Care Home: Crowstone Manor

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What the care home does well The home is well managed and residents are listened to and feel that staff act on what they say. Before a person moves into the home they are given detailed information to help them decide if the home will be suitable. The manager will assess each person`s needs to help assure them that staff will be able to care for them properly.Each resident has a care plan, which describes what level of support they need and how they like to be cared for. Staff review care plans regularly and amend information where there are changes to the treatment or support the person needs. Staff ensure that when a resident is unwell that they see their doctor and that they have routine checkups for eyesight, hearing and dental needs. Residents can make choices about how they spend their time and what food they like. Residents are happy with the food provided at the home. Staff are recruited thoroughly and they do not support residents unsupervised until all the relevant checks such as references have been obtained. There is an ongoing programme for training staff to help them understand resident`s needs and care for them properly. Staff are trained to recognise and report any ill treatment or abuse of vulnerable people. Residents feel that they are listened to and if they have complaints or concerns that these will be investigated and dealt with properly. The homes environment is comfortable, safe and clean. What has improved since the last inspection? The way that staff record information about residents needs has improved. What the care home could do better: A wider range of activities could be provided. Residents told us that staff are too busy to take them out as often as they would like. CARE HOMES FOR OLDER PEOPLE Crowstone Manor 38 Crowstone Road Westcliff On Sea Essex SS0 8BA Lead Inspector Carolyn Delaney Unannounced Inspection 11:30 21 November 2008 st 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 Crowstone Manor DS0000015429.V369469.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. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crowstone Manor Address 38 Crowstone Road Westcliff On Sea Essex SS0 8BA 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) 01702 333594 01702 333594 manager@crowstonemanor.fsnet.co.uk www.crowstonemanor.fsnet.co.uk Angela Murray Mrs Wendy Livingstone-Stallard Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Accommodation and personal care to be provided to no more than 13 older people over the age of 65 years (OP). Total maximum number of service users to whom accommodation and personal care is to be provided shall not exceed 13. 5th September 2007 Date of last inspection Brief Description of the Service: Crowstone Manor is registered to provide accommodation and personal care for up to thirteen older people over the age of sixty-five. The home has a separate lounge and dining room and bedrooms are situated on the ground and first floor. A passenger lift gives access to both levels. The home is well maintained throughout. Crowstone Manor is an attractive and spacious property, built in 1912 as a family home in a pleasant residential area. Many of the original features are still in place, such as an oak panelled hall and dining room with parquet flooring. There are nine single rooms of which two have en-suites and two shared rooms both with en-suite facilities. Crowstone Manor is close to local shops, public transport and local amenities. There is a garden and small area to the front of the building for parking and an attractive and secure garden at the rear with seating and tables for the use of the residents. Residents and staff who smoke are required to do so in the garden. The most recent inspection report was available in the office and staff room. An up to date Service Users Guide and Statement of Purpose were available. The cost of a place in the home ranges from £416.50 to £714.00 (for single use of a larger double bedroom) per week. Crowstone Manor DS0000015429.V369469.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 stars. This means the people who use this service experience good quality outcomes. This was a routine unannounced inspection, which included a visit made to the home between the hours of 11.00 and 18.00 on 21st November 2008. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We normally request that managers complete an Annual Quality Assurance Assessment (AQAA). This tells us how the home is meeting the needs of residents, where improvements are needed and the manager’s plans for the next twelve months. However we had not requested this at the time of completing this inspection. We gave surveys to residents and staff to complete and we spoke with visitors to the home. The views and comments expressed by these people were reflected in the report. We also observed how staff interacted with residents when supporting them with activities such as meals, mobilising and providing recreation and stimulation. During the site visit, records including residents care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. In addition some residents bedrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the service does well: The home is well managed and residents are listened to and feel that staff act on what they say. Before a person moves into the home they are given detailed information to help them decide if the home will be suitable. The manager will assess each person’s needs to help assure them that staff will be able to care for them properly. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 6 Each resident has a care plan, which describes what level of support they need and how they like to be cared for. Staff review care plans regularly and amend information where there are changes to the treatment or support the person needs. Staff ensure that when a resident is unwell that they see their doctor and that they have routine checkups for eyesight, hearing and dental needs. Residents can make choices about how they spend their time and what food they like. Residents are happy with the food provided at the home. Staff are recruited thoroughly and they do not support residents unsupervised until all the relevant checks such as references have been obtained. There is an ongoing programme for training staff to help them understand resident’s needs and care for them properly. Staff are trained to recognise and report any ill treatment or abuse of vulnerable people. Residents feel that they are listened to and if they have complaints or concerns that these will be investigated and dealt with properly. The homes environment is comfortable, safe and clean. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know when they move into the home that their assessed needs will be met. EVIDENCE: The manager told us during the inspection that when a person enquires about a place in the home they are provided with a copy of the home’s brochure, a sample menu and the range of fees charged. If they are interested in moving in they then receive a sample contract, a copy of the service users guide, a copy of the most recent inspection report and the results from the most recent survey carried out to obtain people’s views of the home. This information provides the enquirer with detailed information about what it is like to live there, the views of residents and their families and our findings following inspection visits, and is useful in helping them decide if the home will be suitable. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 9 Before a person is offered a place in the home the manager and deputy manager assess their needs. We looked at the assessments carried out for two people who had moved into the home since the last inspection. The assessments clearly described the care and support each individual needed to carry out activities of living such as washing and dressing, mobilising and eating and drinking. Specific wishes for each person were recorded such as the time they like to get up and go to bed, any particular food likes and dislikes they have, and information about hobbies and how they like to spend their time. Once the assessment is carried out the manager makes a decision as to whether the home will be able to accommodate the person’s needs and records this in the assessment. When a person moves into the home they are introduced to staff and residents and given time to settle into their new surroundings. Three residents completed surveys and told us that they had a contract and they had received enough information about the home to help them to make a decision about moving in. During the visit we spoke with three residents and one relative. One resident and relative told us they had visited other homes in the area. They told us that ‘this was the best’ and ‘the home is brilliant’. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well cared for and their assessed health and personal care needs are met in a way, which suits them. EVIDENCE: Each person in the home has a care plan, which describes the care and support they need. We looked at the care plans for three residents. There was detailed information as to how these people were to be supported. The manager told us that staff help residents remain independent for as long as possible. Care plans included information about what residents were capable of doing in respect of carrying out activities of daily living. This helps them to support each person so as to promote independence. Residents who completed surveys told us that they receive the care and medical attention that they need. Residents who are able to visit their doctor at the surgery and where people are too frail to do so the manager arranges for their doctor to visit them in the home. Staff record when the doctor sees residents and any changes to the person’s treatment. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 11 We saw that staff identify and assess risks to each person’s health and safety. Risks of injury due to falls, developing pressure sores as a result of poor mobility and risks of malnutrition were assessed and plans were in place to monitor each person and to minimise the risk. We saw that where a person is at risk of injury from falls that the manager seeks the advice of the local falls prevention team to help find ways to minimise risks of falls and injuries. We looked at accident records where staff record any injuries and accidents. These indicated that there had been no serious injury to residents within the past twelve months. There is a policy in place for the safe storage and administration of medication and staff receive training every year. We saw that when people moved into the home they were asked if they wished to keep their medicines and take responsibility for taking them. Where a person wished to do so the manager assessed any risks and whether the resident was capable of doing so safely. We saw that one resident had been keeping and taking their medicines and the manager had reviewed this regularly. Recently the person had been experiencing difficulties and it was agreed with them that staff would take over the responsibility for their medicines. We observed staff when they administered medicines to residents. They did so in accordance with the home’s policy, ensuring that residents took their medicines before they completed medication records. We looked at how medicines were stored and how staff keep records. We saw that records were well maintained and medicines were stored safely. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents make choices about their daily lives and how they spend their time. The range of activities provided does not meet all residents’ needs and wishes. EVIDENCE: There is information available in the service users guide about how activities are provided. People are told that there is not a set pattern for activities and that residents are free to decide and plan what they would like to do. Residents confirmed that they can choose what they like to do. The manager said that there is usually an extra member of staff on duty between 10am and 2pm to plan and assist residents with activities. We looked at the rotas and these confirmed this. Residents told us that there are sometimes music and exercise, which they enjoy. Residents told us that they would like more activities and that ‘staff are very busy and cannot always take them out for walks and shopping when they would like’. One person told us ‘staff do their best but they are very busy’. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 13 On the day of the inspection we did not observe any organised activities and residents told us that there were none. Two residents did get together to play a game of Ludo in the afternoon. One relative we spoke with told us that they are always welcomed into the home. Residents told us that they can go out with relatives and friends. There is a planned menu for meals. This is reviewed regularly and residents are asked what meals they would like to have. Residents we spoke with during the inspection and those who completed surveys told us that they enjoy the meals provided. One resident said ‘The food is very good and there is always a choice and something different if we want’. Others told us ‘the food is excellent’ and ‘meals are very nice’. On the day of the inspection we observed staff serving residents their lunchtime meal. The meal of fish, mashed potatoes and vegetables looked appetising and residents told us that they enjoyed it. There was a selection of condiments and sauces available to compliment the meal and staff were on hand to assist residents where needed. We saw that staff asked residents if they were finished and if they had enough to eat before removing their plates. We looked at food supplies in the home and saw that there was a good range of fresh, frozen and tinned foods available. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated well and safeguarded from abuse. All complaints and concerns are taken seriously and investigated. EVIDENCE: The manager told us that there have been no complaints made since 2006. There is a copy of the complaints procedure displayed in the home and in the information provided to each person when they move in. This describes how a person can make a complaint if they are unhappy, and how their concerns will be dealt with. Staff told us in surveys that they knew what to do if a resident or other person raised any concerns or were unhappy. Each of the three residents who completed surveys and those people we spoke with during the inspection told us that they knew who to speak with if they were unhappy. People told us that they had no complaints. We looked at the comments made by residents and relatives in surveys as part of the home’s system for monitoring how it meets people’s needs. These comments were positive and indicated that people were satisfied with the home. We saw that staff receive training to help them safeguard people. The training helps staff recognise and identify any signs of abuse of vulnerable people, and identifies what to do if they observe any ill treatment of residents. There is a Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 15 procedure in place to deal with any allegations of ill treatment, which includes a whistle blowing policy. This helps to protect staff from repercussion should they need to raise concerns. The manager told us that she would report any allegations to the local safeguarding team and follow their advice. People we spoke with told us that staff treat them well and we have received no complaints or concerns about the home. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 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 clean, safe and comfortable home, which is equipped to meet their needs. EVIDENCE: Residents who completed surveys told us that the home is always clean and fresh. One person told us ‘the home is cleaned every day’. A cleaner is employed between two and four hours per day to ensure that the home is clean. During the inspection some residents invited us to see their bedrooms. Rooms were clean, warm and furnished with some personal items. We looked at shared areas such as the dining room, lounge and bathrooms. These areas were clean and furnished to suit the needs of residents. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 17 We saw records, which evidenced that routine checks were carried out for hot water and heating systems, fire detecting equipment and all other equipment was kept in good working order, repaired and renewed as needed. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well cared for by a team of competent staff. EVIDENCE: Residents who completed surveys told us that are usually available when they need them. Some people we spoke with said that sometimes staff are too busy to take them out for walks and shopping. The manager told us that four staff cover the morning shift, including one person who spends time with residents, providing activities and two staff cover the evening shift. At night residents are supported by two staff, including one person who ‘sleeps in’ and is called upon if needed. We looked at staff rotas and these showed us that staffing levels are maintained and that staff do not work too many hours without a break and they have at least one day off per week. This helps to ensure that staff are fit to carry out their duties. Staff told us that there are usually sufficient numbers employed to meet the individual needs of residents, unless ‘staff ring in sick’. Staff are responsible for preparing meals and cooking tasks are carried out over each 24-hour period. The manager told us that this reduces the time individual staff are taken away from caring for residents. We looked at how people are recruited to work in the home. The manager told us that three people had been recruited since the last inspection and two of Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 19 these had since left the home’s employment. We looked at the file for the remaining person. This person had been interviewed by the manager and had provided a detailed account of their previous employment history. The manager told us that references had been sent to the person’s previous employers and that a PoVA First and Criminal Records Bureau disclosure had been requested but had not been received. These checks help to ensure that only people who are suitable to work in the home are employed. The person had commenced their induction two days before the inspection. This is a period of time where the person familiarises themselves with the home’s policies and procedures, routines and the needs of residents. We saw that a member of staff was supervising this person until such time that satisfactory references and checks were received. There is an ongoing programme for training and developing staff to enable them to care for residents and meet their needs. Staff told us that they feel they have the right support and experience to care for residents needs. One person said ‘I needed knowledge to care for someone who wears a catheter and I was sent on a course. It was very beneficial’. Another person told us ‘the manager send us on courses if any new way of doing our job comes up’. We saw that all staff working in the home have regular refresher training which includes the safe moving and handling of people, controlling the spread of infection, food hygiene first aid and managing medicines. In addition staff have training to help them understand and care for people who have dementia and how to safeguard people who are vulnerable from harm. Some staff have expressed an interest in training in providing activities for older people and the manager is arranging this. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in the interests of the people who live there. EVIDENCE: At the time of the last inspection a new manager had just been employed. This person had completed their manager’s registration with us and had completed their Registered Managers Award training. This is a recognised award, which helps to ensure that managers are equipped to manage care services appropriately. Residents, relatives and staff all spoke very highly of the manager and the way the home is run. Some people told us ‘the home is excellent’ and ‘it is very good and we are happy here’. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 21 Residents and relatives are consulted with regularly and are asked for their views about the home and any suggestions they have for improvements. Monthly surveys are undertaken with residents on a different topic each month, for example food, laundry and environment. We looked at a sample of the comments made by residents and relatives and these indicated that people were happy with the home and how it is managed. There are detailed policies and procedures in place, which underpin the running of the home and help, ensure that staff act in a consistent way to ensure the health and safety of residents and visitors. The home’s owner reviews and amends these policies each year or more often as necessary. Residents and their relatives are invited to see policies and procedures should they wish. We saw certificates and records in respect of the routine maintenance, repair and renewal of furniture, equipment, gas and electrical systems such as heating and hot water. These were well maintained and evidenced that they were in good safe working order. Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations More opportunities should be made available for residents to participate in activities, which suit their wishes and needs. Staffing levels and daily routines should be regularly reviewed so as to ensure that staff are available to support residents needs. OP27 Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Crowstone Manor DS0000015429.V369469.R01.S.doc Version 5.2 Page 25 - 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. 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