Care Home: Sandygate Residential Home

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What the care home does well We found that people who use the service had information about the home and services provided, they had all been individually assessed prior to admission to the home. The atmosphere within the home was good and people that use the service appeared very happy. Throughout this visit we found that staff were seen interacting with people who use the service in a kind manner, they spent time talking to people who were referred to by their first name, this was agreed and documented in the care plans. Surveys received confirmed that staff always treated people who use the service with respect and maintain their dignity at all times, people said, "staff are excellent and provide a good service". All the people agreed that they received support and care they needed and that staff listen to what they had to say, some examples given." I feel very cared for" and "staff are nice and helpful". There home had was a varied menu, food and mealtimes were discussed with the staff, who gave examples of food available, times of meals and confirmed that people had access to food and drinks 24 hours a day. People on the residential unit made very positive comments about the food on offer, and all surveys received back from people said they liked the food at the home. What has improved since the last inspection? All the issues raised on the last inspection had been addressed, for example issues raised with medication documentation, bedroom window repaired and training for staff that conduct appraisals and supervision. What the care home could do better: The home must ensure that carpets that are identified as requiring replacement are replaced as soon as possible. All care plans should contain evidence to show that all identified care needs are fully met, including any action taken by staff. Continue to monitor staffing levels to ensure that appropriate support for people is available especially at meal times. Continue to support staff to ensure there is a minimum ratio of 50% of staff trained to NVQ Level 2 or equivalent as soon as possible. The manager to continue with the on going NVQ 4 training in management. CARE HOMES FOR OLDER PEOPLE Sandygate Residential Home Sandygate Wath Upon Dearne Rotherham South Yorkshire S63 7LU Lead Inspector Janet McBride Key Unannounced Inspection 11th and 17th October 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000055221.V349766.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. DS0000055221.V349766.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandygate Residential Home Address Sandygate Wath Upon Dearne Rotherham South Yorkshire S63 7LU 01709 877463 01709 878258 paulhulbert@ntlworld.com www.winniecare.co.uk Winnie Care (Highgrove) Ltd 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) Sabina Caddick Care Home 54 Category(ies) of Dementia - over 65 years of age (54), Old age, registration, with number not falling within any other category (54) of places DS0000055221.V349766.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Physical Disability - 1 client only. Mrs Caddick completes the Registered Managers Award by 2005. One specific service user under the age of 65, named on variation dated 9th May 2005, may reside at the home 17th October 2006 Date of last inspection Brief Description of the Service: Sandygate Care Home is a purpose built home offering personal care and accommodation for 54 older people. The home is built on two floors with access via a passenger lift or stairs. There are two units within the home; the upstairs unit provides residential care for older people and the downstairs unit provides care for older people with dementia type illnesses. The home is located just off the main road in the town of Wath Upon Dearne. There are community amenities close by which includes local shops. All bedrooms are single and have en-suite facilities; there are assisted baths and showers on each floor. Outside there is a safe enclosed garden on the lower floor and a sun terrace on the upper floor for people to use. There is a private visitors lounge on the lower floor and a smoking room for people who use the service. Fees range from £ 343:00 to £ 385:00:per week, as at October 2007. Additional charges are made for hairdressing, chiropody and some toiletries, these costs are variable. For further information contact the home. The Statement of Purpose and the Service User Guide, which is available on request, this had information about the home and services available. The home last published inspection report and other various information was available in either the reception area of the home or the homes notice board. DS0000055221.V349766.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this Key Unannounced Inspection, which took place on the 11th and 17th October 2007 for 9:15 hours. The home is registered for fifty-four places, at the time of inspection fifty-three people were receiving services at the home. Prior to the inspection the manager submitted an Annual Quality Assurance Assessment this gives information regarding the home and services provided. Pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Case tracking of three care plans which were cross-referenced with other relevant documentation relating to those people who use the service. A tour of the premises and direct observation of staff interaction with people who use the service was carried out throughout the visit. Information was gathered from as many different individuals as possible, including individual interviews with the manager, members of staff and visitors. We sent out surveys prior to the inspection, twelve were sent to people who use the service within the home, nine were received back. Six were sent to relatives, five were received back, and five were sent to professionals who had contact with the home and one was received back. They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service needs were met. The inspector would like to thank all the staff, relatives and people receiving services within the home for their co-operation in the inspection process. Any issues or concerns that were raised were discussed with the manager at the end of the inspection. What the service does well: We found that people who use the service had information about the home and services provided, they had all been individually assessed prior to admission to the home. The atmosphere within the home was good and people that use the service appeared very happy. Throughout this visit we found that staff were seen interacting with people who use the service in a kind manner, they spent DS0000055221.V349766.R01.S.doc Version 5.2 Page 6 time talking to people who were referred to by their first name, this was agreed and documented in the care plans. Surveys received confirmed that staff always treated people who use the service with respect and maintain their dignity at all times, people said, “staff are excellent and provide a good service”. All the people agreed that they received support and care they needed and that staff listen to what they had to say, some examples given.“ I feel very cared for” and “staff are nice and helpful”. There home had was a varied menu, food and mealtimes were discussed with the staff, who gave examples of food available, times of meals and confirmed that people had access to food and drinks 24 hours a day. People on the residential unit made very positive comments about the food on offer, and all surveys received back from people said they liked the food at the home. What has improved since the last inspection? What they could do better: The home must ensure that carpets that are identified as requiring replacement are replaced as soon as possible. All care plans should contain evidence to show that all identified care needs are fully met, including any action taken by staff. Continue to monitor staffing levels to ensure that appropriate support for people is available especially at meal times. Continue to support staff to ensure there is a minimum ratio of 50 of staff trained to NVQ Level 2 or equivalent as soon as possible. The manager to continue with the on going NVQ 4 training in management. DS0000055221.V349766.R01.S.doc Version 5.2 Page 7 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. DS0000055221.V349766.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000055221.V349766.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People that use the service had information about the home and services provided. People were individually assessed prior to admission to ensure their needs would be met. EVIDENCE: The home offers residential and respite care but not intermediate care. The Annual Quality Assurance Assessment said that information was available in the homes statement of purpose and service user guide. All surveys received confirmed that people who use the service were provided with sufficient information before moving into the home, and that people had the opportunity to visit and stay prior to admission. Six out of the nine people said they had contracts with the home and were aware what they were paying for. The scale of charges was discussed with the manager and any extras that people pay for, which are documented on page 5 of this report. DS0000055221.V349766.R01.S.doc Version 5.2 Page 10 Records showed that people who use the service were fully assessed prior to moving into the home, with other professionals involved if required. DS0000055221.V349766.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Care plans generally provide staff with sufficient information to meet the needs of people who use the service. Arrangements for dealing with health issues are met with support from health professionals. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Two care plans were tracked, these care plans were cross-referenced with medication records, accident records and any other relevant information. Care plans were developed shortly after admission, using the initial assessment of need and any other relevant information gathered by professionals, family and friends. Health, personal and social care needs were set out in an individual plan of care, including religious beliefs. The wishes and arrangements that people DS0000055221.V349766.R01.S.doc Version 5.2 Page 12 wanted in the event of their death were discussed and recorded when appropriate with each individual person. All people within the home were registered with a GP and had access to health care facilities, the district nurse provided the main link to all medical services including dietician, continence advice and general health checks as required by the G.P. A consultant psychiatrist visit the EMI unit at the home every three months, this not only monitors mental health and medication, but also gives staff the chance to discuss any issues or concerns they had about people within the home. Various risk assessments and care plans were completed dependent on individual needs. Records showed that people had been assessed for pressure care, and risk of falls. Nutritional assessment had been completed on admission and records were maintained of peoples weight on a regular basis, to ensure that nutrition and weight is monitored and reviewed on a regular basis. One issue raised with the manager, was that staff recording in care plans should be more detailed and not just all care given, when specific tasks had been completed for people this should be recorded appropriately. Medication policy and procedure were discussed with the person in charge and records checked. All staff responsible for the administration of medication had completed the accredited medication training. Examination of records, storage and recording of medication was completed. All were found to be satisfactory with a big improvement of the handling of medicines and record keeping. All the issues raised on the last inspection had been addressed. Staff were able to say in what way they promoted peoples privacy and dignity on a daily basis. By sharing information, giving choices, valuing people’s opinions, offering privacy and considering dignity during personal care tasks. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. Surveys received confirmed that staff always treated people who use the service with respect and maintain their dignity at all times, people said, “staff are excellent and provide a good service”. DS0000055221.V349766.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People within the home were provided with some stimulation and interesting activities. They were offered a wholesome and appealing balanced diet with a varied selection of food available to meet people’s tastes and choices. EVIDENCE: Information was available in care plans of people’s hobbies, life events, likes and dislikes. Activities within the home were varied, the activities co-ordinator organised activities and social events for people who live at the home. Outings were arranged both on an individual and group basis, this was dependent on weather and staffing. A list of activities was advertised on the homes notice board and staff recorded in peoples care plans what people took part in and what they enjoyed. Some people within the home said they enjoyed one to one chats but did not take part in some activities, this positively respects the right to choose. DS0000055221.V349766.R01.S.doc Version 5.2 Page 14 Visitors were welcome to visit at reasonable hours and a pleasant private sitting room was provided for visitors who wish to use it, a comment from one relative said “the staff encourage my relative to keep in touch with us”. Four people within the home were spoken to, all four said, “they enjoyed life in the home and that staff were always happy and bright in their attitude towards them”. There was a varied menu, this should be displayed on a board in the dining room for people to see, but this was not on display on either days of the visit. Food and mealtimes were discussed with the staff, who gave examples of food available, times of meals and confirmed that people had access to food and drinks 24 hours a day. Kitchen staff on both units serve the meals, observation at the lunchtime on both units, found the EMI unit being very busy with a number of people requiring feeding and prompting by staff. It was nice to see that staff sat with people on an individual basis and that this was unhurried, help was also given from the activities co-ordinator and kitchen staff to help feed some people. People on the residential unit made very positive comments about the food on offer at meal times within the home, and all surveys received back from people said they liked the food at the home. DS0000055221.V349766.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The homes complaints procedure was accessible and displayed within the home. Policies and procedures were in place on adult protection, this promoted and protected people who use the service. EVIDENCE: There was a comprehensive complaints procedure, which was on display in the home. People using the service and relatives said they were aware of the complaints procedure and if they were unhappy or had any concerns they would talk to the manager or deputy managers. Complaint records showed one complaint had been received since the last inspection. This had been recorded, responded and investigated in an efficient and thorough manner. The home had informed and submitted the report to the Commission for Social Care Inspection local office Policies and procedures were in place regarding the protection of vulnerable adults. Staff confirmed they were aware of abuse polices and procedures, and staff were able to say the action they would take on receiving any allegations. No referrals had been made to adult protection since the last inspection. DS0000055221.V349766.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, 20, 24 and 26. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who use the service live in a comfortable and accessible environment with any specialist equipment they required to maximise their independence, although some refurbishment is needed to improve some communal areas this did not affect this judgment. EVIDENCE: The entrance and reception area to the home is very pleasant and welcoming, there is a visitors room on the downstairs floor for any person to use, and a smoking room was available for people who use the service. A tour of the premises, which included all communal areas and some bedrooms, showed that some areas had been decorated with new curtains being fitted in both lounges today. The carpets in both the lounge and dining room of the EMI unit looked very stained with food spillage in parts. DS0000055221.V349766.R01.S.doc Version 5.2 Page 17 Domestic staff said that carpets are cleaned on a regular basis, but a number of people within this unit was observed to walked around with food, therefore needs to be replaced on a regular basis. Communal rooms were comfortable, bright and cheerful and looked very homely with pictures and ornaments around the home. Comments on surveys about the home being clean, fresh and tidy revealed that most people thought the home was “usually clean and fresh”, others “said the home was only clean and fresh only some of the time”. Bedrooms were seen on both units, most had been personalised and furnished well with some people having own TV, video player, fridge and phone. DS0000055221.V349766.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 and 30. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home; a stable staff group ensures continuity of care by staff that knows the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Staffing was discussed with the manager and the duty rota examined, this clearly identified staff within the home and their role, gave a clear line of accountability of management and ancillary staff. There were some staff vacancies and other staff on sick leave, however staff usually cover any extra shifts needed by working overtime. This maintains continuity of care for people living at the home. Observation and checking of duty rotas confirmed there were sufficient staff to meet the needs of people who use the service, however it was evident on the EMI unit that people’s dependency levels was very high at certain parts of the day for example meal times. The manager said she continues to monitor the dependency levels of people within the home, and staffing levels had been increased on the EMI unit as people’s dependency levels had increased. There were robust recruitment and selection procedures that ensured people who use the service were safe and protected. A number of staff recruitment DS0000055221.V349766.R01.S.doc Version 5.2 Page 19 files were examined, which confirmed that all the required employment checks have been undertaken prior to staff being employed, including Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks. Training and development of staff was discussed with the manager and staff. Two new staff members confirmed they were going through an induction period and were shadowing other members of staff. Training records indicated that a number of the staff team had accessed various courses since the last inspection, for example dementia, abuse, communcation, moving and handling courses. Ninety percent of the staff team had also completed a basic first aid course. Development of staff was evident by some staff achieving National Vocational Qualification (NVQ) level 2 or 3 in care with other members of staff continuing to work towards attaining this qualification. DS0000055221.V349766.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 and 38. People who use the service experience Good outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises. The financial interests of people were safeguarded, good health and safety procedures ensured they were protected. EVIDENCE: Management structure at the home consisted of a registered manager and two deputy managers. Discussion with the manager about her role and her own development confirmed she was fully aware of her role and responsibilities within the home, she had the necessary experience to run the home and continues to work towards her NVQ registered managers award. DS0000055221.V349766.R01.S.doc Version 5.2 Page 21 Quality assurance systems were in place and the manager could evidence they monitor the quality of care and services within the home. Surveys are sent out six monthly to gain the views of people who lived at the home. The manager said that any issues raised in these questionnaires by people within the home are addressed and rectified. A number of audits were competed by the management team on a weekly and monthly basis for example care plans, medication and accident analysis reports. The company’s operations manager Moira Ockendon continues to carry out monitoring visits, and completes regulation 26 reports, which state what she found during the visit and who she spoke to, these were available to examine. Staff meetings were held three to six monthly with minutes taken. Finances and financial recording were discussed with the homes administrator, with some random records and balances checked. All were found correct they were stored separately with accurate recording of transactions and receipts kept. Some people within the home control their own finances, with the help of relatives. Staff said they received supervision on a regular basis either from the deputy managers or the manager. Since the last inspection both deputy managers had completed supervision and appraisal training to enable them to perform this task. Maintenance and service records were examined, these were up to date with current certificates. The required Health and Safety policies and procedures and the relevant notices were displayed throughout the home. Fire safety procedures were in place, records examined showed they were current and up to date. This keeps people living and working at the home safe. DS0000055221.V349766.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 3 3 3 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 2 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 2 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 DS0000055221.V349766.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. 1 Standard OP19 Regulation 23(2)(b) Requirement The home must ensure that carpets that are identified as requiring replacement, must be replaced to assure a comfortable environment that meets the needs of people within the home. Timescale for action 30/12/07 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 3 4 Refer to Standard OP7 OP27 OP28 OP31 Good Practice Recommendations All care plans should contain evidence to show the action taken by staff to ensure all identified needs were fully met. Staffing levels continue to be monitored to ensure that appropriate support for eating and drinking can be consistently provided. A minimum ratio of 50 of staff must be trained to NVQ Level 2 or equivalent as soon as possible. The registered manager to continue with on going NVQ 4 in management. DS0000055221.V349766.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000055221.V349766.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. 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