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Inspection on 09/09/08 for Threeways

Also see our care home review for Threeways for more information

This is the latest available inspection report for this service, carried out on 9th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Threeways 14/02/07

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Threeways Threeways Care Home 5 Brighton Road Salfords Surrey RH1 5BS two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Griffiths Date: 0 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Information about the care home Name of care home: Address: Threeways Threeways Care Home 5 Brighton Road Salfords Surrey RH1 5BS 01737 760561 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): devpurmah@yahoo.co.uk Tecknarainsingh Purmah,Mr T Purmah & Mrs B M Purmah,Mrs Bibi Mimma Purmah Tecknarainsingh Purmah care home 6 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: Date of last inspection 0 9 0 9 2 0 0 8 A bit about the care home Threeways Care Home is registered to provide care and accommodation to six service users with a learning disability. The home is a 2 storey, detached house in Salfords, near the town of Redhill, Surrey. There are four bedrooms on the ground floor and two on the first floor. All bedrooms are for single occupancy, with four having en-suite bathrooms, one having an en-suite toilet and wash hand basin and one having a wash hand basin sited in the room. There is an additional bathroom with an easy access bath on the ground floor. There is a large communal lounge/dining room, a kitchen and facilities for laundry. There are garden areas to the rear and the front of the property with ample room for parking at the front of the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This was a key inspection of Threeways Care home. Prior to the Inspection the Manager completed the Annual Quality Assurance Assessment (AQAA) and returned this to the Commission. A visit to the home took place on 9th September 2008 between 11.10am and 2.10pm. The Manager and Registered Providers were at the home during the visit. The inspector had a look around the home and looked at some of the records and care plans. There were two people living at the home and both were at home during part of the visit. The Inspector was able to observe some of their daily activities and speak with one person using the service. The fees currently charged for this service range from £1200 to £1500 per week depending on service users individual needs. What the care home does well The people that live in the home have a full and detailed assessment of their needs before a service is offered to them to ensure their needs can be met. They have lots of opportunity to visit the home to test it out before they make a decision about moving in. Each person has a care plan that ensures their daily needs are met. The people that live in the home lead busy and interesting lifestyles. They are supported to participate in the activities they enjoy in the home and in the local community. People are supported to develop their skills by going to college. The home is spacious and comfortable and people have large bedrooms and access to sufficient facilities in the home. There are regular opportunities for people to have a say in how the home is run and what support they receive. What has got better from the last inspection The Care plans have been further developed and some work has been done with individuals to develop their Person Centred Plans. The range of activities available to people living in the home has increased and people have been supported to access their local college for courses. Some people now enjoy being part of the local church group. What the care home could do better Different ways of communicating with people that do not use speech should be explored. This will help people to make their own choices and decisions in their lives. Better records need to be kept of the activities people do and the meals they are provided with. This will help the manager to monitor that peoples needs are being met in this area. The timescale for responding to any complaints needs to be made clear in the Service User Guide so that people know what to expect if they need to make a complaint. The manager needs to ensure that all staff are up to date with their training, including medication training, and ensure that there are certificates to evidence the training in the home. This will mean that people moving to the home can be assured they are supported by trained staff. It would benefit service users if more staff were to undertake the NVQ. The manager needs to implement a system for monitoring the quality of the service and ensure this includes the views of the people that live in the home. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jo Griffiths The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries.southeast@csci.gsi.gov.uk or by telephoning our order line - Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are provided with the information they need to make a decision about moving to the home. People have their needs assessed before they move into the home to ensure they can be fully met. Prospective service users have the opportunity to visit the home to assess the service before they make a decision to move in. Evidence: The home has a clear and informative Service User Guide which is given to people as they express an interest in moving to the home. Currently the Service User Guide does not state the timescale in which complaints will be dealt with. The Manager stated that a full copy of the complaints procedure is provided alongside the Service User Guide. It is recommended that the timescale for responding to complaints be added to the Service User Guide. It was discussed with the Manager the benefit of developing the Service User Guide in different formats to suit the needs of new service users as they express an interest in the home. The new Statement of Purpose for Threeways had been provided to the Commission prior to the inspection. This contained all the required information, but the information regarding charges for use of the telephone was not clear. The manager agreed to review this and make any charges clear. The two people that were living in the care home had an assessment of their needs completed before they moved into the home. The assessment documentation was seen and was detailed and covered all the areas recommended in the National Minimum Standards. There is one person planning to move into the home within the next month. An assessment of needs has been completed by the care manager and the information used to develop a care package for the individual within the home. The person has been visiting the home regularly for coffee and meals. It is planned that there will be two overnight stays before the person moves in. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have a care plan that meets their assessed and changing needs. People are supported to make their own decisions in some areas of their lives but appropriate communication tools and methods for people without verbal communication skills should be explored and recorded. People are supported to take reasonable, assessed and minimised risks as part of an independent lifestyle. Evidence: Both service users living in the home have a care plan that identifies how their individual needs will be met. The care plan consists of the agreed care package, risk assessments, health action plan, daily records and individual support plans. The individual support plans detail the steps staff must follow to ensure peoples needs in certain areas of daily living skills are met. The manager was advised to review the documentation for the support plan as it currently refers to the persons needs as the problem. This could be seen by the service user to be a negative reflection on their needs. One person had a person centred plan as part of their support plan. This was in written format with some symbols used as the template of the form. The other service user did not have a person centred plan completed as part of their care plan file. The manager stated that one service user is able to verbalise their needs and views and the other person does not use verbal communication. The options for communicating with people that do not use verbal communication should be further explored and recorded within the care plan to ensure that everyone can be involved in developing their person centred plan and taking ownership of it. Consideration should be given to the use of visual and audio tools to support people to have a say in their plan and understand the content. Monthly service user meetings are held in the home and the minutes of these were seen. Again, it is clear how people that verbally communicate have been involved in these meetings, but further work should be done to ensure people with non verbal communication skills are provided with the tools they need to participate in the meetings. The manager stated that weekly meetings between the service user and their keyworker are also held. The manager is attempting to access advocacy support for the service users. Particular priority should be given to those service users who do not have anyone outside of the home involved in their care. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are supported to participate in activities that meet their needs and preferences. They are provided with opportunities to develop their skills through educational courses. People are supported to maintain links with their local community and participate in community based activities. They are supported to maintain and build new relationships, but the provider must ensure their right to intimate and personal relationships in the home is not restricted. The rights and responsibilities of people in the home are recognised. People are provided with a healthy diet, but records in the home do not evidence that they have a choice of meals. Evidence: Each person has their own activity planner as part of their care plan. The activities that are provided are based on the persons needs and preferences. One person is attending college three days per week and the other person has regular sensory sessions at the day centre. None of the people using the service are currently employed or looking for work. Activities that are provided within the home include cookery, numeracy and literacy, board games, music and gardening. The activity planners also show that people go shopping, go out for walks and for outings at the weekend. Both services users attend church and one person is a member of the church social group. This person told the inspector they were looking forward to going to the social group in the afternoon to have coffee and meet their friends. The records of the activities people have participated in show regular entries for going out for a drive. The manager stated that this is not the whole activity and that there will be a walk in the park, coffee out or outing as part of the trip. It is recommended that the activity records be reviewed to reflect the actual activities taking place to ensure the manager can monitor that peoples social needs are being fully met. People are supported to stay in touch with their family and friends and participate in a number of community events including the local college and church groups. The church social group and college both cater for people both with and without disabilities. Service users can invite visitors into the home when they wish and can see them in private. However, it is noted in the service user Guide that visitors are not permitted to stay in the home overnight. The Manager must ensure that people have the opportunity to develop and maintain personal and intimate relationships if they wish to and that this rule does not restrict their right to pursue any such relationship. Service users were seen to have unrestricted access around the home and staff supporting them interacted in a positive and respectful way. The service users are encouraged to get involved in some of the cooking and household duties in the home. There is a new four week menu. This has been devised with the involvement of a dietician to ensure it is balanced and nutritious. The Manager said that the preferences of the current service users have been included in the menu. The menu provides one option of meal per mealtime, although the manager said that service users can have an alternative if they prefer. Ways of communicating the meal options in a way that the service users can understand should be explored and recorded in the care plan. Currently there is no record maintained of the meals that people are eating. A record must be maintained so that the manager can monitor the nutritional intake of the service users, particularly where people are choosing something different from the planned menu. The record will also evidence that people are being offered a choice of meal. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have their health and personal care needs met. People are supported to manage their medication, but the manager must ensure staff are trained and competent to provide the required support. Evidence: Each person has a health action plan as part of their care plan. The care plan files examined contained evidence of the involvement of health care professionals including psychologist, optician, dentist and GP. Records are kept of the health needs of each individual service user as part of their daily notes. Some staff have received training in administering medication through the care home. Other staff have completed training in medication in their role as registered nurses working for the NHS. The provider must ensure that all staff that administer medication are trained and competent to do so and that evidence of medication training and competence to administer medicines is held file. This includes all qualified nurses as they are not employed in a nursing role within the home. The service users consent to have their medication administered by a staff member has been sought and recorded on file. Medication is stored securely and appropriately and records are adequately maintained. The manager stated that a weekly check of the medication stock is carried out. The personal care needs of service users are outlined in the care plan with a description of the steps staff must follow to ensure these needs are met. All personal care is provided in private in one of the bathrooms. Some staff have been trained in safe moving and handling techniques. This should be arranged for all staff as one service user requires some support with their mobility, a requirement has been made in relation to staff training under Standard 35. The district nurse has been involved for the assessment of appropriate continence aids. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home are supported to make a complaint if they need to. People in the home are safeguarded from harm and abuse. Evidence: The home has a complaints procedure and a procedure for safeguarding vulnerable adults. People visiting the home are given the opportunity to complete a survey about the quality of service provided. Service users have the opportunity to talk about any concerns or complaints through the weekly keyworker meeting and monthly service users meeting. As reported under standard 7 it would be of benefit for people with non verbal communication skills to explore other ways of gathering their views about their care. There have been no complaints received about the home. One complaint received by the Commission was referred to the registered Provider and this was managed appropriately and resolved. All staff are required to undergo a criminal records (CRB) check before they are employed. Some staff have completed training in Safeguarding Adults and arrangements for the remainder of staff to completed training in this area must be made. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is clean and comfortable and meets the needs of the people that live there. People living in the home have access to sufficient shared space. Service users have their own rooms that meet their needs. Evidence: The home is clean and comfortable for service users with plenty of shared and private space. Each person has a large bedroom and most have ensuite facilities. The rooms are bright and fully furnished. More could be done to support individuals to personalise their rooms with their own choice of decor and personal belongings. There is a large garden to the rear of the home and a seating area in the side garden. The home has wheelchair access to all areas including the garden. There are two bedrooms on the first floor that are not suitable for wheelchair users. The manager has obtained quotes for fitting covers to the radiators around the home. It is planned this will be completed by the end of December 2008. The radiators have been thermostatically controlled in the meantime. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are not currently supported by staff that are evidenced as trained to meet their needs. They would benefit from being provided with evidence of staff having achieved their NVQ award. Service users benefit from effective arrangements for the supervision of staff. Service users are safeguarded by the recruitment procedures for the home. Evidence: The rota shows that sufficient numbers of staff are employed to meet the needs of the people that live in the home. The numbers of staff on duty will be increased as new people move to the home. The staff recruitment files for two staff members were checked. These contained the required documentation and evidence of the necessary checks having been made before employing new staff. The training files for three staff members were inspected. These showed that the staff have completed the skills for care induction standards. Not all staff had completed training in Safe Moving and Handling techniques or POVA. One staff member had a first aid certificate that had expired. The manager said that some of the staff are also employed as nurses in the NHS and therefore they complete some update training courses there. Where this is the case a copy of the certificate to evidence the learning must be provided on the staff file in the care home. Certificates to evidence that staff have completed all the required training were not available in the home. A training needs analysis was carried out by Train to Gain in August 2007. This recommended that all staff complete training in learning disabilities and breakaway techniques. The Manager stated that he is currently trying to source appropriate training courses in the area. As some of the needs of the current and prospective service users include epilepsy, autism and challenging behaviour these courses should be arranged as a priority. Training for staff in person centred planning, communication skills and sexuality and relationships would also be of benefit to the current service users group. The manager should also include Equality and Diversity training within the training plan for the home. The Manager stated that four members of care staff have completed the NVQ, but that certificates had not been provided by the staff members. It is planned one new staff member will begin the NVQ award. The manager does not plan for the staff that are qualified as nurses to undertake the NVQ, but must ensure that evidence of their continued development is held on file including certificates of all training courses and updates. There is a monthly staff meeting and all staff have supervision approximately every month. Records were seen to be held in the staff files to support that effective supervision is being carried out. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service Service users benefit from a qualified and experienced manager. Service users are consulted on their views of the home at regular intervals. A formal system for reviewing the quality of the service needs to be implemented. The health, safety and welfare of service users is promoted and protected in the home. Evidence: The Manager and the deputy Manager are qualified as nurses in Mental Health and have completed the Registered Manager Award. The certificates were seen to be held on file. The manager ensures that he is kept up to date by attending various training courses including Safeguarding Adults, moving and handling, recruitment and common induction standards. The manager is a member of the Surrey Care Association and receive updates on current good practice via newsletter and conferences. The Manager stated that he is currently devising an annual quality audit for the home. There is currently no report of a quality review of the home or action plan. This should be included as part of the exercise and a copy of the report made available to service users and other stakeholders. Service users are given the opportunity to have a say about how the service is run through the monthly service users meetings. The manager carries out daily health and safety walk around checks and has ensured that all risk assessments are kept up to date. Staff have received training in Health and Safety and safe food handling. Training for staff in Breakaway techniques and managing aggression should be arranged as recommended in the Training needs Analysis completed last year. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 7 12 The registered person must 31/10/2008 ensure that people are provided with the communication tools they need and that the way they communicate is included and reviewed as part of the ongoing care plan. To ensure that people without verbal communication skills are supported to be involved in the person centred plan and other decision making processes in a meaningful and effective way. 2 17 17 The registered person must ensure that a record is maintained of the meals provided to service users. 31/10/2008 To ensure that the manager can monitor that peoples nutritional needs are being met and that they are being provided with a choice of meals. 3 20 13 The registered person must 31/10/2008 ensure that staff receive training in medication and that evidence of training and their competence to administer medication is held in the home. To ensure that service users are supported to manage and receive their medication in a safe way. 4 35 18 The registered person must 14/11/2008 ensure that the home has an annual training plan and that staff undertake the training appropriate to their roles. To ensure that service users are supported safely and effectively and their needs are met. 5 39 24 The registered person must implement a formal system for reviewing, at regular intervals, the quality of care provided in the home. 31/10/2008 To ensure that service users are provided with a service that meets their need and expectations and is in line with the Statement of Purpose. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 6 It is recommended that the timescale for responding to complaints be included within the Service User Guide. It is recommended that the Manager review the use of some terminology within the care plans that could be considered negative. It is recommended that the way activities are recorded be reviewed to ensure the manager can effectively monitor that peoples social needs are being met. It is recommended that the policy on service users right to have guests stay overnight be reviewed to ensure that their right to pursue personal and intimate relationships is not restricted. It is recommended that all care staff complete a qualification in care to level 2 NVQ or equivalent and evidence of completion of the qualification is held on file. 3 12 4 15 5 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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