Inspection on 21/11/05 for 1 Middlefield Close

This inspection was carried out on 21st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1 Middlefield Close 16/08/07

1 Middlefield Close 17/08/06

1 Middlefield Close 15/08/05

1 Middlefield Close 21/09/04

1 Middlefield Close 05/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Middlefield Close (1) 1 Middlefield Close Middlefield Farnham Surrey GU9 8RS Lead Inspector Suzanne Magnier Unannounced Inspection 21st November 2005 10:00 Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 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 Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Middlefield Close (1) Address 1 Middlefield Close Middlefield Farnham Surrey GU9 8RS 01252 718479 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) alison.beverley@new-support.org.uk New Support Options Limited Alison Deborah Beverley Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (2), Physical disability (4) of places Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Of the adults with Learning Disabilities accommodated, 2 people may be over the age of 65 years. Of the adults with Learning Disabilities accommodated up to 4 may have additional Physical Disabilities. Of the adults with Learning Disabilities accommodated, 1 named person may have Dementia. Of the adults with Learning Disabilities to be accommodated, 1 named person may also be over the age of 75 years. All persons accommodated in the home will be over the age of 36 years. 15th August 2005 Date of last inspection Brief Description of the Service: 1 Middlefield Close is a purpose built, detached bungalow set in a private residential cul-de-sac, located close to the town of Farnham. The home is owned and managed by New Support Options Limited and provides accommodation and care for up to five people with learning disabilities and/or physical disabilities. All areas of the home are easily accessible and the doors and hallways are wide enough for wheelchair access. Communal areas are arranged and furnished in a comfortable, homely way and there are ample toilet and bathing facilities. All bedrooms are single occupancy and of a good size, and all have a wash basin. No rooms have en-suite facilities. There is a garden to the rear of the property that is fully accessible to the service users and parking for several cars to the front of the building. The home has its own vehicle for accessing activities in the local community, trips out and attending day centres. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken over a period of five and a half hours. For the purpose of the report the Registered Manager advised that people living in the house prefer to be addressed as supported people. Several supported people, visitors, art and craft therapist and staff including the Registered Manager, were present during the inspection. The main focus of the inspection was to ascertain that that the previous requirements and standards not assessed during the announced inspection in August 2005 had been met. The inspector sampled a variety of documentation including care plans, policies and procedures, risk assessments, financial records and undertook a tour of the premises. Due to the complexity of some of the supported peoples needs direct verbal feedback was not available regarding the service and care being provided at the home. Through direct observation of interaction and body language the inspector concluded that the supported people were relaxed and free to move around their home without restrictions. The inspector would like to thank the supported people and all staff for their cooperation and hospitality during the inspection. What the service does well: The service continues to offer a person centred approach of care to the supported people. Staff are committed to promoting individual lifestyles and developing peoples potentials. The homely atmosphere supports people to live in a relaxed, safe and happy environment, which promotes peoples rights to self-expression and individuality through hobbies and crafts. During the inspection two peoples relatives arrived who spoke highly of the home and the care received. It was evident that the home works closely and supports people and their relatives to continue and enjoy relationships. The home has implemented a pictorial photo menu, which was evidenced as bright and colourful and included nutritional values to enable supported people to have some understanding of their meals. The staff team continue to remain committed and professional in the service provided to the supported people. The home has developed a training plan and all current staff have attended mandatory training and are proactive in having achieved or achieving their NVQ awards. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4. The home is active in ensuring that people admitted to the home have their needs and aspirations assessed and have the opportunity to have a planned move into the home. EVIDENCE: The inspector sampled a care plan and documentation regarding a person recently admitted to the home. The documentation clearly demonstrated that the aspirations and needs of the person and a phased introduction included visits to the home, with overnight stays and meetings with other people at the home including staff. The arts and crafts therapist has made part of the statement of purpose in textiles and some words, which was a creative flair to inform people about the home. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 10. The home promotes peoples rights to advocacy and involvement in the home. Issues of confidentiality need to be addressed by the home with regard to methods of staff communication. EVIDENCE: All supported people have an individual care plan and a ‘person centred plan’ that focuses on their aspirations as well as their assessed needs. The home actively promotes supported people to have advocates in order to offer additional support and promote the person’s wellbeing and welfare. The Registered Manager explained that the care plans do not contain a confidentiality policy, as the supported people would not be able to understand the written concept. The home promotes and advocates regarding issues of confidentiality based on a need to know basis. The inspector observed one person who was relaxed and laughing whilst lying on their sofa in the foyer of their home. It was apparent that they enjoyed watching the activity of the home and were settled and relaxed in their surroundings. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 10 The general atmosphere is homely and it was apparent to the inspector that the supported people feel relaxed and content in the home. It was unfortunate to note that in several of the people’s bedrooms laminated care notes had been attached to walls detailing personal care and specific ways to clean furniture. In discussion with the Registered Manager a requirement has been made that the information is removed from the walls of the room in order to promote the persons right to privacy, dignity and confidentiality and to promote a less institutionalised way of staff communication. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14,16,17. Supported people are encouraged to take part in activities and maintain relationships that reflect their age, personal choices and abilities. Requirements have been made regarding promoting health and safety and help one person to complete their activities board. EVIDENCE: The home has a calm and peaceful atmosphere and it was evident that the supported people enjoy working with crafts and textiles. The inspector observed a painting session with the therapist using hand over hand techniques with one person. There were Halloween masks, dough, paper mache and pottery ornaments and photos of cookery displayed on the notice board. During the inspection two peoples relatives arrived who spoke highly of the home and the care received. It was evident that the home works closely and supports people and their relatives to continue and enjoy relationships. One visitor told the inspector that their relative regularly visits them each week to have lunch. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 12 Outside one persons room an activity board with adhesive pictures and words had been fitted. The Registered Manager explained that it was designed to assist the person in their daily life in order that they are aware of what’s going on. It was noted that the detail of the board was a few days out of date and a requirement has been made that the board is updated daily to promote interest, predictability, security and share information with the person in their daily life. The home has implemented a pictorial photo menu, which was evidenced as bright and colourful and included nutritional values to enable supported people to have some understanding of their meals. The lunchtime meal was calm and relaxed with each person being sensitively and respectfully supported by a staff member. There were lots of sounds of appreciation and laughter and the inspector noted that one staff member was also sharing her mealtime with the other people at the table. Changes and choices made by supported people regarding their meals are recorded in their daily records by staff. The inspector noted that the staff member preparing the meal did not wear suitable protective clothing and a requirement has been made that all staff must wear protective clothing whilst preparing food in order to ensure the safety and wellbeing of all persons in the home. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21. The home continues to meet the physical and emotional health needs of the supported people. Some requirements have been made regarding the medication procedures of the home. EVIDENCE: The individual care plans and ‘person centred plan’ detail each supported persons assessed needs including individual documented funeral plans, which clearly note the preferences and choices that supported people or their families have requested. During the inspection an aroma therapist visited the home and was greeted warmly by one supported person who was going to be receive one to one aromatherapy. It was evident by the records sampled that the home also has access to other specialist services such as chiropodist, physiotherapist, occupational therapists, dieticians, continence advisors and epilepsy consultants. The homes medication has been blister packed and is stored in a locked cabinet. The inspector noted that one person’s medication chart had not been signed following the administration of medication and that medication received into the home had not been accounted for. Requirements have been made that these shortfalls are rectified. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The staff engage positively with the supported people and promote people to share their opinions and views. A recommendation has been made that clear documentation is available to evidence responses to and outcomes of concerns or complaints received by the home. EVIDENCE: The inspector saw the homes complaints procedure. It was noted that a local neighbour to the home had raised a concern and the Registered Manager explained that the concern had been resolved informally by meeting with the neighbour. The inspector observed that there was no clear documentation to evidence that the concern had be dealt with in this manner and a recommendation has been made that clear documentation is available to evidence responses to and outcomes of concerns or complaints received by the home. The Registered Manager explained that one supported person in the home would be able to read the complaints procedure and other people would have to rely on relatives, friends, health care professionals or staff to advocate for them if they were unhappy. It was explained that the Area Managers of the organisation regularly visit the home and changes in the demeanour of people being supported would be observed for example through changes in behaviour, and communication. During the inspection the inspector noted that staff positively engaged with the supported people and actively listened to their views and opinions expressed through behaviour. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30. The supported people live in a generally safe, comfortable environment that suits their individual needs and promotes their independence. Requirements have been made regarding health and safety. EVIDENCE: The home is generally well maintained, has a homely atmosphere and is tidy and clean. The inspector made a full tour of the premises. Each resident has their own room, which are tastefully decorated and contain personal items for example framed pictures, music centres, radios, books, magazines, photos, attractive furnishings and bedding. Several window blinds around the home, including peoples bedroom blinds were broken and in need of replacing. The lounge area of the home was observed as bright and airy and people have their own comfortable chairs and there was also a variety of sensory equipment. One person enjoys having their own fish tank as a hobby. All areas of the home have wheelchair access and adapted facilities are in evidence throughout the home. The home has a newly refurbished bathroom, fitted with a Parker bath and adapted toilet facilities. A requirement has been made that the showerhead in Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 16 the bathroom needed to be repaired. The supported people have made ceramic tiles in the bathrooms, which has made the areas more homely. Several requirements made during the previous inspection have been met which include full deep cleaning of a bedroom carpet and the purchase of a new mattress. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. The staff in the home continue to provide competent and professional support to the supported people. EVIDENCE: The home has made significant changes regarding the recruitment of staff. The inspector sampled staff job descriptions and recruitment files which were in good order and compliant with the current vetting guidelines to ensure the safety and security of the supported people. Several visitors to the home were relaxed and at ease to move around the home freely. Staff were observed to be friendly and welcoming to visitors and relatives in the home. The Registered Manager has ensured that staff meetings are held and the issues of resources regarding staff supervisions were discussed. A recommendation has been made that the Registered Manager considers developing alternative ways in which to maintain the supervision of staff for example the use of staff meetings or group supervisions in order to assist in fully meeting the required standard. The home has developed a training plan and all current staff have attended mandatory training and are proactive in having achieved or achieving their NVQ awards. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,41,42, The home is well run and supported people benefit from the leadership and management approach of the home. Requirements have been made regarding the health, welfare and safety of all people in the home. EVIDENCE: During the inspection the Registered Manager demonstrated an open and approachable management style with all persons in the home. Following the previous inspection the Registered Manager has supernumerary time, which has enabled her to undertake some of the changes and make improvements in the home. She is qualified to NVQ level 3 in care and is near completion of the NVQ 4 Registered Managers Award. She is also continuing to undertake the NVQ assessor training. The inspector sampled the homes arrangements for safeguarding the supported peoples financial affairs. A robust system was in place that is managed efficiently by the Registered Manager and staff. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 19 The laundry room in the home has a washing machine and tumble drier and the room is not readily accessible to the supported people in the home due to the hazards identified. In the cupboards are some laminated cards, which would be used in a first aid emergency situation which detail what action should be taken to treat incidents regarding chemicals within the home. During the tour of the premises the following health and safety requirements have been made: • The general state of repair and issues of storage in the kitchen must be addressed as several kitchen cupboards were observed as broken or missing and the worktop corner damaged. Cooking trays, pans, tins, and glass items had been stored on the top of the kitchen cupboards due to lack of storage space in the kitchen. All debris in the garden must be removed in order that the garden is free from avoidable hazards. A risk assessment must be documented regarding the homes decision not to store the washing powder or liquid softener in a locked cupboard to ensure the safety and well being of the supported people in the home. The broken tiles in the laundry room require replacing. The liquid chemicals must be removed from the top of the cupboards in the laundry area and stored in compliance with the Control of Substances Hazardous to Health guidance (COSHH). Several combustible items were being stored in the boiler room and the inspector has required these to be relocated due to fire safety. • • • • • Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 Score 2 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 3 x 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 3 2 3 x 3 LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 x 16 2 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Middlefield Close (1) Score 3 x 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 2 x DS0000013438.V273322.R01.S.doc Version 5.0 Page 21 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 10 Regulation 12.(4) Requirement Timescale for action 21/12/05 2 16 3 17 4 20 5 20 The Registered Person must ensure that each individual’s personal information is removed from the cards attached to the walls of their bedroom in order to promote the individuals right to privacy, dignity and confidentiality. 16.(2)(m)(n) The Registered Person must ensure that supported people are consulted and involved in their daily lives and that for example activity boards are updated daily to promote the supported persons interest, sense of predictability and security. 13.(4)(a)(c) The Registered Person must ensure that all staff must wear protective clothing whilst preparing food in order to ensure the safety and wellbeing of residents. 17.(1)(a) The Registered Person must ensure that complete and accurate records of all medication administered to supported people are kept. 17.(1)(a) The Registered Person must DS0000013438.V273322.R01.S.doc 23/11/05 22/11/05 22/11/05 22/11/05 Page 22 Middlefield Close (1) Version 5.0 6 25 12.(4)(a) 16.(2)c 23.(2)(j) 23.(2)(b) 7 8 27 42 9 42 13.(4)(b)(c) 10 42 13.(3)(4)(a) 11 42 13.(3)(4)(a) 12 13 42 42 23.(2)(b) 13.(4)c ensure that all medication received into the home must be recorded. The Registered Person must ensure that several broken window blinds around the home must be replaced. The Registered Person must ensure that the showerhead in the bathroom is repaired. The Registered Person must ensure that the general state of repair and issues of storage in the kitchen must be addressed. The Registered Person must ensure that all debris in the garden is removed in order that the garden is free from avoidable hazards. The Registered Person must ensure a risk assessment is documented regarding the homes decision not to store the washing powder or liquid softener in a locked cupboard. The Registered Person must ensure that all chemicals are stored in compliance with the Control of Substances Hazardous to Health guidance (COSHH). The Registered Person must ensure the broken tiles in the laundry room are repaired. The Registered Person must ensure that all combustible items being stored in the boiler room are relocated due to fire safety. 21/12/05 21/12/05 21/03/05 22/11/05 21/12/05 23/11/05 21/03/06 22/11/05 Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 23 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 22 36 Good Practice Recommendations Clear documentation is available to evidence responses to and outcomes of concerns or complaints received by the home. The Registered Manager considers developing alternative ways in which to maintain the supervision of staff for example the use of staff meetings or group supervisions in order to assist in fully meeting the required standard. Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 Middlefield Close (1) DS0000013438.V273322.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!