Inspection on 05/11/08 for Thorpe House Nursing & Residential Home

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thorpe House Nursing &... 21/02/07

Thorpe House Nursing &... 09/12/05

Thorpe House Nursing &... 03/10/05

Thorpe House Nursing &... 18/03/05

Thorpe House Nursing &... 13/07/04

Thorpe House Nursing &... 23/02/04

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Byars Care Home

St Marys Nursing Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thorpe House Nursing & Residential Home Knightthorpe Road Loughborough Leicestershire LE11 4JS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anthea Richards     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Thorpe House Nursing & Residential Home Knightthorpe Road Loughborough Leicestershire LE11 4JS 01509219877 01509262710 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Grace Sumagpao Type of registration: Number of places registered: Rushcliffe Care Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 50. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical Disability Code PD Date of last inspection Brief description of the care home Thorpe House Nursing and Residential Care home is a purpose built home situated in the Thorpe Acre area of Loughborough, and is owned by Rushcliffe Care Limited. It is located close to the centre of the town, and is served by a bus route. The home is on a main road in a residential area. Facilities close by include a local church, a variety of Care Homes for Older People Page 4 of 29 Over 65 0 50 0 50 0 50 Brief description of the care home shops and a number of social amenities, including several pubs and a social club. Accommodation is situated on two floors that can be accessed by a lift or by the stairs. The large garden is laid to lawn and is surrounded by flowerbeds and mature trees. The range of fees charged is between £334:00 - £750:00 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Commission for Social Care Inspection], spent five hours reviewing information received by the Commission for Social Care Inspection [CSCI] since the last Annual Service Review on the 10th March 2008. The visit took place on the 5th November 2008 and lasted seven hours. During the visit we checked all the key standards as identified in the National Minimum Standards. Care Homes for Older People Page 6 of 29 This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to four of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and their families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. We looked at the Annual Quality Assurance Audit (AQQA) that the home had sent to us. This describes the services provided at the home for the residents, how the home are hoping to improve services and statistics about the residents and the staff. During the visit we spoke with the nurse in charge on the day, the manager, the senior manager, the residents, the staff and families and visitors to the home. What the care home does well: What has improved since the last inspection? What they could do better: Care Team Leaders could be trained to write in the care plans for the residential residents. This would make sure that the people who are caring for those residents write the report on them. This would also give the nurses more time to spend with the nursing residents. Care Team Leaders could be trained to give medicines to those residents who are residential as they are looking after them. This would also give the nurses more time to spend with the nursing residents. he menu board could be made clearer for the residents to read. The residents mealtimes could be adjusted to make sure that they are not sat at the table waiting for their meal for an hour. The details for Social Services and the updated details for the Commission for Social Care Inspection could be included in the complaints policy. The unpleasant odour in the home must be removed to make the home a more pleasant place for the residents to live in. An alternative place for storing wheelchairs could be found to avoid the hazard in the bathroom. The staff skill mix should be reviewed to make sure that there are sufficient trained Care Homes for Older People Page 8 of 29 nurses to look after the nursing residents. The home should make sure that there they fulfil the requirements for staff with a National Vocational Award at level 2 or above. The manager must be supernumerary to the staff to allow her the time for her management duties. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1,2,3. 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents needs are always assessed before moving into the home and they have good information to help them make an informed choice about the home. Evidence: The manager, or a senior member of staff always visits prospective residents before they are admitted to the home and there is a thorough pre admission assessment form in place. This was seen in the care plans looked at and confirmed by the residents and the families spoken with. The manager visited me in the hospital Care Homes for Older People Page 11 of 29 Evidence: This makes sure that that the manager and the staff in the home have the the right information before the resident is admitted, so that they can get the best care. It makes sure that the home can meet the residents needs and that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. The families spoken with confirmed that they were given the opportunity to visit the home before their relative came in. Members of the staff spoken with said that they always knew what the residents needs were before they moved in. The current registration certificate from the Commission for Social Care Inspection [CSCI] was displayed in the entrance of the home with an up to date insurance certificate. The latest report from the CSCI was available in the managers office. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff meet the care needs of the residents as identified in the care plans with privacy, dignity and respect. Evidence: All of the case tracked records were found to contain good individual evidence of the care being given to the residents and reflected the care that the residents needed. The residents and the families spoken with told us about the care that they needed and that they were happy that they received it. There are records of the involvement of G.P.s,chiropodist, optician and dentist in the care plans, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other Care Homes for Older People Page 13 of 29 Evidence: health professionals when they needed to. There was evidence that the care plans had been reviewed regularly and had been signed by the resident or the family to say that they had seen the care plan and agreed with it. Signing the careplans makes sure that the resident and/or their families were involved and aware of the care to be given and that they were happy with it. The daily record of care is up to date and described the residents day or night, which makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. All of the care plans are written in by the nurses, the care team leaders could be trained to complete those for the residential people, which would give the nurses more time with the nursing residents. We saw residents being treated with dignity and respect when staff spoke with them and undertook their care. The staff sat down with the residents and spoke with them giving reassurance and talking directly to them. Staff seen giving care mainly did so in the right way, giving the residents privacy where needed, particularly when moving them. There was an incident seen when a member of staff was helping somebody with a drink, but appeared to be more interested in the television. There are records of the residents weight, which makes sure that they are not losing or gaining large amounts of weight. The staff spoken with were aware of the care needs of the residents and the residents and the families spoken with were happy that all care needs were being met. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Medication records for the case tracked residents were in order. Medicines are given by the nurses who have had training to give medicines. Consideration could be given to training the care team leaders in medicine administration for the residential people, which would give the nurses more time with the nursing residents. We saw that the medicines were administered individually and the residents were seen to be taking them. The medicines are packaged by the chemist into a monitored dosage system where each tablet is in a separate pop out card. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and Care Homes for Older People Page 14 of 29 Evidence: disposal of medicines. The manager carries out a monthly written audit of the medicines and the medicine sheets to make sure that they are correct. There was a self-medicating policy in place but there were no residents looking after their own medicines at that time. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 12,13,14,15. Quality in this outcome group is good. This judgement is made using available evidence including a visit to the service. The residents enjoy the activities that they want to and have their spiritual and nutritional needs met. Evidence: The staff were seen to be spending individual time with the residents. A resident told us that The staff often sit and talk to us The T.V was on in the lounges, which the residents told us that they were enjoying. The home has recently employed an activities organiser, who told us that she regularly does activities such as quizzes, sing-a-longs and exercise. She said that because if the needs of the residents she does a lot of individual activities such as reading, talking, nails, colouring and stencilling. We saw this happening on the day of the visit. The staff, the residents and the families spoken with told us that they did have Care Homes for Older People Page 16 of 29 Evidence: activities and that they were happy with the amount. There was evidence in the daily records and in the care plans about the activities that the residents take part in. All the families spoken with said that they were made very welcome in the home, which we saw whilst we were there. The residents spoken with said that the food was good and that they had a choice of what they had. The menus were varied and were discussed with the residents at residents meetings. Comments made by the residents included: I enjoy the food and we can have a choice We spoke with the residents during their lunch, which was served attractively and they told us that they were enjoying it. Most of the residents were taken to the tables up to an hour before they were served their meal as those who needed help with their meals were served first. Consideration could be made to bringing them to the table later or everybody being served at the same time. There was a menu board in the dining room but it was very unclear and the residents could not read it. The religious needs of the residents are met with regular services held in the home or with the clergy visiting the home to see individuals. The hairdresser visits once a week, which the residents said that they appreciated. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 16,18. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. There are systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. This could be made available in a large print and other languages if it was needed, which would make sure that as many people as possible could read it. The home has received no complaints since the last annual service review on 10th March 2008. The Commission for Social Care Inspection has received no complaints in this time. The residents and the families spoken with were aware of the policy, of how to complain and who to complain to. They were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. The complaints policy should be updated to include the contact details for the Social Services and the current details for the Commission for Social Care Inspection. Care Homes for Older People Page 18 of 29 Evidence: The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled correctly. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 19,23,24,25,26. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The residents are protected by the policies and procedures in the home to provide a safe environment. Evidence: Jasmine Court is purpose built home on the outskirts of Loughborough. The home was clean, homely and welcoming on our arrival, but there was a strong unpleasant odour in the entrance and one of the lounges. There are bedrooms, lounges and dining rooms on both of the two floors. The first floor can be reached by the stairs or by the lift. The lounges and dining rooms were clean, bright and well decorated, with suitable seating for the residents. All of the bedrooms seen had been personalised and were found to be clean and well decorated. The residents spoken with were happy with their rooms and said that they were able to bring their own belongings in with them. There was evidence of equipment in the home to help the residents, such as Care Homes for Older People Page 20 of 29 Evidence: wheelchairs, special mattresses and hoists. There was a good provision of bathrooms in the home and most of these were found to be clean and clear of any items that could cause a hazard for the residents. There were wheelchairs stored in one of the bathrooms that could cause a hazard. There was a garden area that was easily reached by the residents and made a pleasant place to sit and walk for them. The residents and the families spoken with were happy with the cleanliness of the home. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with and by the manager. The records for hot water testing were up to date and all the temperatures were within the recommended levels. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 27,28,29,30. Quality in this outcome group is good. This judgement is made using the available evidence including a visit to the service. The recruitment policy and the training meet the residents needs and protect their safety. There is not always the proper skill mix needed for the residents needs. Evidence: The duty rota reflected the number of staff on duty on the day of the visit,there were seven care staff and one nurse on duty. Whilst the numbers of staff were satisfactory the skill mix was not. There should be two nurses on duty to cope with needs of the residents. We were told that there were usually two nurses on duty and the rotas showed that this was usually the case. The residents, staff and families spoken with felt that there were usually enough staff on duty to look after them. Rushcliffe Care do not keep the staff files in the home so we went to the administrative centre to look at them. We looked at three staff files from Thorpe House and the required information was Care Homes for Older People Page 22 of 29 Evidence: complete in two of them. This included evidence of identification, adequately completed application forms, two written references, a Criminal Records Bureau [CRB] check and a Protection of Vulnerable Adults[POVA first] check. The third file only contained one written reference, but the staff assured us that a second one had been arranged. The manager confirms with the office that all the required documentation is in place before an employee starts work. This was confirmed by the staff spoken with, who told us that they could not start permanently until they had all the paperwork in place. Rushcliffe care do allow staff to work supervised if they have a POVA first in place, but they have not received the CRB. We were shown the details of the in-house staff training programme that included the induction training. The staff spoken with confirmed that they had received recent training in moving and handling, dementia, safeguarding of vulnerable adults and first aid. The residents and the families spoken with felt that the staff were well trained to do their job. Some of the care staff either hold a National Vocational Qualification [NVQ] at least at level 2 or are in the process of completing it. The home has not got the numbers required by the National Standards. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 31,33,35,36,37,38. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The residents live in a home that listens and responds to them, whist keeping them safe. Evidence: The registered manager, who has completed her registered managers award and is registered with the Commission for Social Care Inspection, was available for part of the visit. On the day of the visit the only nurse on duty was in sole charge of the home and the manager was having to cover nursing shifts. In a home of this size the manager should be additional to the nursing staff to enable Care Homes for Older People Page 24 of 29 Evidence: her to complete her management role. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. This was confirmed by the residents and the families spoken with and by the minutes seen. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaires. We received positive comments from the residents and the families at the visit amongst which were that the staff were very supportive of them and their relative. The residents accounts were seen and all in order and had two signatures on each entry. This makes sure that the resident and the member of staff handling the money were protected. We saw that receipts were obtained for purchases. There was very little evidence from the staff spoken with that they are having regular, formal supervision with their line manager. We were not able to see many records of supervisions taking place. The manager told us that she is training the nurses and the domestic supervisor to undertake some supervisions for the staff. This will help the staff to have regular supervisions. Formal supervision of the staff gives them and their line manager the opportunity to discuss work and training issues and needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. All the areas of health and safety such as hot water temperatures and fire drills and alarm testing were found to be in order. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 26 That the home is kept free from unpleasant odours. To provide a pleasant environment for the residents to live in. 30/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 9 15 That consideration is given to training the Care Team Leaders to write in the care plans for the residential people. That consideration is made to train the Care Team Leaders to administer medicines to the residential people. That consideration is made to make sure that the residents are not sitting at the tables for an hour waiting for their meal. That the menu board is clear so that the residents can read it. That the details for social services are included in the complaints policy. That the details for the Commission for Social Care Inspection are updated in the complaints policy. That the identified bathroom is kept clear of wheelchairs. 4 5 6 7 15 16 16 25 Care Homes for Older People Page 27 of 29 8 9 10 11 27 30 31 36 That the home makes sure that they have the correct skill mix for the residents needs at all times. That the required numbers of staff with an NVQ at level 2 or above is achieved. That the managers post is supernumerary to the staffing except in cases of urgent need. That formal staff supervision is undertaken at the required frequency. Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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