Care Home: Winchley Home

What the care home does well The Home provides a good standard of care to the residents who live there. The Home is well managed by an enthusiastic Manager who provides good support to the residents, staff team and to visitors. The Home liases well with the local healthcare teams and incorporates advice into the residents care plans. Some areas of the Home provide a high standard of accommodation in a homely style. The residents enjoy their meals and are offered a choice at each mealtime. The views of the residents and their relatives are sought about the quality of the service provided. The Responsible Individual visits the Home on a regular basis and provides support to the Manager. Visitors said that they are made to feel welcome at the Home and that the staff keep in good contact with them. The Home employs a good level of kitchen and domestic staff. What has improved since the last inspection? The Manager has employed an additional member of staff from 6am to 9am in response to the extra support that is needed at that time. The odours that had been noted in one of the bedrooms have been removed. Improvements have been made to the garden, including the installation of a new water feature. The organisation has employed a member of staff to oversee the Human Resources and Compliance issues at the two Homes that it owns. The care plans have started to be reviewed and put into a different format. What the care home could do better: The Manager needs to continually monitor the staffing levels at the Home to ensure that they are able to meet the residents changing needs. Activities are organised at the Home but there are still lots of times when residents are not engaged in any meaningful activities during each day. There is a need for some of the procedures to be reviewed and updated to ensure that staff have accurate guidance available when they need it. There is a need to ensure that the care plans contain detailed guidance about how to meet the residents needs. CARE HOMES FOR OLDER PEOPLE Winchley Home Rectory Lane West Winch Kings Lynn Norfolk PE33 0NR Lead Inspector Lella Hudson Key Unannounced Inspection 11th February 2009 08:45 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 Winchley Home DS0000027342.V374188.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. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winchley Home Address Rectory Lane West Winch Kings Lynn Norfolk PE33 0NR 01553 841582 01553 842270 gemini@winchley.wanadoo.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Gemini Care Limited Mrs Gina Reeve Care Home 41 Category(ies) of Dementia (41) registration, with number of places Winchley Home DS0000027342.V374188.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 people of the following gender: Either Whose primary needs on admission to the home are within the following categories: 2. Dementia - Code DE The maximum number of people that can be accommodated at Winchley Home is: 41. Date of last inspection Brief Description of the Service: Winchley Home is a care home providing personal care and accommodation for 41 people. In October 2008 the Commission agreed a variation to the Homes registration so that they can admit up to 41 older people with dementia. The home is owned by Gemini Care Limited. The home is located in the village of Winchley situated on the A10, four miles from Kings Lynn, where all amenities can be found. The home consists of 31 single rooms and 5 double rooms. There is a shaft lift on one side of the building and a stair climber on the other side to aid access to the first floor accommodation. The home is maintained to a high standard both internally and externally. The home has pleasant views over the front garden. There is good access to the home, which has a large car park at the front of the home. The gardens are a feature of this home The current fee range for the home is £407.00 to £550.00 per week. There are additional charges for items such as hairdressing, newspapers, private chiropody, personal telephone and personal toiletries. Potential residents or their representatives are advised of the fee payable before the resident moves into the home. Fees payable are contained in the Terms and Conditions of Residence. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 5 Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report contains information that we have gathered about the Home since the last Inspection (February 2007). The Manager completed the Annual Quality Assurance Assessment (AQAA) and returned it to us prior to our visit. The report includes information gathered during an unannounced visit to the Home that we carried out on February 11th 2009 between 8.45am and 5.40pm. During the visit we spoke to residents, visitors and staff as well as looking around the Home and looking at a selection of records. We gave brief feedback to the Responsible Individual and the Manager before we left. The quality rating for this service is 2 stars. This means that people who use the service experience Good quality outcomes. What the service does well: What has improved since the last inspection? Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 7 The Manager has employed an additional member of staff from 6am to 9am in response to the extra support that is needed at that time. The odours that had been noted in one of the bedrooms have been removed. Improvements have been made to the garden, including the installation of a new water feature. The organisation has employed a member of staff to oversee the Human Resources and Compliance issues at the two Homes that it owns. The care plans have started to be reviewed and put into a different format. 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. Winchley Home DS0000027342.V374188.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 Winchley Home DS0000027342.V374188.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&3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective residents receive sufficient information prior to moving to the Home. Appropriate assessments are carried out prior to a resident moving to the Home. EVIDENCE: The Statement of Purpose has been updated recently. This document contains a lot of information about the Home and the service that it provides. One of the relatives who spoke to us said that they feel that they had been given sufficient information on which to base their decision for their relative to move to the Home. The Manager or deputy manager carry out the pre admission assessment prior to residents being offered a place at the Home. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 10 This involves gathering information from health and social care professionals involved in the persons care as well as the person themselves and their relatives. The Home was previously only registered to admit up to 16 residents with dementia (with a total registration for 41 older people). In October 2008 a variation was agreed to their registration so that they can now admit up to 41 people with dementia. The Manager said that there are only two residents living at the Home currently who do not have a diagnosis of dementia. She said that they have both lived at the Home for a long time and do not wish to move. Winchley Home DS0000027342.V374188.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 & 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of the residents are met. Medication is managed safely. Care plans are not detailed enough to provide staff with good guidance about meeting residents needs. EVIDENCE: The Manager said that they are currently changing to a new care plan format. We asked to see a selection of care plans and for some residents the information could not be found. The Manager said that this is due to the information being removed to be updated into the new formats. However, this also means that the staff do not have access to the information during this time. The staff who spoke to us gave consistent answers to questions about care that specific residents require and were knowledgeable about the needs of these residents. They said that they have access to the care plans and that usually the information is available. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 12 Some of the information in the care plans that we did see is detailed and provides good guidance to staff about how to meet the residents needs. Some of the information is not detailed enough and there was a lack of information following on from problems being highlighted. For example, a record in the daily record for one of the residents states that they were ‘aggressive’ but there is no detailed guidance for staff about how they should manage these situations. The Manager said that they liase with the Falls Team who provide advice and guidance about how to provide good care for residents who are at risk from falling. We saw falls risk assessments. We looked at accident records and these could be cross referenced with the daily notes for the residents whose care plans we looked at. We observed staff supporting residents in a kind and caring way. They were mindful of the need for privacy and respecting residents dignity. Discussions with staff show that they are enthusiastic about supporting the residents and are keen to provide a good standard of care. The Manager said that they intend to make alterations to the shared rooms so that they will become single en suite rooms in recognition that the majority of residents would prefer a single room. Privacy curtains are provided in shared rooms. One of the residents told us that the staff are ‘marvellous’ and that they provide support in a respectful way and that they encourage him to maintain his independence wherever possible. The Manager said that the residents are usually able to choose to remain registered with their current GP practice and as a result the Home liases with five different GP practices. She said that they also have good relationships with Chatterton House (NHS provision for older people with dementia) in Kings Lynn and that the staff from there have provided training and advice to staff at the Home. We spoke to one of the healthcare professionals who is a regular visitor to the Home and she said that the staff provide a good standard of care to the residents and that they are good at communicating effectively with the healthcare professionals who provide care to the residents. She said that the staff make appropriate referrals and that any advice is incorporated into the care plans. The Manager said that the optician and chiropodist visit the Home and that she has recently arranged for the dentist to also visit residents at the Home for those that would find this easier than going to the dentist in the local community. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 13 We looked at the system for managing medication. Medication is stored appropriately and records are kept of medication which arrives at the Home and any returned to the pharmacy. None of the residents currently look after their own medication. As the residents are registered with different GP practices there are three different systems of medication dispensing in place but the deputy manager told us that the staff receive appropriate training and therefore it is not a problem. Staff receive training about the administration of medication and the deputy manager said that they are observed to ensure that they are competent before administering medication alone. The medication procedure is in need of updating as currently it is not very clear. Winchley Home DS0000027342.V374188.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): 12, 13, 14 & 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although group activities are planned there is a lack of activities taking place on a daily basis. Visitors are made to feel welcome at the Home. The residents are offered a choice of appetising meals. EVIDENCE: Two of the staff at the Home are responsible for organising activities but this is in addition to their work as care staff. They have organised lots of group activities, some on quite a large scale. Residents and staff told us that these are very popular and that the residents enjoy them. At the time of our visit a ‘virtual’ trip to Paris was planned. Residents, and visitors, also told us that there are quite a lot of times when there are no activities taking place on a daily basis. We observed that the staff are constantly busy meeting the health and personal care needs of the residents. The accommodation is spread out over the ground floor with four different lounges. We observed that residents often spent considerable periods of time without meaningful activities. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 15 The needs of the residents currently living at the Home are different to those at the time of the last Inspection as now all, apart from two, residents have some form of dementia. This means that the provision of activities may need to be more focused on spending time with individuals rather than the provision of group activities. One of the residents has access to Broadband for their computer that they have in their room. The resident is involved in putting together leaflets and posters for activities that are taking place in the Home. The Manager said that she intends to start an activities committee and hopes that residents and relatives will join. Staff were seen to offer residents a choice about issues such as food and drink as well as where they wished to spend their time. The Manager is aware of the need for increased training with regard to communication now that the majority of the residents have dementia and therefore, may have difficulties with verbal communication. We spoke to visitors who told us that they are always made to feel welcome at the Home and that the care staff are good at communicating with relatives. They said that they feel that the care staff provide good care for their relative. The Home has recently had a new kitchen fitted. This has been done to commercial standards and provides a good working environment for the kitchen staff. On the day of our visit the cook was off sick and so one of the care staff was preparing the meals but usually there is a cook on duty from 7.30am to 5.30pm every day of the week. The Manager is currently in the process of putting together a photographic menu so that it will be easier for residents to make a meaningful choice about their meals. Although the residents are asked for their choices during the day before the Manager said that the cook always prepares extra food so that residents are able to change their minds if they wish to. Residents said that they enjoy their meals and that they are always provided with plenty of food. They said that they are always given a choice and that the cook will prepare something else if they do not want what is on the menu for that day. The Home uses the MUST nutritional assessments and supplements are provided as necessary. The Manager said that they receive advice from the dietician as required. Winchley Home DS0000027342.V374188.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): 16 & 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously. Staff training and procedures are in place to provide protection to the residents from abuse. EVIDENCE: The Manager said that the Home has not received any complaints since the last Inspection and that there have not been any referrals to the Safeguarding team. The Commission have not received any complaints about the Home. One of the visitors who spoke to us said that they feel that they could raise any concerns with the Manager, or any of the staff. One of the residents told us that the staff always address any issues, however minor, that they are told about. The Home has a complaints procedure which is on display and which is included within the Statement of Purpose. The staff who spoke to us said that they have received training about Safeguarding vulnerable adults, however, this is not updated on an annual basis. The Safeguarding procedure is not accurate and needs to be updated so that the staff have access to the correct procedure in the case of an allegation being made. Winchley Home DS0000027342.V374188.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): 19 & 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home provides comfortable and homely accommodation. EVIDENCE: The Home provides a range of communal lounges so that residents are able to have a choice about where they spend their time. There are also three dining areas. The standard of decoration and furnishing varies in the different areas depending on how recently they have been upgraded. Some areas of the Home are very homely and nicely decorated. The Home has several bathrooms with assisted baths and toilets. All bathrooms have locks on. The Manager said that the residents are given the option of having a key to their bedroom door if they wish to have one. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 18 Some signage has started to be used around the Home to assist those people with dementia to orientate around the Home but this could be further developed. The Manager said that the hot water is regulated and that all of the radiators are covered. We saw that window restrictors are not fitted to all windows. The Home employs domestic staff on a daily basis and we noted that the Home was clean with no odours on the day of our visit. The Home employs a member of maintenance staff to carry out day to day maintenance tasks. Winchley Home DS0000027342.V374188.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): 27, 28, 29 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are provided in adequate numbers to meet the needs of the residents. Staff receive training and support to carry out their roles. Appropriate recruitment practices are followed. EVIDENCE: The organisation has recently employed a member of staff who is responsible for the Human Resources and Compliance issues for both of the Homes owned by the organisation. We spoke to this member of staff about her plans for improvements. She is currently reviewing all of the recruitment files and putting them into a different format which should make it easier to use. She also said that she is updating the induction package to ensure that it meets the Common Induction Standards. She has undertaken training to provide some training sessions to the staff and is currently reviewing the training provided at the Home. We looked at a selection of recruitment files and these contained evidence that the necessary checks were carried out prior to the staff starting work at the Home. Staff told us that they had received a good induction when they started work at the Home and that this had included a period of time working as an Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 20 additional member of staff to give them time to get to know the residents and their needs. The Manager said that they have employed an additional member of staff from 6am to 9am since they have become registered for more residents with dementia. The current staffing levels are for there to be six carers on duty from 7.30am to 5.30pm with the additional member of staff on duty during the early morning. There are then five care staff on duty from 5.15pm to 10pm with three waking night staff on duty overnight. The Manager said that several of the residents request to get up quite early in the morning which is why she has employed the additional member of staff at that time. She said that there is a cook on duty and domestic staff on duty seven days a week so that the care staff are not responsible for these jobs on a regular basis. The staff who spoke to us said that they feel that the staffing levels are adequate to meet the personal and healthcare needs of the residents but that they do not have time to spend with individual residents in addition to this. One of the residents also told us this. Staff said that they have team meetings about three times a year and that they feel well supported by the management team. They told us about a range of training sessions that they have attended. They also said that they feel that they work in a good team and that the staff provide a good standard of care to the residents. Staff were enthusiastic about working at the Home and about supporting the residents. Winchley Home DS0000027342.V374188.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): 31, 32, 33, 35 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home is well managed, in a way which puts the needs of the residents first. The views of the residents are sought about the quality of the service. The health and safety of the residents and staff is given a high priority. EVIDENCE: The Manager has achieved the appropriate qualifications to be the Registered Manager. She has worked at this Home for many years, as has the deputy manager. Staff, visitors and residents told us that the Manager provides good leadership and is enthusiastic about providing a good service to the residents. They said that the Manager is approachable and easy to talk to. Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 22 The organisation carries out regular audits of the quality of the service provided and the new member of staff is responsible for continuing this audit. She said that she has just carried out an environmental audit of the Home and is completing an action plan resulting from this audit. She also said that the annual questionnaires for relatives and residents are due to be sent out shortly. The Responsible Individual visits the Home on a regular basis but is not currently providing the Home with a written report as is required by regulation. The Manager receives regular supervision from the Responsible Individual. Staff at the Home are not responsible for any of the residents pensions but they do look after residents money if asked to do so. This is kept securely and appropriate records are kept of transactions made on the residents behalf. We looked at a selection of health and safety records and can see that regular maintenance and servicing of equipment, including fire safety equipment, takes place. The Manager confirmed that the fire doors recommended by the fire officer have been fitted. The Home has a fire risk assessment dated May 2007 but this needs to be reviewed and updated on an annual basis. Winchley Home DS0000027342.V374188.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 3 x 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Winchley Home DS0000027342.V374188.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. 1 Standard OP7 Regulation 15 Requirement It is required that the care plans contain detailed guidance for staff about how to meet the residents needs. It is required that the medication procedure is reviewed and updated It is required that the Safeguarding Adults procedure is reviewed and updated It is required that a report is provided following the providers monthly visits to the Home Timescale for action 30/04/09 2 3 4 OP9 OP18 OP33 13 13 26 31/03/09 31/03/09 31/03/09 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 OP9 OP18 Good Practice Recommendations It is recommended that a record is kept of observations of staff administering medication and a record of when competence to administer is agreed. It is recommended that staff receive an update of Safeguarding training on an annual basis DS0000027342.V374188.R01.S.doc Version 5.2 Page 25 Winchley Home 3 4 5 OP24 OP27 OP38 It is recommended that further signage is used around the Home It is recommended that the staffing levels are monitored to ensure that the needs of the residents are met at all times It is recommended that the fire risk assessment is reviewed and updated Winchley Home DS0000027342.V374188.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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