Inspection on 22/07/05 for Victoria Court

This inspection was carried out on 22nd July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Victoria Court 14/05/08

Victoria Court 15/05/07

Victoria Court 13/07/06

Victoria Court 23/02/06

Victoria Court 29/03/05

Victoria Court 18/11/04

Victoria Court 02/03/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Victoria Court 39-41 Victoria Court Bridlington East Yorkshire YO15 2AT Lead Inspector M.A. Tomlinson Unannounced 22 July 2005 09:30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Victoria Court Address 39-41 Victoria Court Bridlington East Yorkshire YO15 2AT 01262 676205 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Arthur Lindley Mrs Sheila May Wilson Care home only 19 Category(ies) of MD Mental Disorder (19) registration, with number of places Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31st March 2005 Brief Description of the Service: Victoria Court was first registered with the local authority in 1988 and has been subsequently operated as a family concern. Victoria Court is a large detached double fronted property located in a residential area of Bridlington and is conveniently situated for all of the main community facilities including the public transport network. It is registered for nineteen adults who have a mental health problem and require primarily personal care such as support and guidance. Nursing care is not provided. Should such care be required then it will be provided by the community health care services. The service users (residents) accommodation is located on three floors. The care home does not have a passenger lift and is therefore only considered suitable for service users who are reasonably ambulant. There are five single and seven double or shared rooms. The double rooms are only shared with the expressed agreement of the occupants. There are three lounges on the ground floor, two of which are designated smokers lounges. There is a large secluded garden that provides the service users with reasonable privacy. The stated aim of the care home is, To provide a homely environment where the residents can feel comfortable and secure whilst receiving the support and guidance they need to achieve their goals. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two statutory unannounced inspections by the Commission for Social care Inspection during this inspectoral year. The inspection took a total of five and a half hours including one hour’s preparation time. The registered manager was available throughout the inspection and the Responsible Individual for the latter part. The Commission for Social Care Inspection registered the manager, who has been employed in the home for a number of years, since the previous inspection. An inspection of the ground floor, including the communal space, was undertaken along with an examination of the records. Eight service users were spoken to as a group without the staff being present. A discussion regarding the service provided by the home was held with a visiting District Nurse. A discussion was held with the Responsible Individual regarding proposed changes to the Registration Certificate. What the service does well: What has improved since the last inspection? What they could do better: The staff recruitment procedure needs to be reviewed to ensure that new staff are not employed until after the completion of a CRB/POVA check and the Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 6 receipt of two satisfactory written references. An Immediate Requirement Notice was issued on the matter. A number of the service users displayed apathy and lethargy. One said that there is little specific to do in the home. The Responsible Individual acknowledged this problem and gave their assurance that solutions are continually being sought. It was recommended that greater use is made of community resources and advice sought from the local mental heath team. It was strongly recommended that the level of day staffing be reviewed in order to provide the manager with dedicated time to fulfil, and expand on, her managerial duties and to ensure that quality time is available for staff to spend with the service users. To an extent this issue had been identified by the quality assurance programme with the result that increased ‘contact time’ is to be introduced for the key workers to spend with the service users. According to the Responsible Individual the electrical wiring of the home has never been subjected to a safety check since the home was initially registered. This matter is to be given a high priority by the responsible individual. 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. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 Prospective service users are provided with adequate information on which to base a decision as to whether they wish to live in the home. EVIDENCE: The home had a Statement of Purpose and Service Users’ Guide. Following the requirement made at the previous inspection, the Guide had been revised to ensure that it contained all of the required information. The Guide was written in ‘user friendly’ terms and placed considerable emphasis for the prospective service user to see Victoria Court as their home. It was evident from discussions held with the service users that they had been provided with appropriate information on which they could make a considered decision on whether they wished to be admitted into the home. The five care records inspected contained recorded evidence that the service users had been assessed by the home prior to their admission. This was in addition to any assessment undertaken by the placement agency. Where possible service users had been encouraged to visit the home prior to their admission along with their care coordinator if necessary. The records also contained copies of the contract of residence provided for each service user. These had been signed in agreement by the service user concerned. One service user who had experience of other care homes stated, “This (Victoria Court) is one of the better ones”. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9 The systems for consultation with the service users are good with some evidence that their views are actively sought and acted upon. EVIDENCE: The five care records inspected contained an individual care plan for the service user. These were fairly basic in content but highlighted the primary needs of the service user concerned. They also identified the action required by the staff in order to meet the service users’ assessed needs. In addition to their primary mental health problem, several of the service users had a history of aggression. All of the service users spoken to were aware of their care plans and confirmed that they were involved in the development of the care plans. They had signed their personal care plan in agreement. The care records also contained risk assessments of the service users and evidence that the care plans had been reviewed monthly and six monthly by the key workers. There was evidence of involvement of the service users and social care professionals. The manager and responsible individual stated that one of the main problem areas was the apathy of some of the service users that had become a barrier to them achieving goals and developing socially. From discussions with the service users it was evident that they were at liberty to make decisions for themselves. They provided examples of this such as the use of the their personal money and their daily routines. The service users Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 10 also demonstrated a good knowledge of what was going on the home including physical changes to the property and the situation regarding staffing. Another example of this involvement was demonstrated by the way that the inspector was met at the main entrance door by a service user who wished to know his name and reason for visiting before going to get a member of staff. All of the service users, except one, were able to come and go from the home without supervision. They gave several examples where their independence had been promoted. For example, although for they did not have unsupervised access to the kitchen on health and safety grounds, several had been provided with facilities in their rooms for making hot drinks. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,16 and 17 The current programme of activities is not conducive in minimising the service users’ apathy or in generating their enthusiasm. EVIDENCE: It was evident from discussions with the service users that they are encouraged to make maximum use of the community facilities in order to follow their personal interests. It was also evident, however, that in the majority of cases this was restricted to visiting drop-in centres and local cafes. This appeared to stem from a general apathy displayed by the majority of the service users and their insistence on their maintaining a routine. From an inspection of the records and discussions with the staff it was apparent that whilst efforts had been made to motivate and stimulate the service users, this had only had limited success. One service user stated that, “There is nothing specific to do”. He could not, however, quantify what he would like to do. The service users felt that they were limited as to what they could do by their limited finances. For example, they could only afford to get the majority of their clothing from local charity shops. The recently introduced quality assurance programme identified this problem and had a stated aim to Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 12 encourage the service users to become more involved particularly in the running of the home. This will include increased contact time with their key workers and should consequently provide greater opportunity to discuss the service users’ lifestyle and personal goals. From observation of the service users and the staff, it was apparent that the staff spoke to the service users appropriately and with respect. Some restrictions were in place with regard to specific service users particularly in relation to their use of personal money and cigarettes. The service users’ agreement had been obtained and recorded with respect to these restrictions. The menus indicated that the meals were reasonably varied and provided an appropriate diet. The service users confirmed that they assisted in planning the menu for the coming week and that their food preferences were taken into account. The service users were all satisfied with the quality of breakfast and lunch. Two, however, considered the teatime meal to be inadequate and consequently that the time was too long between tea and breakfast without a substantial meal. They were provided with supper but, according to the service users, this generally consisted of a biscuit. According to the food records the teatime meal consisted of a ‘snack type meal’. The service users did confirm that they could have a cooked breakfast. One service user stated, “We arrange the meals every week. The staff cook what we want. There is fish, chips and mushy peas today”. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 The service users’ health and social care needs are met. EVIDENCE: From observation of the staff and service users it was evident that a good relationship existed. Communication was natural and spontaneous and the service users were not reticent to voice their views and opinions to the staff. The service users spoken to expressed satisfaction with the service provided by the staff and were aware of who was their nominated key worker. Staff provided support and advice for the service users in an appropriate mature way, which was reciprocated by the service users. One of the service users, who had been accommodated in the home since 1988, was over the age of 65 and required considerable physical care. For example, whilst he was weight bearing to an extent he did require the assistance of two staff with his personal care needs. He also used a wheelchair. The service users said that he had been active until relatively recently. He also received the support of District Nurses, two of whom were visiting this service user on the day of the inspection. This service user was accommodated on the ground floor to take into account his lack of mobility. The records confirmed that the service users had good access to health and social care professionals. One service user, for example, had recently obtained digital hearing aids. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 14 The home continues to use a monitored dosage system (NOMAD) for the administration of the service users’ medication. The medication was appropriately secured. The staff responsible for the administration of medication had undertaken ‘distance learning training’ on the safe handling of medication and had been formally assessed as being competent to undertake the process. The medication records were complete and up to date. None of the service users self-medicated. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Not assessed on this occasion. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,28 and 30 Overall the standard of decoration and furnishings are acceptable although somewhat undermined by dirty and stained furniture particularly in the ‘smoking lounge’. EVIDENCE: The premise presented as being informal and appropriate for the needs of the service users. The service users looked at home and relaxed in their environment. Without exception they expressed satisfaction with the quality of their accommodation The service users’ private space (bedrooms) was not inspected on this occasion. The majority of the bedrooms are doubles although only three were being shared at the time of the inspection. Those service users who were sharing bedrooms said that they did not object to doing so as ‘they got on with each other’. The responsible individual reiterated that service users would only share with their agreement. There were three lounges located on the ground floor; two being designated for use by service users who smoke. On the day of the inspection eight service users were sat in the smokers’ lounge several of who did not smoke. Whilst this lounge was furnished to an acceptable standard, it was noted the backs of several of the armchairs were stained and Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 17 marked from constant use. It was also noted that several areas in the lounges and dining room were showing signs of wear and tear and would require redecorating in the near future. The service users had access to a secluded rear garden and patio area. The service users sat at tables for two or four in the dining room. There was an external laundry room with appropriate equipment available. Following the requirement made at the previous inspection the laundry room floor had been painted. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34 and 35 The level of day staffing is considered inadequate to meet social and personal development needs of all of the service users. The staff recruitment procedure does not fully protect the service users. EVIDENCE: The staff roster indicated that there had been no regression in terms of the staffing level since the last inspection. On the day of the inspection the staffing consisted of the registered manager and one care assistant. By necessity the manager was therefore directly involved in the providing the service users with their personal care (e.g. bathing). In addition to this both staff were involved in the preparation and cooking of the lunchtime meal and cleaning the premises in the absence of the cleaner. The manager was also involved with dealing with visiting health care professionals, as well as the inspector, answering the telephone and supporting service users. This situation was further exacerbated by the fact that one service user required both staff to assist him with his personal care. It was evident that during this time the manager had little opportunity to undertake her specific management tasks. The manager acknowledged the situation and said that managerial tasks, such as updating care plans, was undertaken in the afternoon. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 19 Three staff records were inspected. The records of the two most recently appointed staff indicated that one was employed before a full CRB/POVA check was completed and with only one written reference and the other also commenced their employment with only one written reference. An Immediate Requirement notice was issued with regard to this. The night staffing consisted of one person on-call in the building and another on waking duty. The records indicated that the staff had been provided with an opportunity to participate in a range of courses including the safe handling of medication, health and safety, healthy eating and nutrition, infection control and first aid procedures. The registered manager confirmed this. It was planned for several of the staff to renew their first aid certificates. The responsible individual had recently undertaken a course on the use of ‘Non-violent Crisis Intervention’ and was intending to cascade the information to the staff. According to the responsible individual “There is, never has been, and never will be any use of restraint at Victoria Court”. Some staff had either achieved, or were in the process of achieving, a National Vocational Qualification at level 2 or 3. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The service users’ safety has been undermined by the lack of a safety inspection of the home’s electrical wiring system. EVIDENCE: Since the previous inspection the Commission for Social Care Inspection had registered the manager. She stated that she is in the final stages of obtaining a National Vocational Qualification in Health and Social Care at level 4 and is intending to commence the Registered Manager’s Award in September of this year. She demonstrated a good understanding of the needs of the service users particularly those elements such as promotion of independence and choice that go to provide them with a good quality of life. Due to the staffing arrangements she did, however, have limited time available to solely dedicate to managerial tasks (See staffing). It was evident that she was well supported by the responsible individual. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 21 Following the previous inspection the recording of money kept by the responsible individual on behalf of some service users had been formalised and rationalised. Financial records relating to each of these service users indicated money deposited with, and transferred by, the responsible individual. Where necessary receipts had been retained. All of the service users had signed an ‘agreement’ allowing the responsible individual to look after their personal money. The responsible individual had assumed that the inspector would audit these records as part of the annual inspection. This arrangement was not practicable and consequently alternative arrangements are to be made. Of concern was the amount of money being looked after in some cases. Those parts of the premises inspected presented as being safe and appropriate for the use of the service users. The responsible individual confirmed that the hot water was not controlled. The rationale being that the service users had the competence and capability to assess the dangers of hot water themselves. This was also based on a risk assessment of the service users. One service user was relatively frail and required considerable staff input and consequently without the close supervision of the staff could be at risk from hot water. It was established that whilst all of the electrical equipment had been safety checked, a check of the overall electrical system had never been undertaken. A current gas servicing certificate was available. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 2 Standard No 11 12 13 14 15 16 17 2 3 3 3 x 3 2 Standard No 31 32 33 34 35 36 Score x x 2 1 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Victoria Court Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 2 3 x x 1 x J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 23 Yes Are there any outstanding requirements from the last inspection? 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 24 and 42 Regulation 13(4)(c) Requirement A full safety inspection of the homes electrical wiring system is to be undertaken by a qualified electrician. Evidence of the inspection is to be provided for the Commission for Social care Inspection. No person may be employed until after the successful completion of a CRB/POVA check and the receipt of two satisfactory written references. Timescale for action 1st September 2005. 2. 34 19(4) and Schedule 2. Immediate. 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 8 and 11 Good Practice Recommendations Action should be taken to provide the service users with meaningful activities and opportrunities for personal development. Advice on this matter should be obtained from the local mental health team. A review of the tea-time meal should be undertaken in consultation with the service users. Action should be taken to ensure that the furniture, particularly in the smoking room remains clean. A review of the day staffing level should be undertaken to J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 24 2. 3. 4. 17 30 33 Victoria Court 5. 38 ensure that the staffing level is adequate for the assessed needs of the service users and enables the staff to spend quality time with the service users to promote the service users life and social development. The manager should not be an integral part of the care team but be provided with dedicated time to fulfil and expand on her management duties. Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Victoria Court J53-J04 S19766 Victoria Court V239745 030805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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