Care Home: Crawford Care Home

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What the care home does well Crawford offers a homely, supportive and comfortable environment for the people who live there. In order that the individual and diverse needs of service users can be met, robust pre-admission assessments are carried out and a plan of care agreed for each person. The people living in the home have access to good healthcare and emotional support networks and the home works well with a variety of healthcare professionals. The people living in the home tell us that they are happy there, that they have opportunities for leisure activities education and employment and are part of the local community. Both service users and their families are very complimentary about the skills and commitment of the staff team and say that they are treated with respect and kindness. People are protected by their being a robust recruitment process in place and the staff team are well trained and well supported. What has improved since the last inspection? The home has undergone a programme of redecoration and refurbishment, some new furniture has been purchased, a hydrotherapy bath fitted and a fire sprinkler system installed. In order to gain the views of service users and their families, a quality assurance process has taken place ansd outcomes have been recorded. What the care home could do better: To ensure that service users are protected from medication errors at all times, the completing of Medication Recording Sheets must be kept up to date and a list of medication handlers and their sample signatures kept on the medication file. To ensure that the home is kept clean and hygienic and that infection control issues are addressed, the flooring in the upstairs bathroom must be replaced and the rusted radiator attended to.To allow the acting manager to become competent in the role of manager, the staffing rota should allow for management time off the working shift pattern to complete management tasks. CARE HOME ADULTS 18-65 Crawford Care Home 3 Alexandra Terrace Clarence Road Bognor Regis PO21 1LA Lead Inspector Mrs A Taggart Unannounced Inspection 5th November 2007 3:00 Crawford Care Home DS0000065030.V349649.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 Crawford Care Home DS0000065030.V349649.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. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crawford Care Home Address 3 Alexandra Terrace Clarence Road Bognor Regis PO21 1LA 01243 865353 01243 867662 darrenling2@yahoo.co.uk 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) Crawford Homes Limited Post Vacant Care Home 11 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: The Crawford is a private care home registered to accommodate up to eleven service users in the category (LD) Learning Disabilities. One service user is accommodated in the category LD (E). The premise is a three - storey middle of terrace property located in the town of Bognor Regis. Its communal rooms consist of a non-smoking lounge, dining area and small lounge at the rear of the premises. The property has a small patio garden, which is regularly used in the summer months. Crawford is near to the main shopping area, library, health centre, front and beach and is adjacent to the town hall. There are bus routes to Chichester, Worthing and Brighton and the mainline Station is within walking distance. Crawford Homes Ltd privately owns the service. The responsible individual is Mr Gajaruban Ragunathan and the registered manager is Mrs Deborah Guy. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit an Annual Quality Assurance Assessment (AQAA) was sent to the manager, this was returned to CSCI in the given timescales and contained good information about the home. Survey forms were sent to service users, families and professionals involved with the home, four service user and three family surveys were returned and comments from these have been included in the report. We read the last report and any correspondence and information regarding the home that had been sent to us since the last visit. In order to meet with the people living in the home this unannounced visit was carried out at 3pm and lasted for 3.5 hours. We spent time talking with service users both in communal areas and in their private bedrooms and they all were very complimentary about the service they receive. We also spent time talking with the staff on duty and observed staff practice. Three care plans with supporting documentation were tracked with any issues that needed further clarification being discussed with the relevant service user or the staff member on duty. The staff files of three staff members were seen and they contained all of the required documentation including a current Criminal Bureau Check (CRB) and two references. We saw a meal being prepared, looked at food records and spoke with service users about their satisfaction with the meals provided. Records for the running of the business were seen including fire check and staff fire training, the complaints book, accidents and incidents logs and health and safety records. The acting manager was present and received feedback following the visit. What the service does well: Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 6 Crawford offers a homely, supportive and comfortable environment for the people who live there. In order that the individual and diverse needs of service users can be met, robust pre-admission assessments are carried out and a plan of care agreed for each person. The people living in the home have access to good healthcare and emotional support networks and the home works well with a variety of healthcare professionals. The people living in the home tell us that they are happy there, that they have opportunities for leisure activities education and employment and are part of the local community. Both service users and their families are very complimentary about the skills and commitment of the staff team and say that they are treated with respect and kindness. People are protected by their being a robust recruitment process in place and the staff team are well trained and well supported. What has improved since the last inspection? What they could do better: To ensure that service users are protected from medication errors at all times, the completing of Medication Recording Sheets must be kept up to date and a list of medication handlers and their sample signatures kept on the medication file. To ensure that the home is kept clean and hygienic and that infection control issues are addressed, the flooring in the upstairs bathroom must be replaced and the rusted radiator attended to. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 7 To allow the acting manager to become competent in the role of manager, the staffing rota should allow for management time off the working shift pattern to complete management tasks. 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. Crawford Care Home DS0000065030.V349649.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 Crawford Care Home DS0000065030.V349649.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): 1 2 4 and 5 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. Prospective service users and their families can be confidant that they will be given information about the home, that their needs will be assessed and recorded and visits to the home encouraged. EVIDENCE: The home has a Statement of Purpose and Service user Guide in place, both of which can be supplied in an accessible format. In order to ensure that the home can meet individual needs, robust preadmission assessments are carried out and recorded and records show that the home involves service users, families and healthcare professionals in the process. Service users confirmed that they had been able to make visits to the home before moving in and one person was on a structured, twelve-week assessments period on order to assess the suitability of the home and the person’s compatibility with other service users. Contracts of terms and conditions of residency are agreed and samples were seen on service user’s files. Crawford Care Home DS0000065030.V349649.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 and 9 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. Care plans are designed to be accessible to service users and contain good information to guide the staff team to the needs and wishes of the people they are supporting. EVIDENCE: In order to ensure that the individual and diverse needs of service users can me met, the home records a plan of care that is developed from information gained from the pre admission process. We tracked three care plans and all contained comprehensive information to inform the staff team of the need and wishes of each person. The plans were in an accessible format using pictures or symbols and there was evidence that the documents had been completed with input from service users, their families and other healthcare professionals. The plans contained risk assessments, behaviour management plans where appropriate, and outline daily routines and preferences. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 11 Where restrictions are placed on service users, this is agreed and documented. One service user confirmed that they had agreed to some restrictions on community access and said that they understood the reasons for this. Goals for future development and personal wishes are also contained in the plans and service users confirmed that they met with their key worker on a regular basis to review and update the plans if necessary. There are also records of formal reviews, which are held either six monthly or annually and families and care managers also have involvement with these meetings. Crawford Care Home DS0000065030.V349649.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 14 15 and 17 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. The people living in the home have access to educational and employment and opportunities and attend leisure activities. People can meet with their family and friends and have a variety and choice of meals. EVIDENCE: From reading daily records and from speaking with service users, it is clear that people are involved in a variety of leisure activities, have access to educational and employment opportunities and are involved in their local community. During the visit people were coming back from day services or employment settings and others were going out shopping and for coffee and snacks. People said that they liked going on holiday, to the cinema, the pub and to Brighton or to the local shops. People’s private bedrooms have been personalised to assist people with their hobbies and interests and one person had a pet bird to care for. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 13 One person said that they did not like going out into the community very much but said that they enjoyed carrying out regular tasks about the home that made them feel valued and included. People confirmed that they kept in contact with family and friends and that their visitors were made welcome. In the AQAA the manager told us that the home has it’s own vehicle for outings and holidays and some people said that the preferred days out or short breaks as they did not like being away for too long. Comments from service users included, “ I just knew it was the right place for me. I am very happy here” and “ this is a good place, everyone is very kind, we get to go out a lot and there is always someone to talk to if you feel down”. Records show that a variety of fresh, home cooked meals are provided and service users said that they had recently been involved in updating the menus. Mealtimes are flexible to suit people’s needs, people also have occasional meals out or said that they could make themselves a snack if they felt like it. Crawford Care Home DS0000065030.V349649.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 and 20 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. Although the people living in the home receive good healthcare and emotional support, there could be potential risks to them regarding the recording of medication administration. EVIDENCE: Each person living in the home has a detailed healthcare plan in place that forms part of the care plan. People are given a choice of who supports them with personal care and routines are flexible. Records show that the home works with a variety of healthcare professionals including learning disability teams, mental health teams, speech and language therapists and local doctors. Where people have specialist needs, for example epilepsy, training for the staff team is provided and care plans have very clear guidelines in place. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 15 From looking at records and from observation during the visit it is clear that that staff team work with people with behavioural difficulties on a daily basis, which they said could be very stressful. The home works on the “Gentle Teaching” model, using negotiation and nonconfrontational methods to manage situations and the staff team have received training in personal safety and managing challenging behaviour . Observation showed that the staff on duty were very patient and friendly in their interactions with people and service users were very clear about what strategies to support them were in place and who they would go to for emotional support. Medication is stored in a locked cabinet in the office and a monitored dose; Nomad system of administration is in use. The staff team receive training in the administration of medication and guidelines regarding what each medication is for and what it looks like are recorded for each person. For people who self-medicate, there is a risk assessment in place and a locked cabinet is situated in their bedrooms. Some gaps were found in the Medication Recording Sheets (MAR) and there was no list of medication handlers in place in the file. A Requirement has been made in respect of this Standard Crawford Care Home DS0000065030.V349649.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 and 23 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. The people living in the home can be confident that their complaints and concerns will be addressed and the home’s working practices are designed to protect people from risk of abuse or harm EVIDENCE: The home has a complaints procedure, which has been also produced in an accessible format and is displayed around the home. Records show that complaints and concerns are recorded and acted upon and people said that they would feel comfortable telling a member of staff if they were unhappy. In the AQAA the manager told us that one formal complaint had been made in the last year and that this had been upheld. All of the staff team receive training in the protection of vulnerable adults from abuse and there is a flow chart for reporting any concerns posted in the office. All of the people on duty during the visit were aware of their responsibilities regarding safeguarding issues and said that they would report and suspected abuse straight away. Crawford Care Home DS0000065030.V349649.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 27 and 30 Outcomes for service users in this area are considered as adequate, This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and homely environment for the people who live there but needs to be further improved to ensure that safe standards of hygiene are met. EVIDENCE: There has been a programme of refurbishment and redecoration undertaken in the last year and all of the bedrooms and communal areas have been decorated. The home is comfortable and homely ,some new furniture has been purchased and a fire sprinkler system fitted throughout the house. There has also been a hydrotherapy bath installed. Although many improvements have been made there are still some areas of the home that need to be addressed . Some of the sinks and sink units are old and have become stained or lime scaled and need replacing and the kitchen is in need of updating. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 18 In one bathroom on the first floor, the floor covering does not fit properly around the toilet and is worn and the radiator is rusted, therefore causing a potential infection control risk. Service users private bedrooms have been personalised with their belongings and reflect people’s personalities and hobbies. Although recently redecorated, some rooms are already showing signs of wear and tear such as peeling wallpaper and paint in bad condition on doors. Service users said that they were very happy with their rooms and were able to lock their doors when going out. The laundry room is situated outside the house, near to the kitchen and in the AQAA we were told that moving the laundry was being considered. Generally the home was clean and hygienic but it was discussed with the acting manager that some people might need further support in keeping their bedrooms clean. The acting manager said that improvements needed to the home had already been discussed with the Registered Provider and have been recorded as needing attention. This area will also be assessed at the next visit. Crawford Care Home DS0000065030.V349649.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 34 35 and 36 Outcomes for service users in this area are considered as good, This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a caring and competent staff team and are protected by the home’s robust recruitment processes EVIDENCE: The staffing rota showed that there are four staff on duty during the day and one awake and one sleeping in person at night. The acting manager also works as part of the rota. This level of staffing meets the needs of the ten people currently living in the home but potentially may need to be reviewed as one service user’s assessments and records show that the person needs a very high level of one to one staffing. Many of the staff team have worked in the home for a number of years and have developed very good relationships with the people they are supporting. In order to ensure that the people living in the home are protected, there is a robust recruitment process in place. We saw the recruitment files of three members of staff and all contained the required documentation including a current Criminal Bureau Check (CRB) and two references. Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 20 All new staff receive a structured induction in line with Skills for Care and the British Institute for Learning Disability guidelines and during the visit we saw induction books and observed a new staff member shadowing more experienced staff. During the induction period, all staff attend mandatory training such as health and safety, first aid and adult protection and there is also a programme of further training opportunities in place, including training on the specific needs of the client group being supported in the home. In the AQAA, the manager told us that over 50 of the staff team have NVQ 2 or above and others are currently working towards gaining the award. Records show that staff supervision takes place but some are not up to date. The acting manager said that this was being addressed. The staff on duty said that regular staff meeting are held and that they felt well supported. Both service users and families were very complimentary about the staff team and said that they were very friendly, competent, kind and caring. In a survey a parent commented, my relative is always happy and is well cared for. I have never needed to make a complaint and I feel that the home really cares about the people living there. The staff are marvellous”. Crawford Care Home DS0000065030.V349649.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 41 and 42 Outcomes for service users in this area are considered as good. This judgement has been made using available evidence including a visit to this service. A competent acting manager is currently managing the home, there is a quality assurance process in place in order to gain the views of service users and most records are in good order. EVIDENCE: The Registered Manager has recently left the home and the deputy manager, who has worked in the home for six years has taken over as acting manager. During the visit the acting manager confirmed that she was completing NVQ 4 in care and would then begin the Registered Managers Award. The acting manager was coming to terms with the new role and at the present time is finding it difficult to attend to the paperwork required by the manager’s role and also be part of the working rota. It is recommended that management Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 22 time be included on the staffing rota to allow the acting manager to fulfil the role. Records show that regular Regulation 26, Registered Provider’s visits are carried out and recorded and the home has undertaken a quality assurance process by sending questionnaires to service users. Outcomes have been collated and recorded. The acting manager said that there was a plan in place to extend the quality process by sending questionnaires to families and other professionals involved with the home. There is a robust process in place regarding the safekeeping of service user’s monies. Receipts are kept on file and all transactions are recorded. The records and money of two people were checked and were correct. Fire checks and staff fire training are up to date and as detailed earlier, because there are people who smoke living in the home, a modern sprinkler system has been installed throughout the home. The staff team receive regular health and safety training and the home has a designated health and safety person in place. As a result of this visit two Requirements have been made, one regarding the recording of medication and one to update the upstairs bathroom to prevent an infection control risk. Crawford Care Home DS0000065030.V349649.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 3 2 3 3 3 4 X 5 3 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 X 27 3 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 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 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X 3 3 x Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 24 No 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 YA20 13 (2) Regulation Requirement Timescale for action 30/11/07 2. YA27 23 (2) (b) In order to ensure that service users are protected from errors occurring, medication-recording sheets should be fully completed and a list of approved medication handlers and their sample signatures kept on the medication file. In order to ensure that the home 30/12/07 is clean and hygienic and that infection control issues are addressed, the flooring in the upstairs bathroom should be replaced and the rusted radiator upgraded. 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 YA37 Good Practice Recommendations In order to ensure that the acting manager has time to become competent in the management role, it is recommended that management time be built into the staffing rota. DS0000065030.V349649.R01.S.doc Version 5.2 Page 25 Crawford Care Home Crawford Care Home DS0000065030.V349649.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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