Care Home: Amersall Court

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What the care home does well Atmosphere and interaction between staff and people living at the home were good, daily routines appeared flexible and people looked relaxed and comfortable. People were assisted and supported by staff to make decisions and choices about all daily living needs, this included people`s wishes and preferences. Care plans showed detailed individual information of peoples care needs when assessing and planning health care needs, these were found to be monitored on a regular basis. People had the opportunity to participate in leisure activities and live as part of the community. People were encouraged to continue with education if they wished, one person said they were doing a computer course at college. People said they were encouraged to pursue their own interests or hobbies; one person said they enjoy going to football matches on a regular basis. Religion was documented in care plans and people were supported if they wished to practice their religious beliefs. Feedback from people within the home and observation on the day of the visits showed that staff treated people with respect and dignity. Positive comments were received from people within the home. For example, "staff work hard to provide things for us" "staff make them feel wanted and cared for" "staff is available when I need them". What has improved since the last inspection? CARE HOME ADULTS 18-65 Amersall Court Amersall Road Scawthorpe Doncaster South Yorkshire DN5 9PQ Lead Inspector Janet McBride Key Unannounced Inspection 29th April 2008 11:15 Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 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 Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amersall Court Address Amersall Road Scawthorpe Doncaster South Yorkshire DN5 9PQ 01302 781857 01302 788624 NONE None Doncaster MBC 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) Ms Lynda Stocks Care Home 18 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Physical disability (14) of places Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user under the age of 65, named on variation dated 18th September 2006, may reside at the home 4th May 2007 Date of last inspection Brief Description of the Service: Amersall Court is a care home for adults offering care to two different service users groups aged 18 to 65 with physical disabilities/ learning disabilities, accommodating 18 service users. The Registered provider is Doncaster Metropolitan Borough Council (DMBC) The home was purpose built and accommodation is provided in four bungalows, Three bungalows provide single bedrooms with en-suite toilets and showers, a communal lounge and kitchen/dining room. A two-bedded unit for semiindependent living provides communal lounge/dining, kitchen and shared bathroom; corridors internally connect all of the accommodation. To the rear of the home is a large, enclosed patio area, and a car park is provided at the front of the home. Fees range from £1022:22 per week, as at April 2008. Additional charges are made for hairdressing, Chiropody, toiletries, magazines/papers, taxis and contribution to petrol and holidays, these cost are variable for further information contact the home. Information about the service is available to service users and their families via the home’s Statement of Purpose and the Service User Guide. The home last published inspection report is kept in the office, which is available on request for visitors to read. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. One inspector carried out this Key Unannounced Inspection, which took place on the 29th April 2008 starting at 11:15 and finished at 18:15 hours. Prior to the inspection the home submitted an Annual Quality Assurance Assessment this gives information regarding the home and services provided. Pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection, documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Three care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. A tour of the premises and direct observation of staff interaction with people who use the service was carried out throughout the visit. Information was gathered from as many different individuals as possible that had contact with people within the home, including individual interviews with the manager, deputy manager and three members of staff. Two people who receive the services within the home were spoken to and four relatives were contacted by telephone. They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service needs were met. Some judgements about quality of life and choices were taken from direct observations of people on the day, followed by discussion with support staff and evidencing records held at the home. We would like to thank all the staff, relatives and people receiving services within the home for their co-operation in the inspection process. Balanced positive feedback as well as any issues or concerns that were raised were discussed with the deputy manager at the end of the inspection. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Address the requirements and recommendations raised on this inspection regarding the premises. Update all policies and procedures. Ensure all night staff receive any updates in training they need. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 &4. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People were individually assessed prior to admission to ensure their needs would be met and supported to make informal choices. EVIDENCE: Staff said they encourage people to visit the home many times before moving in on a permanent basis, this was confirmed when speaking to people receiving the services at the home. Care plans showed that people within the service had been assessed before being placed in the home. People were introduced into the services at a slow pace taking into account background history of the person, risk assessments and a detailed plan of care that reflected any specialist interventions. The scale of charges was discussed with management and any extras that people pay for, are documented on page five of this report. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 &9. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Care plans provided staff with sufficient information to meet the needs of people who use the service. People were assisted and supported by staff to make decisions and choices about all daily living needs. EVIDENCE: Three care plans were checked these set out in detail healthcare, personal and social care needs in an individual plan of care. All contained up to date information that reflected people’s needs as detailed in their assessments. This ensured that staff know the care required and that peoples needs were identified and met. Health action plans were in place for those people who had learning difficulties. People were encouraged and supported by staff to make decisions about everyday tasks. This ensured people were consulted and had choices about daily living needs. Advocacy services were available when needed. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 11 People were supported in taking risks as part of an independent lifestyle, therefore risk assessments were in place to minimise any identified risks or hazards. These plans stated what support was needed for each individual person, and contained approaches and strategies to deal with any issues or concerns. This ensured staff were well informed about how to support each person in the home, this helps people to achieve their maximum potential. One person who goes out independently said if the home stopped them taking that risk it would have a big impact on their life. Feedback from people within the home and observation on the day of the visits showed that staff treated people with respect and dignity. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 &17. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Opportunities were provided and encouraged for the development of social and practical skills. This ensured that people had the opportunity to participate in leisure activities and live as part of the community. People were offered a wholesome and appealing balanced diet with a varied selection of food available to meet people’s tastes and choices. EVIDENCE: Daily routines within the home were flexible and individual for each person. Interactions between staff and people were positive with people being called by their preferred name, all being attended to promptly and staff respecting privacy by knocking on doors before entering. The home do not employ an activities organiser therefore its left to the staff to try and organise activities, this is dependent on staffing numbers. The majority of people spent some of their time outside of the home, and had opportunities to mix with other people for example, day centres, college, Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 13 shopping trips and various outings. The home has its own mini bus to facilitate outings. They can take part in activities if they wish and are encouraged and supported to be as independent as possible and had the opportunity to make the most of their abilities. People were encouraged to continue with education if they wish, one person said they were doing a computer course at college. Other people said they were encouraged to pursue their own interests or hobbies; one person goes to football matches on a regular basis. Religion was documented in care plans and people were supported if they wished to practice their religious beliefs. People said they are supported and encouraged to maintain links with their families and friends, majority people had contact with relatives and go on home leave. All people that use the service were offered the option of a holiday, however when speaking to one person who said despite all the other people on the unit were going on holiday but they did not wish to go. This confirmed that people had choices and were treated as individuals. Staff promoted a healthy and nutritious diet, menus seen showed that most people followed a healthy eating plan. People who were capable helped prepare food and cook meals. They also went shopping with staff to buy food and help plan meals for each week. Some people had the input of a dietician and all were weighed on a monthly basis. This ensured that nutrition and weight was monitored and reviewed on a regular basis. Positive comments were received from people within the home. For example, “staff work hard to provide things for us” “staff make them feel wanted and cared for” “staff is available when I need them”. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 &20. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People’s health is monitored and arrangements for dealing with health issues were met with support from health professionals. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Care plans showed that people had access to a range of health care professionals, including district nurses, chiropodists, dentists and optician. Records clearly showed that people were assisted and support by staff to make decisions and choices about all daily living needs. Some people were able to comment on this those spoken to, who confirmed that they visit the dentist or opticians when required. People on the learning disability unit had a health action plan. Detailed information of peoples personal care needs was available, this included people’s wishes and preferences, and when staff provided personal support in daily routines. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 15 Staff were able to describe the care needs of each person, they were also aware of any restrictions on privacy, for example risks when bathing alone. Risk assessments were in place to identify any risks and how they could be managed. Records were maintained for current medication for all people within the home. Records were checked all were found satisfactory with recording systems in place. Storage of medicines was in an appropriate locked cabinet cupboard with each unit. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 &23. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who use the service and relatives were provided with information to enable them to raise concerns or complaints about the home and their care. Policies and procedures were in place on adult protection, and staff had knowledge and understanding of adult protection issues. This promoted and protected people who use the service. EVIDENCE: The home had a comprehensive Concerns Complaints procedure (DMBC View Point). There is also a monitoring form that is used to record complaints, included timescales for complaints to be acknowledged and investigated. Complaint records showed no complaints had been received since the last inspection. Policies and procedures were in place regarding the protection of vulnerable adults. All staff had checks completed before being employed for example Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks. Staff confirmed they were aware of protection polices and procedures, they were able to describe the action they would take on receiving any allegations. This ensured people who use the service were safe and protected. Training records showed that most staff had received updates in adult protection, with the exception of some night staff. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,29 &30. People who use the service experience Adequate outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home was clean and tidy, but a number of areas are in need of refurbishing. However people who use the service felt they lived in a comfortable and accessible environment with any specialist equipment they require to maximise their independence. EVIDENCE: The home was purpose built and designed to suit the service users group, corridors internally connect all of the accommodation. This was fully accessible for people in units 2,3 and 4,but unit 1 had a keypad for people’s safety, as Unit 1 accommodation is for people with learning disabilities. Each unit has communal lounge and kitchen/dining room, unit 4 is a semiindependent unit which provides communal lounge/dining, kitchen and shared bathroom. Tour of all units found them to be comfortable bright and cheerful, all were made to look very homely with pictures and ornaments around the home. It was clean and tidy but some of the paint work on doors and skirting boards Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 18 was very scuffed and marked and in need of painting. A number carpets throughout the units were either stained or showing signs of wear and tear. These were identified to the manager for example, corridor carpet from unit 2 to unit 4,office carpet and the lounge carpet in unit 4. The grounds were well-maintained, accessible communal patio to the rear of the home, the manager said that garden furniture had been purchased for people or visitors to use on nice days or when they had barbecues. Each of the three units provided single bedrooms with en-suite toilets and showers, each person’s bedrooms had been individually decorated in a style to suit them. These rooms reflected the different interests and hobbies of each occupant. Each room had a lockable facility, a television, music centre, adjustable bed, overhead tracking, accessible electric with furniture and fittings being of good quality. All had adaptations and equipment to suit individual person. Two bedrooms were identified as requiring new carpets to be fitted, these were identified to the manager. The home has very little storage space. The inspector was informed on the last two inspections that outbuilding were going to be provided to give further storages space. However this still has not been provided and impacts on the premises being used for inappropriate has storerooms for wheelchairs, carpet cleaners and incontinent pads. The home had taken action regarding issues raised on the last inspection, storages of hazardous substances and control of infection regarding clinical waste. This inspection found all hazardous substances were stored in the laundry room, which is kept locked at all times. They had resolved this issue about Clinical waste, this is now collected twice a week. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 &35. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Staff had the skills and knowledge to fulfil their roles, and worked positively with people who use the service to improve their quality of life within the home. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: All units are staffed separately and staffing was discussed with both the manager and staff members. Although the home had filled the vacant posts for care staff, staff still had to cover duties over and above their contracted hours to ensure minimum numbers were maintained. The home had a thorough recruitment procedure, staff recruitment records are held at the Councils head offices. However discussions with the manager, and new staff who were interviewed, confirmed they had been interviewed, Criminal Records Bureau checks completed, and two written references provided. Staff said they were given copies of the General Social care Council code of practice. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 20 Each member of staff had an individual training file, these were examined and training opportunities were discussed with the manager and staff. A number of staff had completed Learning Disability Award Framework (LADAF) and achieved National Vocational Qualification level 2 to 3 in care (NVQ) training. Since the last Inspection access to mandatory training and refresher training for staff had improved. Staff that were spoken to appeared to be competent and worked positively with people to improve their quality of life. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,41&42. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Detailed records ensured that people who use the service have their health, safety and welfare promoted and protected at all times. They continue to make improvement in the provision of services to ensure effective outcomes for people. EVIDENCE: Management structure at the home consisted of a registered manager, and two deputy managers and an administrator. The AQAA was completed by the deputy manager and gave clear information about the current situation within the service, as the manager had been on sick leave for a number of months. The home had recently sent out surveys to gain the views of relatives about the care and services provided, these are waiting to be collated for the results. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 22 A number of meetings had been held since the last inspection, for example staff meetings, resident meetings, these covered a variety of topics all had minutes taken to record peoples views. This gives an opportunity for people living at the home to influence the care provided. Polices and procedures were discussed with the manager as the AQAA showed that a number require updating and should be done as soon as possible. Compliance in record keeping had improved, with the CSCI receiving Regulation 37 incident forms on a more regular basis. Finances and financial recording were discussed with the homes deputy manager, people manager their own money where possible. There were no changes since the last inspection, records and balances were checked and found correct, with accurate recording of transactions and receipts. Health and safety and safe working practice were discussed with manager and some members of staff during the visit. Maintenance and service records were examined, these were up to date with current certificates. Fire safety procedures were in place, records examined showed they were current and up to date. At the time of the visit all hazardous substances was securely stored in a locked cupboard within the laundry room. Training records showed the majority of staff had received training and updates in first aid, moving and handling, health and safety and fire training. This keeps people living and working at the home safe. Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 2 3 3 X Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA35 YA24 Regulation 18(1)(c) 23(2)(b) Requirement Night staff must receive updates in training appropriate to the work they perform. Premises all parts of the home must be kept reasonably decorated and in a good state of repair. • Carpets must be replaced in the identified areas. • Redecorate in the identified areas. • Replace the washable floor covering in the identified bedroom with carpet. Timescale for action 30/06/08 30/09/08 Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard YA24 YA32 Good Practice Recommendations Provision should be made for the storage of equipment. The home should continue with on going NVQ training to ensure a minimum ratio of 50 of care staff are trained to NVQ Level 2 or equivalent is achieved. The home’s written policies and procedures should be updated to comply with current legislation and recognised professional standards. 3 YA40 Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Amersall Court DS0000065521.V363694.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!