Inspection on 25/10/05 for Woodlands Manor

This inspection was carried out on 25th October 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 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

Woodlands Manor 23/11/09

Woodlands Manor 17/07/07

Woodlands Manor 01/06/06

Woodlands Manor 18/11/04

Woodlands Manor 28/07/04

Woodlands Manor 07/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodlands Manor Ruffet Road Kendleshire South Glos BS36 1AN Lead Inspector Andrew Pollard Unannounced Inspection 10:00 25 October 2005 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodlands Manor Address Ruffet Road Kendleshire South Glos BS36 1AN 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) 01454 250593 Woodlands Manor Care Home Ltd Mrs Cheryl Lynn Lawrence Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 40 persons aged 65 years and over who are receiving nursing care Of the total of 40, up to 2 persons (who must be aged 65 years and over) who are receiving personal care only may be accommodated. Manager must be a RN on parts 1 or 12 of the NMC register. Of the total of 40, up to 5 persons aged over 50 years may be accommodated that have a physical disability (PD) 7th April 2004 Date of last inspection Brief Description of the Service: Woodlands Manor is a part converted and part purpose built home registered in November 2004 by Woodlands Manor Care Limited and operated by the directors Mr and Mrs Jenkins. Mrs Jenkins is the responsible individual for the Home. The home is situated in a rural location, but is on a local bus route to Bristol and Yate and is accessible to local shops and amenities by car. Communal areas are provided by way of a dining room, lounges and large conservatory area. There is level access throughout the home and all areas of the home are accessible via a lift. There are a suitable number of bathrooms and toilets with adaptations to meet the care needs of residents in the home. Appropriate equipment can be provided for individual use based on assessed identified needs. All rooms have a call alarm system. The home is set in its own grounds, which are beautifully maintained and accessible to residents. Car parking is available for several cars. Visitors are welcome to the home at any time. In house activities and entertainments are provided. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was commenced on 25th October; however in accord with the commissions Health and Safety policy the inspector conducting the inspection believed that their personal safety was threatened by the behaviour of Mr Jenkins and the inspection was aborted. The inspector reported this matter to a manager and records of the incident were made. There have been subsequent meetings and correspondence between the commission and Mr and Mrs Jenkins and the matter is now closed. The inspection was concluded on 7th February 06. The report draws on the findings from the October visit but is largely based on findings from the inspection of 7th February. An inspection focusing on staffing arrangements was conducted on 30th December 05 for which a separate report was issued. A number of residents, staff and relatives were consulted about their views of the Home and the service provided. The inspector spoke to the manager, Registered Nurse (RN’s), care assistants and ancillary staff about their roles and responsibilities. The staff morale has been low over the last few months. However the inspector considers the atmosphere is changing and that all levels of staff at the home are committed to seek improvements in the working environment and quality of life for the residents. A further inspection will be carried out in May to monitor the progress. A range of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were reviewed. A number of the Commissions comment cards were completed and sent to the Commission by resident’s relatives and visiting health care professionals. What the service does well: People are treated as individuals and their physical and mental health needs are met. Staff were observed assisting and interacting with residents in a caring and friendly manner. It was apparent that the staff have a good rapport with the residents. Comment cards gave a variety of views but in general they were positive. Residents are offered a range of social and recreational activities. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 6 The environment internally and externally is of a very high standard, and appreciated by residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 7 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 Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Prospective clients and their families are given relevant information in written or verbal form about the home. The assessment process is satisfactory. Contracts and terms and conditions of services are provided to all clients but there is no breakdown of the fee. EVIDENCE: The statement of purpose (SOP) and service user guide SUG documents meet the regulatory requirements are comprehensive and written in plain English. Minor amendments have been made a full review will be undertaken by the manager in due course. The manager or senior RN visits and assesses prospective residents. On occasions urgent admissions are accepted if they have written health and or social care assessment documentation. All residents have Waterlow, handling and continence assessments. Residents care records were reviewed to ascertain how residents care needs are assessed. The assessment records were informative, and showed assessment of the persons physical, mental and social needs had been carried Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 9 out. However, the needs of residents’ in the Home are changing, and referrals are also taken for people requiring palliative care. This has led to a significant increase in the perceived dependency levels of a number of residents. It was agreed that a dependency rating should be adopted or devised to assess the dependency of potential new admissions and existing residents to allow for an informed decision to be made on the level of resources and skill mix of the staff to be determined. A number of residents stated verbally or through comment cards that while staff were kind and helpful, they have to wait for longer periods of time for assistance when they ring their call bell. Residents also said if they require assistance to go to the toilet, often staff were so busy it took too long before they could get to them to give them the help they need. . There have been concerns raised by relatives and carers that the number of staff on duty for each shift does not reflect this increased dependency and the specialist needs of residents who require palliative care. The issue of staffing has been addressed under Standard 27 below. All residents have contracts and written terms and conditions, however there needs to be a more detailed breakdown of haw the fee is made up to meet the amended requirements of Regulation 5. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 The staff provide appropriate personal and nursing care to maintains residents health and well-being. Proper arrangements are in place for residents to access primary healthcare services. The staff properly stores, administers and records medication. Care plans are clearly written but some lack sufficient detail. EVIDENCE: The Standex system of documentation is in use and the activities of daily living is the model of care on which care plans are based. All newly admitted residents are given a core care plan within the first week, which is evaluated and updated as the person settles in. Several residents care plans were inspected. Care plans addressed the physical and psychological health care needs of the person but some lacked personalisation. Two care plans were insufficiently detailed and did not clearly show how to assist the residents to meet their assessed needs. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 11 We discussed the value of key workers preparing short biographies of residents as away of developing relationships and a more person centred approach. The manager will raise this at the next care staff meeting. In general there was quite detailed information stating how best to meet the residents needs. Care plans had been reviewed on a regular basis by registered nurses, demonstrating that health care needs were being monitored and kept under review. However it was suggested that more detail be recorded in the monthly evaluations and that every year a full reassessment be carried out. This update could well take place when the PCT reassessment involving the residents and key worker is carried out as the named nurse assists in this process. Records are kept of visits by opticians, dentists and chiropodists. The home has good support from the hospice and they facilitated recent training in pain control in the home. Medication procedures and practises in the Home were reviewed, and the Home operates a safe system of storage, administration, disposal and recording of medication. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 The Home provides a varied range of social and therapeutic activities for residents. Residents are able to maintain close contact with families and friends. The Home provides a balanced diet for residents. EVIDENCE: Previously the inspector spent time discussing with the activities organiser the range of activities provided. The activities organiser was very enthusiastic and committed to her role. Many of the residents the inspector met said how much they enjoyed the range of arts and crafts, games and quizzes that take place. Previously whilst talking to residents, the inspector was also able to meet a number of relatives all of whom said that they are able to visit at any time they so wish. The menu was reviewed, to see the choices of meal the Home offers. The choices seen were nutritionally well balanced. However there was some repetition in the range of choices offered over the two-week rota. Residents were asked their views of the quality and variety of meals provided at the Home. A number of residents said they felt meal choices were bland and repetitive and a number enjoyed the food. As a result of these views the menu has been rewritten and will run over three weeks and it is hoped that residents will enjoy the greater variety on offer. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 13 The manager will conduct a survey of resident’s views about all aspects of catering in the coming month to assess people’s levels of satisfaction. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 The Home addresses promptly and thoroughly complaints made about the service. The Home supports residents to uphold their legal rights. Proper arrangements are in place to protect residents from abuse. EVIDENCE: The Homes complaints procedure is included in the service user guide, and a copy is given to residents on admission. There is a copy of the complaints procedure on display in the main foyer. Over the last few months the commission has received a number of telephone and written complaints that have focused mainly on staffing levels, workloads and staff disquiet. The complaints were from relatives and staff members and some were anonymous. Recently a regulation manager carried out an unannounced inspection to investigate staffing arrangements and a separate report has been issued with the findings. Other complaints were passed to Mrs Jenkins who has provided a full written response, which was forwarded to the complainants. No complaints were raised on the day of inspection and no further complaints have been made to the commission since early January. It is possible that a new more positive and constructive atmosphere is developing and staff morale rising which will reduce the number of complaints. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 15 No allegations of abuse have been received. The home has the Local Authority “Protection of Vulnerable Adults (POVA) inter-agency reporting procedure”. The home had formulated written procedures for adult protection; whistle blowing and management of resident’s money/valuables. The majority of staff have undergone in house and NVQ based training in understanding and prevention of abuse. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,25,26 The standard of furnishing and décor is high. The Home is safe, well maintained, and suitable for the needs of residents both internally and externally. The standard of cleanliness is high. EVIDENCE: The Home is built in landscaped gardens, surrounded by a lake, and peacocks roam the grounds. The gardens are fully accessible for wheelchair users as well as to the more able-bodied and are very popular and well used by residents and their visitors in warmer weather. The home has been designed to create a feeling of homeliness, with sufficient space and facilities for older people. There are suitable adaptations in place throughout the Home, to assist residents who may have limited mobility. The home is over two floors. There is level access to all areas via two passenger lifts. The home was well maintained is warm, well decorated and furnished and cleaned to a high standard. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 17 Residents can chose to socialise or have quiet time in their own rooms or one of the communal lounges or conservatory. The home operates a no-smoking policy. All bedrooms were well presented, offering appropriate furnishings and fittings relevant to need. Individual residents, with their families and/or friends, have personalised rooms with photographs, plants, TV, smaller items of furniture, etc. A number of the bedrooms have en-suite facilities and there is good provision of communal bathrooms and toilets. Resident areas are fitted with appropriate aids such as grab rails, fixed and mobile hoists. All rooms have a nurse call system with audible alarm facility. Sluice areas included sinks, sluicing disinfector on each floor. The laundry has sufficient washing machines and tumble dryers. There are appropriate infection control, policy and procedures in place. There are good arrangements in place for the service and maintenance of plant and equipment. Maintenance staff are employed providing full time cover for the home and gardens. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 On the day of inspection staffing levels were EVIDENCE: Currently there is evidence from care staff that indicate they feel they do not feel able to fully meet resident’s needs, based on letters and phone calls and conversations. Prior to the inspection a number of residents and relatives comments cards supported there being a lack of staff to fully meet needs. Comments cards from residents and their represented also stated that staff themselves were generally very kind and hardworking, but there was a perception of there being an insufficient number of staff on duty. The two most recent inspections have not found this to be fully substantiated. The nature of admissions and high dependency of some residents is a key factor in this situation and the manager and RNs are to devise a dependency assessment that relates needs to staffing and will assist in decisions about the suitability of admissions when related to staffing numbers and skills. A new staffing notice has been submitted to Mrs Jenkins to formalise minimum staffing levels for given resident numbers as no updated notice was put in place following the increase in bed numbers. The staffing levels agreed with a the manager for the current occupancy are; AM, 6 care staff and 1 RN, PM, 5 care staff and 1 RN, Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 19 Night, 3 care staff and 1 RN. The manager’s hours are in addition to the above. There are currently two care assistant vacancies. A new full time cook has recently been employed to work with the part time cook. A kitchen assistant is on duty every day. A laundry person works every day. Three housekeepers work Monday to Friday and two at weekends. A maintenance man works full time. The activity organiser works twice a week for five hours and a volunteer once a week. One of the night Sisters provides admin support once a week. The staff training arrangements will be looked at in detail in the May inspection. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35,36,38 The manager is trying to create an open and constructive ethos in the home. The Homes financial procedures safeguard resident’s finances. The Home protects the health and safety of residents and staff. EVIDENCE: The inspector-spent time talking with staff, to ascertain their views. In discussion with the inspector Mrs Lawrence also conveyed a commitment and enthusiasm to build staff confidence and improve morale. The importance of finding a balance between the considerable demands of office work and the new emphasis on closer interactions with the care staff team were also discussed. The one to one supervision sessions are to be fully reinstated every two months and planning to introduce an annual appraisal. Timetables and recording of these events are in place. The suggestion was made that RN’s Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 21 should conduct the one to one supervision sessions with the care staff that are key workers in the teams they oversee. However the manager has had no supervision from Mrs Jenkins. The regulation 26 reports are not submitted monthly as required. There has been no recent care staff meeting although one has been booked for the end of February. Clinical RN meetings take place periodically and the manager attends a quarterly S.Glos home manager meeting. The Home is able to look after resident’s personal spending money, and provides a secure safe for this purpose. Each person has a ledger sheet recording receipts, debits and balances. Two signatures are required to endorse any debits. The valuable held for safekeeping have not been recorded in an inventory, which must be done. The Home has a range of Health and Safety (H&S) policies and procedures in place to ensure the safety of residents and staff. The manager is a load-handling instructor and has completed H&S management training. Up to date service and inspection records were seen for; hoists, lifts, gas supply, electrics and fire alarm and extinguishers. The kitchen was very tidy and well organised. An Environmental Health Officer last visited in January and found all to be in good order. There have been no formal surveys of resident, relative or staff views and opinions recently. However the manager has started planning for this to take place and we discussed the value of making these themed surveys. It is hoped that the first results will be available for the May inspection. The responses from visiting health professionals in comment cards were all positive and praised the home and staff. In general the comment cards received from relatives were positive other than comments about the perceived numbers of staff on duty. Residents comment cards were also in general positive but did not praise the variety of food and some wished for different activities. The comment cards and discussions with the inspector said they felt that all the staff worked very hard were helpful and caring. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 2 x 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 2 x 2 2 x 3 Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? None 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. 2. Standard OP7 OP5 Regulation 15.1 5 Requirement Care plans must be personalised and show in sufficient detail how residents needs are to be met. Provide nursing residents a breakdown of fees specifying the cost of accommodation including food, nursing and personal care. The manager receives regular supervision from the Responsible Individual Submit a report monthly in the format set down by the regulation. Record in a ledger all valuables held for safekeeping. Create and maintain a system for reviewing and improving the quality of care. Put on public display for the benefit of residents and visitors a copy of the service user guide including the most recent inspection report. Timescale for action 10/03/06 30/03/06 3. 4 5 6 7 OP33 OP33 OP35 OP33 OP1 18.2 26 16 Sch 4.9 24 5.1 10/03/06 28/02/05 10/03/06 01/04/06 15/03/06 Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 24 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. 3 4 Refer to Standard OP7 OP3 OP36 OP36 Good Practice Recommendations Record more detail in the monthly evaluations and carry out an annual reassessment thence re-writing the care plan. Create admission criteria including a dependency rating and relate this to the existing dependency levels in the home and the staff numbers and skill mix. That named RN’s conducts supervision for the care staff that work in their teams. Ensure monthly care staff meetings are organised and full records made of actions and outcomes from previous meetings. Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Woodlands Manor DS0000059729.V275834.R01.S.doc Version 5.1 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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