on the CSCI data base was checked for events recorded about deaths and any special incidents, complaints and concerns, reports and letters sent by the provider of the service and any other relevant information recorded by letter, e-mail or telephone. Survey forms were also sent to people using the service, relatives and staff. The inspector also spoke to several relatives by telephone. On the site visit day several people using the service were spoken to in depth plus one relative, a group discussion took place with people living in the home. The inspector also spoke individually to members of staff on duty. The inspector checked a variety of records and documents; looking at several staff records in depth and some care plan records of people resident in the home. The cook escorted the inspector on a tour of the kitchen area and the manager on a tour of the whole home. The manager, Mrs M Robinson, was present throughout the site visit day. What the service does well: The home always has a friendly and open atmosphere and staff are very welcoming when they greet each visitor. The people who use the service used words such as “kind”, “patient”, “caring” and “thoughtful”. When assisting the people in the home, the staff appeared dignified and respectful. The Company has provided a good range of documentation to ensure staff can record events, which have taken place in a person’s life. This starts from before a person is admitted, to their daily lives, planning for the future and clear instructions for when a person should leave or when their life draws to a close. Staff ensure that those records are kept up to date, so that current needs of each person can be addressed and that sufficient equipment and staff are available to meet those needs through a 24 hour period. This not only covers medical and mental health needs, but also the expectations of each person for their social life and involvement in the local community. Meals are provided 4 times a day and are detailed in special booklets and displayed for people using the service to see. This provides a good nutritional The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 6 balance, with no long gaps between meals. Snacks, if required, will always be provided when required and all food is prepared in a clean and safe environment. Well-trained kitchen staff also caters for special diets. Through the Company’s quality assurance programme the home is well maintained and the views and needs of the people living there are taken in to consideration. The manager ensures that new items of furniture and linen are budgeted for on a regular basis and areas are refreshed with repainting as soon as a need arises. This ensures the home is a safe and comfortable environment in which to live. Safety checks are made on staff prior to employment and they are supervised and trained to do their jobs. Encouragement is given for them to progress in their careers and keep up to date with the latest guidance to enable them to look after the people living in the home. What has improved since the last inspection? What they could do better: Some concerns had been raised by the people living in the home that at times there were not enough staff on duty to fulfil all their needs. The manager does keep a record of each person’s level of dependency, but she was asked to recheck this and adjust the staffing levels, if necessary, to ensure everyone’s needs can be met. Please contact the provider for advice of actions taken in response to this The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 7 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. The Meadows DS0000002822.V320991.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 The Meadows DS0000002822.V320991.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Company provides comprehensive information to ensure prospective service users can make informed choice about the services provided. Service users are assessed using a holistic tool to help staff prepare for their admission. EVIDENCE: During the course of the inspection Standards 3,4 and 6 were tracked. The pre-assessment tool remains unchanged from the last inspection and looks at every aspect of a service users history. This enables staff to prepare in advance for their admission. The manager tends to usually assess prospective service users, but two senior care staff have also now been trained in this aspect of their work and are helping, under supervision, to assist the Manager. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 10 One service user spoken to stated they felt the staff knew a lot about them prior to their admission, which had helped them feel more settled, as being in care was a new experience. The staff training records also showed more sessions had taken place for service specific training, such as care of the dying person, stroke awareness and pressure area care. This has enabled staff to keep up to date and have the latest knowledge base to assist them in caring for each person’s individual needs. The home does not give intermediate care and therefore Standard 6 is not applicable. The Meadows DS0000002822.V320991.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care plan documentation had been evaluated on a regular basis to ensure all service users needs were being addressed correctly and the delivery of care had been accurately recorded. EVIDENCE: During the course of the inspection Standards 7,8,9 and 10 were tracked. Prior to the inspection 19 survey forms were sent to relatives and 13 retuned, 19 sent to service users and 11 returned and 13 sent to staff and 3 returned. The inspector also spoke to 4 relatives by telephone. The inspector also spoke to 4 service users in depth, one relative in depth and a small group of service users about general issues, on the site visit day. Individual items raised by one service user were fed back on the day to the manager. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 12 The staff needed to be praised for the high level of input on the care plan documentation seen. 3 care plans were tracked in depth. There was excellent follow through on all documentation from the time of admission to identifying initial needs and then following through certain needs and problems. Each section had been evaluated on a regular basis and supplementary records kept, for example for pressure area care or dietary needs. There was also a section for care required at night. On tracking the care plans and also speaking to service users the care documented appeared accurate. For example one service user had been unwell the early morning of the day of the site visit and this had been recorded by the afternoon, but staff were aware on the later shift when the inspector spoke to them. There was also evidence that the care plans were being monitored on a regular basis. The key worker keeps a check; this is followed up by the team leader check and then the manager’s and sometimes the Director of Operations quality auditing checks. Action plans are inserted if elements are found to be missing. This ensures that staff are aware of the importance of keeping accurate records to ensure that each individuals needs are being met at all times. A small number of service users stated they felt staff did not pass on information between shifts this was balanced by service users stating they felt staff knew every thing about them all the time. The staff were able to state to the inspector how events are passed on and there was ample evidence that these were recorded in the care documentation. The majority of service users also stated they felt staff were caring and words such as “lovely”, “kind”, “friendly” and “patient” were used. Staff had stated that there had been previous concerns over the breakdown of the hoist. This has been a recent occurrence and the Company were willing to hire a replacement if the need should arise. It was recommended that the manager highlight action to be taken if this arose again with a possible flow chart of events to follow. This will ensure no service user is put at risk from equipment not being available. At the time of the visit there was only documented evidence to support one person requiring the use of a hoist. The senior carer on duty went through the medication records with the inspector. The person was very knowledgeable about the systems in use, the needs of service users and any problems identified of practises of GPs’ used by service users. All records appeared accurate and the staff member was aware of the need to document instructions by GPs’ and other health professionals. The home is The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 13 experiencing some difficulties with the quality of service provided by its supplier. Staff were observed assisting service users in a variety of tasks through out the day such as meal times, an activities session and personal care needs. They performed in each task in a dignified and caring way and appeared to be very patient with each person. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff ensure that procedures are in place to ensure that service users can exercise control and choice in their lives depending on their specific needs. The home offers a varied menu to ensure that service users have a good nutritional balance in their daily meals. EVIDENCE: During the course of the inspection Standards 12,13,14 and 15 were tracked. The service users surveys stated that there had been a lack of activities in the past months due to a staff member leaving. On the day of the site visit a new activities coordinator had been in post for just over a week. Already a full programme of group events had been arranged until Christmas. Key worker staff had completed the social needs assessments in the care plans, but the activities coordinator would need time to ensure they were up to date and they were aware of each persons needs. Each individual service user The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 15 has their own activities record, which details dates, activities, evaluation and signatures. The inspector observed a group activities session taking place on the site visit day, which the activities person and other staff appeared to conduct in a calm and relaxed manner. Menus had been submitted prior to the site visit and showed the home was now in its winter cycle. These showed a good nutritional balance and four meal sessions a day including supper. Some concerns had been raised by staff and a service user who felt there should be sandwiches on offer each tea time, but they are on the supper menu and the other staff and the manager stated sandwiches can be given if requested. The cook was able to show the inspector the details she keeps in the kitchen on each service users needs and additional information was in each care plan tracked. This ensures meals can be tailored to each person’s needs. The cook escorted the inspector on a tour of the kitchen and storerooms. All areas were clean and food was prepared in a clean and safe environment. The records were accurate and the cook stated all equipment was in working order and they were happy with their suppliers. The maintenance of the kitchen had been kept up, but the ceiling in the main part of the kitchen could at sometime be added to the redecoration programme to freshen it up. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust system in place to ensure complaints can be handled effectively and service users are protected from abuse. EVIDENCE: During the course of the inspection Standards 16,17 and 18 were checked. There had been no concerns or complaints direct to CSCI since the last inspection, when the event history had been checked. One complaint had been resolved in house with a satisfactory outcome. Service users, relatives and staff stated that they had every confidence in the management team to deal with any issues, which may occur. All polices and procedures were on the programme of quality assurance checking to ensure that those dealing with complaints, concerns, incidents and any protection of vulnerable adults issues were up dated by any changes in legislation. Since the last inspection the manager has been able to ensure that copies of any documents relating to power of attorney documentation is now kept on file. Evidence of this was seen as it is kept with the copies of contracts of each The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 17 service user and also their details if any solicitors are involved. This ensures that any changes to the care plan documentation of service users and in the event of a death information can be accessed quickly. There was evidence in the care plan documentation tracked that care plans had been signed by service users or their next of kin to ensure they were aware of events recorded and staff also complete a record, as soon as practicable for instructions for a person’s death. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and tidy and presented as a relaxed and safe place for service users to live in and staff to work. EVIDENCE: During the course of the inspection Standards 19 and 26 were tracked. Relatives had raised concerns that the stoned drive way caused difficulties for those with walking difficulties, although there are paved sections. The manager informed the inspector that a new tarmac drive had been put on hold as some major building work was to commence in the future on the site. The gardens were well laid out with different seating areas and were free from hazards on the day of the visit. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 19 The manager accompanied the inspector on a tour of the home where toilets, bathrooms, all communal areas and a selection of service users rooms and staff areas were inspected. Each area was clean and tidy and some major redecoration had taken place since the last inspection. This included some refurbishment of bedrooms, a bathroom refurbishment, corridors painted, some new easy chairs in the main sitting rooms and some carpets being replaced. There is a planned programme of maintenance and reports made to the managers’ meetings. The staff have a maintenance book to write in small items to be repaired for the Company handyman. Service users spoken with stated they were happy with the standard of cleaning and one person said “ I couldn’t do it better myself, they are very careful with my belongings too”. Some service users stated how they had been asked how they wanted their rooms decorated and one person said how bringing in some of their own possessions had helped them settle into the home. The quality audits by staff and detailed maintenance programme has ensured that the home is a pleasant and safe place in which to live and work. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users needs are met by a competent and trained workforce, but levels of staffing need to be monitored regularly to ensure adequate numbers of staff are on duty at all times to address service users needs. EVIDENCE: During the course of the inspection Standards 27,28,29 and 30 were checked. Service users surveys and those of staff stated that at times they feel there are insufficient staff on duty to meet all their needs. Service users and a relative spoken to on the day did not indicate any problems and staff reaction to the same question was mixed. A copy of the dependency tool used by the manager to keep herself up to date was taken and this showed a low dependency level in the home, as did the pre-inspection questionnaire sent prior to the site visit. The manager was asked to recheck this information using the matrix tool provided by the CSCI residential staffing forum guide, to ensure there were sufficient staff on duty to meet everyone’s needs 24hours a day. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 21 35 of staff have now completed their NVQ at level 2 and the training records showed that 8 more had been enrolled at that level, 1 at level 3 and 2 at the level 4 management award as part of their Registered manager’s award. These records and also the individual training records of staff, with details of courses applied for and also taken were also seen. These showed that all mandatory training had taken place and also service specific training, tailored to individual staff needs. The manager completes a skills matrix to keep abreast of all training and the last completed one seen was dated October 2006. This helps the manager to be aware of training planned and build this in to the staff needs and levels of staff which may need to be adjusted on the staff rota. Of 5 staff spoken to on the site visit day they stated how this high level of training had helped them in their work and one stated how this had helped them decide their own career progression. This will also ensure that staff have the latest knowledge base to ensure they are giving the correct type of care to meet each service users needs. 4 staff personal files were tracked in depth and had all the correct documentation in place to ensure checks were being made prior to their employment. These also detailed when they had received copies of the uniform policy and the General Social Care Council code of conduct. The home has a robust system in place to ensure staff are safe to work with service users and are trained to do their job. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Company has a robust quality assurance system in place to ensure the home and the staff who work in it are safe to work with this client group in a safe environment. EVIDENCE: During the course of this inspection Standards 31,33,34,35 and 38 were tracked. The manager was able to produce evidence to show that she has kept herself up to date in he last year and also some written evidence that she has completed certain projects. These included catheter care, control of infection The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 23 and stress related problems. She completed the Registered Manager’s Award some time ago and also has been able to maintain her “live” registration as a professionally trained nurse. She has also been asked to complete work with other manager’s in homes in the Group, which will be a new challenge for her. Service users and relatives spoken to stated they had every confidence in the manager in keeping them informed of any changes in the home and dealing with any issues, which may arise. Since the last inspection a business and financial plan had been produced for 2006/07, which detailed the organisational structure, but also long, medium and short-term goals and strengths, threats and action analysis for the home. This will ensure that the Company as a whole will keep abreast of any issues and forward plan for the home’s growth. The home has a very detailed system of quality auditing and records were seen at the site visit. This involves not only senior management staff, but also other staff, service users, relatives and visitors to the home. Service users and relatives spoken to stated they were aware of different processes taking place and were asked their opinions not only about their own care, but also about the general issues of running the home. Records were seen to ensure that the home maintains accurate records for service users personal allowance records. 3 were tracked in depth and records appeared accurate. The manager has ensured that the resident’s fund is only run by staff working in the home since the last inspection. All other records were seen to ensure that the home is maintained to a high standard and is safe to live and work in. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 24 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 3 3 X X 3 The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP27 Regulation 18.1.a. Requirement The registered person must ensure that adequate staff are on duty to meet the needs of service users at all times. Timescale for action 20/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP28 OP19 Good Practice Recommendations Continue to work towards a minimum ration of 50 trained members of care staff to NVQ level 2 by 2005. Continue to ensure that the staff are aware of what to do if the hoist breaks down and develop a flow chart. The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 The Meadows DS0000002822.V320991.R01.S.doc Version 5.2 Page 27 - 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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