Care Home: Collamere

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What the care home does well The registered manager is approachable and residents confirmed that they would feel able to express any concerns. All the residents spoken with said that they were happy with the care provided, and they found the staff to be kind and attentive to their needs. The nurse team is well lead by the matron.The premises are clean and well maintained, offering safe, level access throughout the home. The home is well provided with aids to meet the care needs of residents. There is an evident commitment to resident wellbeing from the staff. What has improved since the last inspection? The recording of the care plans has improved. Considerable progress has been made in meeting the social care needs of the people at Collamere. A number of activities and "one to one" time is spent with the people in the home. A staff member has responsibility for this. Policies and procedures have been reviewed within the last 12 months. A quality assurance survey has been completed Legionella is properly monitored Various areas of the home have been upgraded. Staff training remains a priority Recruitment procedures are robust. What the care home could do better: There are two Statutory requirements issued as a result of this inspection and two recommendations. Medicines should be stored in locked metal cabinets. It is a requirement that a care home must be suitably staffed at all times. To this end it is recommended that that two trained nurses are on dutythroughout the day to ensure that all nursing interventions are carried out within a reasonable time frame. To consider additional recording by care staff in the residents daily notes to illustrate the overall lifestyle of residents. Where applicable, all reference to the CSCI in policy and procedure documents should include the up to date address and telephone number. CARE HOMES FOR OLDER PEOPLE Collamere Grenville Road Lostwithiel Cornwall PL22 0RA Lead Inspector Mike Dennis Unannounced Inspection 14th July 2008 09:30 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 Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Collamere Address Grenville Road Lostwithiel Cornwall PL22 0RA 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) 01208 872810 01208 872823 collamere@btconnect.com Pinerace Jane Eldridge Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (6), Terminally ill over of places 65 years of age (6) Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users not to exceed a maximum of 45 Date of last inspection 30/01/2007 Brief Description of the Service: Collamere is a large traditional house with purpose built extension, registered to provide nursing and social care for a maximum of 45 people to include elder care, care for the terminally ill and care for a maximum of 6 physically disabled people. The home offers both permanent and respite care. A registered nurse is on duty at all times. The property is situated just on the outskirts of Lostwithiel. Most accommodation is provided on the ground floor but there is a passenger lift for access to first floor rooms. The home has two lounges and a large dining room. There are four double rooms, the rest being single all of which now have en-suite facilities. Assisted bathing facilities are available. The majority of corridors are wide. There is good chair access on the ground floor. The grounds can also be accessed by wheelchair and extend around the home. There is a sheltered central courtyard with seating. There is a car park with good wheelchair access to the main front door. Collamere DS0000009005.V368389.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. This unannounced inspection took place over a period of approximately 7 hours on the 14th. July 2008. The inspector met with the registered manager, the registered provider, staff, and residents, and toured the premises, as well as inspecting relevant documentation. The key inspection focused on the premises, meals, medication, records relating to care, staffing and management to include policies and procedures. Case tracking of five people took place and some of these people were spoken to during the course of the day. Very positive comments were received in relation to the care that they are receiving at the home. For example: “I get regular visitors and I like my privacy, which the staff respect” “I would not change anything”, “I get a choice of meals and have a lovely room, I would not like to be anywhere else”. It is noted that the physical care needs of a number of the people at Collamere are high. The management at Collamere House have complied with the requirements made at previous inspections and continue to make progress. Overall, there is a good outcome for residents, with an evident commitment from staff and management to resident welfare and protection. What the service does well: The registered manager is approachable and residents confirmed that they would feel able to express any concerns. All the residents spoken with said that they were happy with the care provided, and they found the staff to be kind and attentive to their needs. The nurse team is well lead by the matron. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 6 The premises are clean and well maintained, offering safe, level access throughout the home. The home is well provided with aids to meet the care needs of residents. There is an evident commitment to resident wellbeing from the staff. What has improved since the last inspection? What they could do better: There are two Statutory requirements issued as a result of this inspection and two recommendations. Medicines should be stored in locked metal cabinets. It is a requirement that a care home must be suitably staffed at all times. To this end it is recommended that that two trained nurses are on duty Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 7 throughout the day to ensure that all nursing interventions are carried out within a reasonable time frame. To consider additional recording by care staff in the residents daily notes to illustrate the overall lifestyle of residents. Where applicable, all reference to the CSCI in policy and procedure documents should include the up to date address and telephone number. 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. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose and service user guide documentation provide prospective people with details of what the home provides helping an informed decision about admission to the home. The manager and/or nurse in charge assesses all people prior to admission to the home to ensure that the home will be able to meet their care needs. People may visit the home prior to admission. EVIDENCE: Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 10 Some resident admissions have occurred on the basis of recommendations, and some residents staying for respite care have moved in permanently. The home has in place good detailed information in the service user guide document and statement of purpose on the terms and conditions of placements at Collamere. The information provided in these documents allows decisions to be made (by prospective people) on the suitability of the home for them. These documents were revised and updated in February of this year. A copy of the Statement of Purpose and Service User Guide is kept in every bedroom. Visits to the home to have a look around, see the accommodation and meet the staff are encouraged prior to admission. Information is included in the service user guide on the admission assessment procedure and visits to the home. Prior to admission an assessment of care needs takes place by the registered manager and/or nurse in charge to establish that the care needs of the people can be met. When the assessment has been undertaken through care management arrangements the home has received a summary of the assessment and a copy of the plan. A care plan is then developed from the pre admission assessment document. The home enjoys good links with other healthcare professionals, (e.g. tissue viability nurses). Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning documentation has been considerably improved. The care plans evidence that the care needs of the residents are being met at all times. Medication is being administered correctly to residents. Staff are fully aware of the principles of respect, dignity and privacy in their delivery of care to the residents. EVIDENCE: The residents’ health and personal care needs are set out in an individual plan of care that is based on the activities of daily living. The care plans are Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 12 reviewed and upgraded with new documentation and information at regular intervals. The care plans clearly identify the care needs of the people and how these are being met. Regular reviews of the care plans are also taking place. The care plans are fully accessible to the staff to include the carers and the nurses. Residents’ health care needs are generally well met. There is a wide variety of aids available to assist in meeting residents’ care needs. All residents are registered with a GP. The home has a number of link nurses. There are currently link nurses in place for dementia care, tissue viability, infection control and continence care. The home maintains good links with visiting health care professionals. Residents were complimentary about the care and attention of staff. The home has a medication policy in place, referencing the Royal Pharmaceutical Society (RPS) Guidelines. The home uses a monitored dosage system. The medication administration records (MAR) were signed and dated appropriately and each sheet contained a photograph of the resident. The Controlled Drugs (CD) were stored securely and recorded correctly. Trained nurses only administer the medication. Medication was seen to be administered appropriately, using a medicine trolley and two personnel during the morning. The morning medication round can take anything from 2-3 hours, dependent in interruptions and other demands placed on the nurse on duty. Comment is made later in this report about the pressures on the nursing staff, especially on morning shifts. We were informed that the medication storage facilities will shortly be moved to another area. When this is done the existing cupboards should be replaced with metal ones Residents confirmed that staff always knock before entering rooms, and all felt that their privacy and dignity were protected. Without exception, all the residents spoken with were complimentary about the kindness and consideration of the staff. All residents have access to a telephone, though some have their own telephone in their rooms. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment of the social care needs of residents and the activities being provided at the home meets residents needs. Visitors to the home are welcomed and encouraged. During the course of the inspection the residents commented very favourably on the standard of the meals at the home. EVIDENCE: Residents confirmed that their waking day is flexible, and determined by their own wishes. Residents’ interests are known, and encouraged. A member of the care staff has been given dedicated time to organise and implement the activities undertaken by the home. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 14 There is a monthly activity plan and a record of those activities having occurred, including whether residents participated and enjoyed the event. Care staff could do more to ensure that entries in the daily records also give a picture of the resident’s lifestyle at the home. Residents spoken with confirmed that visiting is open and free from restrictions, and many residents are from the local community in and around Lostwithiel. A visitors’ book is kept in the entrance, which shows regular and frequent visitors to the home. Residents are able to handle their own financial affairs for so long as they wish and are able to do so. Residents are entitled to bring personal possessions with them and this was evident in some rooms. The home invoices for personal costs retrospectively, rather than accessing residents’ money. The registered manager advised the inspector that only a small number of residents have small amounts of money held at the home, and all residents have their own bank accounts. The cook has responsibility for providing a large number of meals within the home. The menu is mainly traditional and changes over a four week period. The menu includes for example two roast dinners in the week and fish and chips on a Friday. An alternative choice to the main meal is always available. On the day before a care staff member asks each service user what they would like to eat for the following day. Special diets are catered for, as are liquidised meals for example. Local suppliers are used to provide the meat and vegetables. All the cooks have obtained their basic food hygiene qualification. Records are in place to comply with the District Council Environmental Health Department “Better Business”. It was noted during the course of the inspection that the staff were able to assist people sensitively with the meals where they are more dependent. Each person spoken to during the course of the day expressed very positive comments on the standard of the meals. A quality assurance survey is conducted annually. A “Collamere” news sheet is regularly published. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure provided to the people in the service user guide. Adult protection policies and procedures have been reviewed and are deemed satisfactory , in line with the local council multy-agency procedures. EVIDENCE: Should a person wish to make a complaint, clear information on this process is available in the service user guide. In addition the complaints policy and procedure is displayed in the home. The home has received no complaints. The home has in place a good adult protection policy and procedure that has recently been updated by the manager. The policy and procedure has been distributed and read by all the staff. A number of staff have attended external adult protection training and a number of staff have watched an in house adult protection video. It is appropriate for the staff who have not received any training to undertake this as a priority to ensure the safety and well being of the people in the home at all times. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 16 Please note that the complaints procedure now needs a further update to include the change of address of the CSCI contact point • CSCI, South West Regional Office, 4th.Floor, Colston 33, • 33 Colston Avenue, Bristol BS1 4UA. Tel: 01179307110. E. enquiries.southwest@csci.gsi.gov.uk Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well maintained, clean, and hygienic environment, which is suited to its stated purpose. EVIDENCE: Collamere is a clean, well-maintained and easily accessible home. The home has a spacious feel with a large dining room near the main entrance, and a large lounge. There are safe internal areas where residents can sit or wander around as they wish. There is an internal courtyard, which affords seating in Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 18 more clement weather. Furnishings within the communal areas were appropriate and of a good standard. The communal areas are smoke free. Wheelchair users can access the grounds. The corridors are wide and internal access is level. The home provides various aids/equipment and has sufficient assisted toilets and baths. Grab rails are located in most areas of the home. Rooms are individually and naturally ventilated and are centrally heated (gas). Heating can be controlled in each room. Residents’ rooms were personalised to varying degrees and all offered comfortable, spacious, pleasant accommodation. Emergency lighting is provided throughout the Home. Staff were seen to carry their own alcohol solution for hand washing, in addition to the facilities provided in lavatories and bathrooms. The kitchen is spacious, clean, and well organised, with a storage area adjacent. The Laundry has been re-sited away from the kitchen area in line with previous recommendations. It is now housed in a larger room and deemed more suitable for purpose. Industrial equipment has been installed and all of the homes’ washing is now dealt with in house. The laundry person has worked at Collamere for a several years, and confirmed the improvements made. Bedrooms are re-decorated as and when they become vacant. Additional ensuites/wet rooms have been added. All bedrooms now have this facility. New furniture has been purchased for the dining room and new carpets laid to certain areas. An improved storage area for waste bins has been provided. Residents informed us that they were satisfied with their environment. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at Collamere are appropriate to meet the needs of the people. Recruitment procedures for new staff are satisfactory. Staff training is ongoing with a large amount of training recently undertaken and more planned. This is to the benefit of the people in the home and the staff. EVIDENCE: At the time of the inspection there were two nurses and seven care staff on duty, with additional support staff (laundry, cleaners). There were 41 residents living at the home. The matron was one of the nurses on duty and able to support the other duty nurse. It is noted that the matron is also allocated administrative time and is not always available to assist with care provision. We were told that the morning medicine round could take anything from 2-3 hours depending on interruptions and other demands on the nurse’s time. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 20 Based on discussions and review of the records, it is evident that a high number of residents require dressings, bloods and the administration of controlled drugs. The registered nurses were seen to be very busy and in order to maintain a high level of care it is considered that two nurses should be on duty at all times through the day to ensure that care needs are met promptly and safely. The duty rota shows that the home employs 21 care staff, of which 18 (approximately 85 ) have achieved NVQ Level 2 or above. Recruitment procedures were found to be satisfactory on the day of the inspection. Two written references and a criminal records bureau check are in place for all staff. New staff undertake a National Training Organisation compliant induction programme, a sample of which was seen at the time of the inspection. Staff spoken with confirmed that there are regular and frequent training opportunities, relevant to the position held. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,33, 34, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team at Collamere are experienced and competent in delivering positive outcomes to the people in the home. People spoken to during the course of the day expressed very positive comments on the standard of care that they are receiving at the home. EVIDENCE: Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 22 The manager, Jane Eldridge, became the acting manager in March 2007 and has now been the registered manager since May 2008. She is a qualified Registered General Nurse and also holds the Registered Managers Award, plus a number of other relevant qualifications. The registered manager has introduced a healthy atmosphere of inclusion within the home and this is demonstrated by residents’ comments. Residents confirmed that the manager of the home was accessible and they were complimentary about the attitude of the staff and the care provided. There are regular quality assurance questionnaires, the results of which are published in the (at least) quarterly ‘Collamere Times’ newsletter. Quality assurance includes service provision, and an audit of the premises, and is extended to residents and their representatives. Policies and procedures are comprehensive and reviewed regularly. Residents are able to handle their own financial affairs for so long as they wish and are able to do so. The home invoices for personal costs retrospectively, rather than accessing residents’ money. The registered manager advised the inspector that only a small number of residents have small amounts of money held at the home, and all residents have their own bank accounts. Staff supervision records are in place and staff confirmed that their supervision occurs within regular time scales. Maintenance and service records show that the home is well maintained and safe. There are contracts in place for the regular and frequent maintenance/checks of the building and its equipment. Appropriate safety equipment (hot water valves, fire extinguishers) are fitted and serviced. Staff receive relevant and appropriate training, in areas such as: Induction, Fire and 1st Aid. Accidents and incidents are recorded and properly reported. Collamere DS0000009005.V368389.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 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement Medicines kept at the home should be stored within a metal cabinet in accordance with the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the Misuse of Drugs Act 1971 The registered manager must ensure that there is sufficient nursing staff on duty to effectively meet the care needs of the residents. Timescale for action 01/12/08 2 OP27 18(1)(a) 01/09/08 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 OP16 Good Practice Recommendations Please amend the complaints policy to detail the current address of the CSCI Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 25 2. OP27 It is strongly recommended that two nursing staff are on duty throughout the day. Collamere DS0000009005.V368389.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Collamere DS0000009005.V368389.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. 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