Care Home: Greenhill

What the care home does well The people using the service had their care needs had been assessed and they had been reassured that their needs could be met, right from the start of their stay in the home. People using the service had their health, personal and social care needs fully met. People were involved in decisions about their lives, and played an active role in planning the care and support they received. Surveys returned to the Commission from relatives, service users and staff said "if taken ill the support in this areas is excellent". The surveys consistently indicated that people were happy with the care and attention they received. Care Plans and assessments were well completed and included information focused on people`s needs and preferences. This mean that staff had the information they needed to care for people safely. Medication administration systems in the home were good so that staff dealt with peoples` medication safely and reliably. People` s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their skills. Social, educational, cultural and recreational activities met most people needs and expectations.Surveys from staff and the people using the service said that the service "treats people as individuals" and "gives individual care". Activities and social events were available to people so that people enjoyed a varied lifestyle. People enjoyed an appealing, varied diet in pleasant open surroundings, at a time that suited them. People said that the meals were "excellent" and that there was "always a choice". People felt listened to and able to raise any concerns, and complaints and know they would be dealt with. The Staff were trained, skilled and competent and been subject to rigorous recruitment checks. This meant that people were well cared for by staff who were suitable to work with vulnerable people. People lived in a comfortable, clean well -maintained house, which offered a range of facilities and was safe. People lived in a well managed home, with the management, administration and staff team, working together to provide a stimulating, safe environment that respected and protected peoples` rights. One survey said, "this is an excellent home well run by the outstanding manager and all her staff". What has improved since the last inspection? As this was the first inspection this information was obtained from the homes Annual Quality Assurance Assessment document. Some of the improvements over the last twelve months included; The Chef has been on training courses looking at nutritious diets and diabetic food. New nurse call system, new kitchen floor and upgrade in the serving areas. Extensive redecoration has been carried out throughout the home and new carpets fitted. Have developed a positive ethos of whistle blowing on poor practice and supported staff to come forward with concerns. We have recruited a deputy house manager to support the home manager with the smooth running of the home. CARE HOMES FOR OLDER PEOPLE Greenhill Priscott Way Kingsteignton Newton Abbot Devon TQ12 3QT Lead Inspector Andrea East Unannounced Inspection 14:00 11 and 18th June 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greenhill DS0000071055.V363682.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. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenhill Address Priscott Way Kingsteignton Newton Abbot Devon TQ12 3QT 01626 202642 01626 202643 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) Guinness Care and Support Ltd Mrs Edith May Tucker Care Home 36 Category(ies) of Dementia (36), Old age, not falling within any registration, with number other category (36) of places Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia - (Code DE) The maximum number of service users who can be accommodated is 36. First inspection since new ownership 2. Date of last inspection Brief Description of the Service: Greenhill was designed and built as a care home for older people in 1993 by Devon Community Housing Society, who operate a number of care homes and sheltered housing schemes throughout Devon. Devon community Housing has now changed its name to become part of Guinness Care and Support Ltd. It is registered to provide care for thirty-six older people including those with dementia and/or a physical disability. Accommodation is provided in single flatlets on the ground and first floors. Each of the flatlets has a spacious bed-sitting room and a bathroom and toilet. The communal areas consist of a large main lounge/dining room and a small separate lounge on each floor. In addition there is a spacious entrance hall with seating. The home is well equipped, having assisted baths, mobile hoists, grab rails, raised toilet seats and various items of manual handling equipment. The doorways provide easy access for wheelchairs, and there is a shaft lift to the first floor. Outside there is an attractive, level, central, courtyard garden. There is level access to the entrance of the building and ample car parking. A separate daycentre for older people, and sheltered housing are located adjacent to the home, which are managed separately. Greenhill is situated in Kingsteignton, close to Newton Abbot. There are local Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 5 amenities nearby including shops, churches, and public houses. Fees are currently between £450 and £477 per week. Written information, in the form of a colourful service users guide and statement of purpose, regarding the home and the services provided is available to people planning to come into the home and on request. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 6 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. The inspection site visit was carried out over two days. A range of documents including staff and individuals’ files, policies and procedures were examined. People were spoken to in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager was present throughout the inspection. Feedback about the home was also received by post in survey questionnaires, in the homes Annual Quality Assurance Audit, and by the homes own quality assurance system. What the service does well: The people using the service had their care needs had been assessed and they had been reassured that their needs could be met, right from the start of their stay in the home. People using the service had their health, personal and social care needs fully met. People were involved in decisions about their lives, and played an active role in planning the care and support they received. Surveys returned to the Commission from relatives, service users and staff said “if taken ill the support in this areas is excellent”. The surveys consistently indicated that people were happy with the care and attention they received. Care Plans and assessments were well completed and included information focused on people’s needs and preferences. This mean that staff had the information they needed to care for people safely. Medication administration systems in the home were good so that staff dealt with peoples’ medication safely and reliably. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their skills. Social, educational, cultural and recreational activities met most people needs and expectations. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 7 Surveys from staff and the people using the service said that the service “treats people as individuals” and “gives individual care”. Activities and social events were available to people so that people enjoyed a varied lifestyle. People enjoyed an appealing, varied diet in pleasant open surroundings, at a time that suited them. People said that the meals were “excellent” and that there was “always a choice”. People felt listened to and able to raise any concerns, and complaints and know they would be dealt with. The Staff were trained, skilled and competent and been subject to rigorous recruitment checks. This meant that people were well cared for by staff who were suitable to work with vulnerable people. People lived in a comfortable, clean well -maintained house, which offered a range of facilities and was safe. People lived in a well managed home, with the management, administration and staff team, working together to provide a stimulating, safe environment that respected and protected peoples’ rights. One survey said, “this is an excellent home well run by the outstanding manager and all her staff”. What has improved since the last inspection? As this was the first inspection this information was obtained from the homes Annual Quality Assurance Assessment document. Some of the improvements over the last twelve months included; The Chef has been on training courses looking at nutritious diets and diabetic food. New nurse call system, new kitchen floor and upgrade in the serving areas. Extensive redecoration has been carried out throughout the home and new carpets fitted. Have developed a positive ethos of whistle blowing on poor practice and supported staff to come forward with concerns. We have recruited a deputy house manager to support the home manager with the smooth running of the home. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 8 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. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 9 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 Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people using the service were confidant that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: Four files holding a range of information were examined. Files held preadmission assessments on peoples, needs, preferences and details of how people wished to be cared for. People said that they had been offered the opportunity to visit the home before moving into the home on a more permanent basis. The manager, said that people were welcome to stay in the home on a probationary period, to ensure that they settled into the home and were happy Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 11 with the services provided. This had included a tour of the building, lunch and the opportunity to talk to staff and some of the people living at the home. People received information about the services provided, through informal discussion and in a contract of ‘terms and conditions.’ A colourful service users and statement of purpose had been made available to everyone living at the home. These documents were also available for people thinking of moving into the home and available on request. So that people had received a range of information about the home and had a chance to talk about there individual needs before moving into the home. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People using the service had their health, personal and social care needs fully met and this was set out in an individualised plan of care. People were involved in decisions about their lives, and played an active role in planning the care and support they receive. People were treated with dignity and respect and their privacy was upheld EVIDENCE: Four files, including a range of information, on peoples needs were examined. Care Plans and assessments were well completed and included information focused on people’s needs and preferences. The assessment process included asking people what name they wished to be called by and what routines they wanted to continue with: for example what time people wanted to get up and what time they wanted to go to bed. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 13 Assessments also included detailed medical histories, personal safety issues, including any history of falls and any mental health concerns or considerations. People said that they felt well cared for by staff and that they were asked about how they wished to be cared for. Ongoing daily records such as diaries, communication books, reviews of care plans and daily evaluations showed constant consideration to peoples changing needs. Records also included information on health professionals visits. Staff described peoples’ needs and preferences and demonstrated a gentle, flexible approach in meeting peoples’ needs. For example one person became distressed if not listened too or staff did not share his understanding of where he was. The manager and staff team had developed a range of strategies to support this person safely and with kindness. Surveys returned to the Commission from relatives, service users and staff said “if taken ill the support in this areas is excellent”. The surveys consistently indicated that people were happy with the care and attention they received. Medication administration systems in the home were good. Medication was stored safely and administered by staff who knew the medication policy and procedures well. People said that staff dealt with their medication safely and reliably. Medication records examined were well maintained and the manager and staff looked for ways to continually improve medication systems. For example; discussion with the staff and the manager about some kind of audit checklist for stock medication, ensuring medication is in date and labelled correctly took place. Shortly after the inspection visit a audit checklist was sent to the Commission which was being implemented. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their life skills. Social, educational, cultural and recreational activities met individual’s expectations. People enjoyed an appealing, varied diet in pleasant open surroundings, at a time that suited them, with attentive considerate support from staff. EVIDENCE: People said that friends and family were welcomed into the home at any time. People also described how relatives and friends were also invited to join in with fundraising events, special celebrations and activities. The manage had highlighted in the homes Annual Quality Assurance Audit a wish to appoint a part time ‘activities co-ordinator’ who would organise individual and group activities on a month- to -month basis. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 15 Currently staff undertook activities with some of the people in the home in the afternoons and this was monitored and recorded in an activities book. For example music afternoons, Holy Communion and quiz games. People said that they really valued the time and energy staff spent on trying to provide a stimulating and varied range of entertainments and activities. They also appreciated the one to one discussions with the staff and the manager. Activities planned in the home were displayed in the foyer in a one - page newsletter and copies were also in peoples’ rooms. The activities person also kept a record of what people had participated in and enjoyed. Any concerns about people while participating in events were discussed with care staff. On the day of the inspection people were, waiting for transport to take them out to a friends house and socialising in their rooms or in the homes lounge. A range of documents including risk assessments, care plans and ongoing daily records showed how those people using the service were encouraged to maintain links outside of the home and with families and friends. Staff described how people were supported to make day- to- day choices in care, for example; in making sure that people wore their favourite accessories to, people deciding how they wished to spend their time. The people using the service praised the quality of the meals provided and said that they were pleased with the level of choice of menu on offer. Lunch was served as the main meal of the day. Staff said that there was always a choice of menu and people were welcome to have visitors join them for lunch. A menu board detailed what was on the menu for the day and staff reminded people what was for lunch throughout the morning. Surveys from staff and the people using the service said that the service “treats people as individuals” and “gives individual care”. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were protected from abuse, and had their rights protected. EVIDENCE: The people using the service said that they felt able to talk to all the staff including the manager about any concerns issues or worries. There was a format for writing down formal complaints, which included recording the outcome of the complaint and how it was resolved. There was also a compliments folder that held letters and cards from relatives and friends thanking staff for the care given. The manager also monitored the record of complaints and compliments. Staff records showed that care staff had received training in issues relating to the protection of vulnerable adults. Greenhill DS0000071055.V363682.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People lived in a well -maintained house, which offered a range of facilities and was comfortable, clean and safe. EVIDENCE: Greenhill presented as a spacious and well designed home. The environment provided people with wide corridors, good -sized bedrooms, bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. On touring the premises the home appeared to be clean, tidy and comfortable. The lounge and dining areas presented as pleasant, welcoming areas, that the people using the service were observed enjoying, as they were using these areas to socialise in. People were chatting in the lounge with staff and the other people living at the home. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 18 Surveys from staff and the people gave a mixed picture about how clean the home was, some said the home “was always clean and fresh”, while others said that home “could be cleaner” and “there was not enough cleaning staff”. The manger was aware of fluctuating standards in some of the basic cleanliness in one area of the home and was addressing this. The manager had reviewed and updated a range of information for staff in policies and procedures, including health and safety and risk assessments for the premises. All areas of the home including peoples’ individual rooms had been personalised with items of furniture, photographs and ornaments. Surveys returned to the Commission said that the home was always clean and fresh. Greenhill DS0000071055.V363682.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people using the service, were supported by Staff, who were trained, skilled and competent. Staff had been subject to rigorous recruitment checks. Sometimes the numbers of staff employed in the home, particularly in the evening and night could affect peoples’ care EVIDENCE: The people using the service described the staff as kind and caring and one survey said; “everyone is so kind and helpful, they are all so cheerful and have a wonderful attitude to us all. The manager and staff said that the home continued to support staff to complete a range of training based on the needs of the people using the service. This included training in key areas such as infection control, health and safety and first aid. Staff training records and supervision records for staff showed that staff had completed internal and external training. This included staff completing National Vocational Training in Care at level two or above. A sample of staff files were examined and they included completed application forms, interview notes, proof of identity, reference and police checks. Staff files also held details of staff induction into the home, staff supervision and any disciplinary action the home had taken. These records demonstrated the Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 20 homes commitment to ensuring that only those suitable to work with vulnerable adults were employed in the home. Surveys from staff, and the people using the service expressed concern at the numbers of staff employed at night. They said “shortage of staff limits [care and support] especially at night” and the numbers of staff employed at night could be better”. When looking at accidents and incidents a high number of accidents had occurred in the evening or night. This may indicate the low numbers of staff limiting contact with the people using the service. The staffing numbers in the night - time falls to two members of staff on duty for up to thirty- six people with varying needs. Staffing at night did not take into account possible risks to people in the event of a fire and moving people. Staffing at night also does not take into account of peoples needs if they are taken ill suddenly. Greenhill DS0000071055.V363682.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People lived in a well managed home, with the management, administration and staff team, working together to provide a stimulating, safe environment that respected and protected peoples’ rights. EVIDENCE: The home was well managed by the manager and staff team who worked together with the people living at the home to make sure that people received the services they wanted. The manger had a range of training and skills that she had continued to update to ensure that good care practices were carried out. People said that the manager was “wonderful” “always helpful” and that “nothing was too much trouble”. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 22 Surveys from staff said that the home was “a very happy home, with residents looked after really well” People said that they felt safe and that what they wanted or were concerned about someone in the home would “always sort out”. Throughout the visit to the home people repeatedly said that the home “was well run and they “enjoyed living here”. Records required to be kept on the management of the home and the care people received were well completed and regularly reviewed and updated. This included risk assessments for the premises and for individuals’ specific needs. Staff training and a staff induction programme, was carried out on a routine regular basis, so that staff were aware of peoples needs and how to care for them. The manager and staff team had implemented a range of quality assurance systems including asking the people living at the home their views. Peoples’ finances and personal allowances were well managed by the home. People were supported to manage their own finances with support of relatives and outside advocates such as solicitors. Good record keeping systems were in place to safeguard people’s finances and these records were audited. Greenhill DS0000071055.V363682.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 x x 3 x x 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 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 x x 3 Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard OP27 Good Practice Recommendations Staffing numbers at night should be reviewed and increase to take into account possible risks to people in the event of a fire and moving people and to take into account peoples needs if they are taken ill suddenly. Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 25 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 Greenhill DS0000071055.V363682.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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