Care Home: Inglemere

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What the care home does well All the people who use this service now have a `person centred` plan of care. This is seen as good practice as it involves people in producing these, which therefore records care needs from their own perspective. All medication training occurs annually. Staff supervision sessions now exceed the minimum of six sessions during a twelvemonth period required. This provides a better supervised workforce. In addition to staff doing the required six week induction training, agency workers also do this induction. This creates a better inducted workforce. The Standards require 50% of staff to have a NVQ2. This home has now exceeded that figure which provides a better trained workforce. What has improved since the last inspection? Staff have stopped the old practice of feeding people from a standing position and not engaging with them during the process. This provides a more dignified provision of care. Staff supervision sessions now exceed the minimum of six sessions during a twelve month period required. This provides a better supervised workforce. In addition to the formal supervision records, the manager now records the adhoc supervision sessions to better demonstrate levels of overall staff supervision. The corridors do not provide a clear line of sight to adjoining rooms at this home. In the past this has reduced the efficiency of staff supervision of people to the extent that incidents were occurring at a high level {see last key inspection report for details}. The manager has now monitored the level of staff supervision support and guidance provided for the people in relation to the awkward positioning of rooms on the ground floor. As a result of this monitoring, the manager has redistributed the staff at key times of the day. This has resulted in better supervision of the people who use this service and fewer incidents. What the care home could do better: Staff should not use the `residents lounge` and armchairs to store their bags, as this does not show respect for their space. To put this in perspective it was only one small bag on this occasion, where it was a number of bags and staff coats on previous occasions, also is not occurring daily anymore. The provider should continue to examine the suitability of the current layout of the building, and explore whether it is conducive to safely meeting the care needs of the people who use this service, based on their individual needs and current staffing levels. This is being done as a part of the organisations examination of all homes it runs. CARE HOME ADULTS 18-65 Inglemere 2 Pollards Hill East Norbury London SW16 4UT Lead Inspector Barry Khabbazi Unannounced Inspection 21 September 2008 09:00 st Inglemere DS0000025798.V369101.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 Inglemere DS0000025798.V369101.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. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inglemere Address 2 Pollards Hill East Norbury London SW16 4UT 020 8679 6726 F/P 020 8679 6726 NO EMAIL 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) Surrey and Borders Partnership NHS Trust Meghanaden Rengasamy Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2007 Brief Description of the Service: Inglemere provides residential care for up to nine adults with moderate to severe learning disabilities. Some service users are also visually impaired. Each service user has their own bedroom, which is decorated to suit their individual tastes. The home is situated on a corner plot surrounded by gardens and a patio area. There is a communal lounge area as well as a dining room. It is within walking distance of Norbury high street and transport links and is close to the Croydon /Merton boundary. Fees for this home are from £1372.00 per week. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating of the service is 2 star. This means the people who use this service generally experience Good outcomes. The raising of standards recorded and required in the last report is continuing. This has resulted in the rating rising from 1 star to 2 stars at this inspection. This inspection was unannounced. As the people who use this service go out early in the day, the inspection started early to allow the people who use this service to be met and so involved. As the manager was not present on the first day, a second day was arranged to meet the manager so staff files etc could be examined. The manager was interviewed, and records, policies, care plans, and the building were examined. The manager’s latest self-assessment {AQAA} was used to support findings in this inspection. Staff were seen to be supportive and responsive to peoples’ needs. What the service does well: All the people who use this service now have a ‘person centred’ plan of care. This is seen as good practice as it involves people in producing these, which therefore records care needs from their own perspective. All medication training occurs annually. Staff supervision sessions now exceed the minimum of six sessions during a twelvemonth period required. This provides a better supervised workforce. In addition to staff doing the required six week induction training, agency workers also do this induction. This creates a better inducted workforce. The Standards require 50 of staff to have a NVQ2. This home has now exceeded that figure which provides a better trained workforce. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 6 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. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 7 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 Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 8 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): Standard 2: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who want to live at this home can be confident that their needs and aspirations will be assessed and recorded so that they can be met by the home. EVIDENCE: Standard 2 was assessed as met at previous inspections. The home has not had a new admission since the last inspection. A completely new placement will need to be made before this standard can be fully re-assessed. However, it was met at the last inspection and therefore currently remains met. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 9 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): Standard 6, 7, and 9: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The needs and changing needs of people who use this service are assessed and recorded so that staff know and can therefore meet these needs. People who use this service are supported to make decisions about their lives, to maximise their independence and choices. People who use this service are consulted on and participate in all areas of life at the home. EVIDENCE: Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 10 The home’s AQAA {self assessment document} told us that there was a new working care planning pro forma. Person-centred plans were also being developed and staff were receiving training in this area. Files sampled showed us that the new care planning document was clearly laid out so that it was easy to access information. There was also a specific health plan. We saw that all the information required was now included in these plans, including more information regarding religious and cultural needs. In addition we saw that these plans had been regularly reviewed. We saw that person-centred plans are also being developed to help support people who use this service to make decisions about their lives and maximise their independence and choices. This is also helpful as it describes how a person wants care to be provided from their perspective. We saw that risk assessments are in place and as a result of this process restrictions on liberty have been recently removed. For example, the kitchen had previously always been locked but the risk assessment process identified that this was no longer needed. This resulted in access to the kitchen for people and increased independence in that area with support from staff. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 11 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): Standard 12, 13, 14, 15, 16, and 17: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service receive sufficient access to activities to maintain a stimulating life. People who use this service are participating in the local community, with the aim of maximum integration and challenging discrimination. People who use this service are supported in maintaining appropriate relationships, so that their social lives are maximised within chosen boundaries. The daily routines and house rules do generally promote the rights of people who use this service, to ensure equality and that all rights are enjoyed by all. Dietary needs are catered for and a balanced diet is provided, to ensure health and enjoyment of food. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 12 EVIDENCE: We saw that activities were occurring and recorded on a timetable and that there had been an increase in community use since the last inspection. At this inspection we saw two people being supported to access a social club at a local church. The people who use this service are offered a holiday with £150 of extra staffing hours. People are currently required to pay for the cost of the holiday themselves. The last inspection report contained a recommendation for each person to be offered a seven day holiday paid for by the home. The existing recommendation remains. The staff team at Inglemere encourage people to remain in contact with their family members. There is an open visitors policy. The home has regular social events, such as a Christmas party. Family and friends are invited to any social events held at the home as well as reviews. The home has a key worker system and it is part of their role to keep parents and carers informed of their progress. Visitors can be seen in any of the home’s communal areas as well as people’s bedrooms. The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments. At the weekends there is more flexibility with breakfast times, getting up and bedtimes. The last inspection report contained the following requirement: Staff must feed people from a seated position and engage with them during the process unless a risk assessment shows otherwise. This was not the case at this inspection and this requirement is currently met. Breakfast was observed at this inspection and we saw that staff were sensitive and supportive at this time. People were offered choices and allowed to change their minds. Staff assisted from a seated position when required and talked to the person receiving assistance. The menu at Inglemere is based on a four-week rota, which reflects the likes and dislikes of the people who use this service. The dietician employed by the Trust then checks the menus. Referrals to the dietician are made where required. Alternative meals are provided if people do not like the main option. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 13 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): Standard 18, 19, 20: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Personal care needs and physical and emotional health needs are met. This ensures that the physical and emotional health of people who use this service is well maintained and therefore the quality of life experienced is also maximised. Medication is also well managed to ensure maximised good health. EVIDENCE: The corridors do not provide a clear line of sight to adjoining rooms at this home. In the past this has reduced the efficiency of staff supervision of people to the extent that incidents were occurring at a high level {see last key inspection report for details}. Because of this the last inspection report contained the following requirement: The manager should continue to monitor the level of staff supervision, support and guidance provided. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 14 The manager has now monitored the level of staff supervision, support and guidance provided for the people, in relation to the awkward positioning of rooms on the ground floor. As a result of this monitoring, the manager has redistributed the staff at key times of the day. This has resulted in better supervision of the people who use this service and fewer incidents. This requirement is now therefore met although this concern will continue to be monitored. The home’s AQAA {self assessment document} told us that the entire staff team has participated in a training program that challenges old values and incorporated some team building exercise. This also told us that the home has promoted respect of individuals as the main focus when staff deal with people living in the home. We saw that healthcare needs are recorded in peoples’ files, and that people were supported to attend outpatient appointments and other medical appointments as required. Everyone at the home is registered with a local G.P. They are able to access community health facilities such as opticians and district nurses as required. It was seen as good practice that medication training occurs annually and additional annual training occurs in ‘as and when medication’, and also in rectal diazepam usage. The home has a copy of the British Medical Association guide to medication and a copy of the British National Formulary in place. Medication profiles and clear medication administration record sheets were seen in records sampled. Medication is kept securely in a locked metal cabinet fixed to the wall. This home uses a controlled drugs register when controlled drugs are used. Since the last inspection the home has been advised to keep the medicine cabinet’s temperature monitored. We saw that this was occurring at this inspection. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 15 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): Standard 22 and 23: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home manages complaints well so that people feel their concerns are listened to. The home’s policies and procedures relevant to this Standard currently promote protecting people from abuse. EVIDENCE: The organisation’s complaints procedure was clear and contained all of the elements required to meet this Standard including a response time of less than 28 days. This was also the case for the local procedure, which included details of how to contact the Commission at any stage of a complaint. The complaints procedure was also converted into pictorial format to increase access for more people. The home has a copy of Croydon’s Vulnerable Adults Policy. The Trust runs mandatory training in this area. We have seen that the home has all the other required protection policies and guidance. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 16 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): Standard 24 and 30: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The environment and furniture generally met the needs of the people who use this service, and the environment promotes their well being. The home is particularly hygienic and clean, homely and comfortable. This environment therefore facilitates the health and emotional well-being of the people who live there. EVIDENCE: The building is generally well maintained with regular maintenance provided by the Trust’s works department. We saw that the building had been re-decorated throughout and had new carpet downstairs. The bathroom floorings had also been replaced. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 17 The last inspection report contained the following recommendation: The provider should continue to examine the suitability of the current layout of the building, and explore whether it is conducive to safely meeting the care needs of people, based on their individual needs and current staffing levels. {See also Standard 18} We saw that the organisation is currently examining this area. The recommendation remains until the process has concluded. On previous inspections many staff coats and bags were seen in what is called the residents’ lounge. This was disrespectful to the residents’ own space and requirements were set regarding this. This was not seen at the last two inspections and that requirement was removed. However, one small staff bag was on a chair in the lounge on this occasion. As the practice of staff using the lounge to store their coats and bags had reduced dramatically in frequency and quantity, to be proportional a recommendation only will be set on this occasion as follows: Staff should not use the residents’ lounge and armchairs to store their bags, as this does not show respect for the residents’ own space. The last report recorded that ‘the cleanliness of the home was borderline at best, but definitely not tidy at the time of the unannounced inspection. As a cleaner is about to be recruited this area will be monitored and requirements only made if the service manager’s strategy for improvement in this area does not bring the improvements needed.’ Since that time the cleaner has been recruited and the cleanliness of the environment has improved. The home was clean and hygienic at the time of this inspection. The home has specific policies on the disposal of clinical waste, infection control and Control of Substances Hazardous to Health. There are laundry facilities with a sluice and an industrial-type machine, which is capable of washing at high temperatures. The laundry is separate from the kitchen and has floors and walls that are easy to clean. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 18 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): Standard 32, 34, 35,and 36: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are supported by appropriately qualified staff, which raises the quality of staff and their practices. The home’s recruitment procedures protect the people who use this service through vigorous staff vetting. Staff receive induction training to national training sector specifications. This ensures a better inducted staff team. Staff are well supervised and this Standard is currently exceeded. This produces a well supervised staff team. EVIDENCE: Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 19 An initial ‘in house’ induction is provided for all staff from their starting date. The required six weeks induction training to Sector Skills Council workforce training targets is also being provided in the form of ‘Skills for Care’. In addition to staff doing the required six week induction training, agency workers also do this induction. This creates a better inducted workforce. The Standards require 50 of staff to have a NVQ2. We saw that his home has now exceeded that figure which provides a better trained workforce. We saw that staff recruitment files were in order and contained all the required vetting documentation. The last inspection report contained the following requirement: Staff supervision sessions need to be evenly spaced out to ensure that there are not large gaps between sessions and that there are a minimum of six sessions during a twelve month period. We saw that this was now occurring. In addition to this staff supervision sessions now exceed the minimum of six sessions during a 12 month period required. This provides a better supervised workforce. In addition to the formal supervision records, the manager now also records the ad-hoc supervision sessions to better demonstrate levels of overall staff supervision. The home’s AQAA {self assessment form} told us the following: The entire staff team participated in training that challenges old values and incorporated some team building exercises. The house has an appraisal system in place. Each staff member has an appraisal which is reviewed six monthly. {This exceeds the minimum standard.} Each staff member has a personal development plan where areas of improvement are identified and training needs identified. Two staff have been seconded to complete a degree in nursing. By the time of the next inspection, the above good practice may have translated into measurable outcomes for the people who use this service. At that time this group of standards may be assessed as excellent. Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 20 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): Standard 37, 39, and 42: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced and well qualified manager who ensures a quality service. There is a quality assurance system, which involves the people who use this service and provides a way for them to measure improvements in quality for themselves. The home promotes the health and safety of the people who use this service, so that practices and the environment do not place their health and safety at risk. EVIDENCE: Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 21 The previous reports cited gaps in management cover over the previous years as contributing to the identified significant fall in standards. The organisation moved quickly to provide a new manager for this home. This enabled a number of previous requirements to be met and the previously identified drift in standards identified in the previous reports has since been addressed. This has resulted in a consistent rising of standards at this home with some standards now exceeded. The manager is a qualified nurse who has a management degree and is currently undertaking the Registered Managers award. We have seen Quality Assurance tools have been put into a structured Quality Assurance system that makes people who use the service central to the process. All of the health and safety policies and procedures relevant to this standard were seen to be present. Moving and Handling, Fire Safety, First Aid, Food Hygiene, Infection Control, and Handling and Disposal of Clinical Waste policies are all also included in staff induction. Control Of Substances Hazardous to Health policies and data sheets were present and all these items are locked away securely. An asbestos survey had occurred in line with the current asbestos at work regulations. The testing of systems required in Standard 42 were also present. Inglemere DS0000025798.V369101.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 3 36 4 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 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 23 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. 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 YA14 YA24 Good Practice Recommendations Each service user should be offered a seven-day holiday paid for by the home. The provider should continue to examine the suitability of the current layout of the building, and explore whether it is conducive to safely meeting the care needs of people who use the service, based on their individual needs and current staffing levels. Staff should not use the residents’ lounge and armchairs to store their bags as this does not show respect for their space. 3. YA24 Inglemere DS0000025798.V369101.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Inglemere DS0000025798.V369101.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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