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Inspection on 30/09/08 for Abbeygate Residential Home

Also see our care home review for Abbeygate Residential Home for more information

This inspection was carried out on 30th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

An assessment of need is undertaken before a new service user moves into the home. Health care professionals visit the home and service users can keep their own GP where this is possible. Staff are mindful of dignity when supporting service users with personal care and service users can choose when to go to bed and so on. In-house activities are provided. Service users can see visitors and they are made welcome. There is a choice at meal times. The home has a complaints procedure which is made available to service users. The home is kept clean. The rota shows a number of different staff on duty to support all aspects of maintaining the home. A high number of staff have achieved a national qualification in care. Staff have received general training and systems are in place to ensure refresher courses are attended. There are quality assurance systems in place. The home looks after money on behalf of service users and keeps accurate records.

What has improved since the last inspection?

The last inspection report did not suggest any improvements. The manager told us that improvements had been made to the environment.

What the care home could do better:

Care plans were not accurate, up to date or person centered. One service user`s medication records showed several errors. The home does not have appropriate policies and procedures in place for the reporting of suspected or alleged abuse. The home did not have a plan for the ongoing maintenance of the building. Recruitment checks are not in place before new staff begin working at the home. Staff do not have regular supervision sessions. Risk assessments were not in place for hot water.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeygate Residential Home 42 Quarry Road Winchester Hampshire SO23 0JS     The quality rating for this care home is:   zero star poor service 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: Beverley Rand     Date: 3 0 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. the things that people have said are important to them: They reflect 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 Older People 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. Care Homes for Older People Page 2 of 27 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 Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Abbeygate Residential Home 42 Quarry Road Winchester Hampshire SO23 0JS 01962855056 01962856910 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jean Benjamin Type of registration: Number of places registered: Avonpark Care Centre Limited care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Not more than 5 service users in the category MD (E) referred to above are to be accommodated at any one time for as long as service user D.O.B 01/11/1910 stays in the home; then revert to 4 service users Not more than four service users in the category DE (E) referred to above are to be accommodated at any one time. Date of last inspection Brief description of the care home Abbeygate is a large care home on the outskirts of Winchester and is part of the Avonpark Care Centre Ltd. group of homes. The home is registered to provide personal care for 30 older people. Four of the beds are registered for dementia and or mental health care provision. The home is located in a quiet, residential, area of Winchester, Care Homes for Older People Page 4 of 27 Over 65 4 4 30 0 0 0 Brief description of the care home not far from the city centre and amenities. The home is surrounded by a large mature garden, which is not overlooked. Sufficient parking is available on the premises; there is a steep incline from the car park to the front door of the home but there are also steps from the car park to the side of the house. Care Homes for Older People Page 5 of 27 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key unannounced inspection. Before we visited the home we looked at the last key inspection report and the Annual Service Review which was completed last year. During this inspection we spoke with two service users, five staff and the manager. We looked around the home and looked at a variety of records including recruitment files and care plans. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 27 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. There are good systems in place to assess the needs of service users before they move into the home, which assures residents that their needs can be met. Evidence: The manager told us that she, or the Head of Care, visits potential service users to undertake an assessment of their needs. We looked at two assessments and found that one appeared to be done on the same day the person moved in. The manager said she had put the wrong date on the form. The second assessment was dated the day before the person moved in. The manager also gathers information from the local authority adult services, where this is available. The assessments were brief but covered various aspects of peoples needs. Care Homes for Older People Page 9 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit by keeping their own GP where possible. Systems are not in place to ensure up to date and effective care plans. Medication records were generally accurate but more complex medication needs were not well managed. Evidence: We looked at the care plans for three service users, two of whom were considered to have the most complex needs and the other one was relatively new. The files contained assessments of breathing, communication, nutrition, elimination, personal hygiene, dressing, mobility, social care, mental health, sleeping and medication. If a need was highlighted from these assessment tick box forms, a care plan was then written. The plans were structured in a similar way, with stock phrases being used. This format resulted in limited care plans being in place, for example, someone with complex needs only had brief care plans only covering elimination, personal hygiene, mobility and medication. Significant mental health needs were not in the care plan and the assessment continually showed there was no change. Other records, and discussions with staff showed that the service user exhibited challenging behavior. Care Homes for Older People Page 10 of 27 Evidence: Staff were not clear about how to support this persons needs: one said they would leave the person and return a bit later, one found a particular activity always worked, one thought the morning medication should be given, or would ask colleagues for their ideas. A mobility assessment for another service user said that the person used a stick, but staff told us that in recent weeks the person now needed to use a wheelchair around the home and was hoisted for transfers. The assessment showed no change and there was not a moving and handling assessment for hoisting. None of the plans showed sufficient individual, person centered planning, for example, assist with personal hygiene. We spoke to three staff about how they supported service users with their personal care. One said they followed the same routine with each person, and that no-one wanted it to be different. Another said that one service user had particular preferences but that everyone else was supported in the same way. The third staff member said they asked the service user how they preferred to be supported. If the service user could not respond, the staff member would talk to their supervisor. None of the staff said they would refer to care plans. The plans did contain personal profiles, which is seen as good practice. This information covers where a person was born, their families, past employment and so on. Records showed that healthcare professionals visited the home when needed. Service users can keep their own doctor if possible and the home has doctors from three different surgeries. District nurses visit when necessary, as does the chiropodist. Most of the medication is delivered in blister packs from the pharmacy and is kept in a trolley in part of the home where service users do not access. However, when we arrived in the home, we say the medication trolley in the dining room, locked but with the keys in the door. The manager told us the trolley should have been locked and advised staff of this. There is a photo of each service user on the Medication Administration Record, (MAR). The MAR for two service users were studied more closely and we found them to be inaccurate. One stated that a sleeping tablet should be taken, one at night when required but there was no care plan as to when the medication could be required and what other steps could be taken to reduce the need for medication to be administered. Records showed that if the person was asleep, then the medication was not given and this was recorded on the back of the MAR. For an eight day period, one day was recorded as none given twice, there was one gap, three days appeared accurate and three days showed no further information, even though the code recorded on the MAR was to see overleaf. We looked at the MAR for the previous month and found there Care Homes for Older People Page 11 of 27 Evidence: were seven gaps with no explanation. It was not possible to know whether the service user had had the medication or not. We looked at the number of tablets for this service user and found that two tablets were missing from the blister pack. We cross referenced this with the MAR and found that the person had been sleeping on those days and so had not had the medication. This means that medication was missing and could not be accounted for or had been given but not recorded accurately. Staff were seen to knock on bedroom doors before going in and told us how they maintained dignity whilst undertaking personal care. Care Homes for Older People Page 12 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Service users enjoy various activities and visitors are welcome to the home. Service users enjoy their food and can make choices about what they would like to eat. Evidence: Staff told us that activities were provided in house such as quizzes, bingo, giant snakes and ladders and throwing bean bags. Visitors to the home include a man who plays music and sings and a woman who encourages exercise to music. We spoke to service users about the activities and they confirmed activities were happening and that they did not wish to do anything other than what was provided. Service users said they enjoyed the food and that there were, big portions. Visitors are welcome to the home and a service user told us that they could take visitors to one of the lounges which was private. They can also access the garden from there. We saw two visitors on the day who spoke well of the home. Service users are able to bring personal possessions into the home and this was confirmed by a resident. We also saw evidence of this as we walked around the home. Care Homes for Older People Page 13 of 27 Evidence: The home has a two week rolling menu and the chef asks service users what they would like for the next days main meal. We heard the chef asking service users if they would like cheese on toast for tea and some had soup or sandwiches. The chef said she had provided curry for the main meal at lunchtime but had also provided jacket potatoes as not everyone liked curry. She also said that she cooked an extra potato in case someone changed their mind on the day. She was aware of service users likes, dislikes and allergies and demonstrated that people could make individual choices, for example, someone liked pickle in their sandwich one day, but not another. The chef said that she was providing pureed food when necessary. She monitors what food, if any, is not eaten and changes the menu accordingly. A record is kept of the food provided. Care Homes for Older People Page 14 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 feel able to complain. Should there be an allegation or suspicion of abuse, the procedures are not sufficiently robust to protect service users. Evidence: The home has a complaints procedure in place which is displayed on the notice board. New service users are given their own copy. We looked at the complaints log and the home has not received any complaints from service users or their relatives. Service users who we spoke with said they had, no complaints. The manager said she had an, open door policy. Staff have received training in the protection of vulnerable adults and were aware of the need to speak to the manager if there was an allegation or suspicion of abuse. We asked the manager about the procedure she would follow if staff were to report abuse to her. She told us she would, go out there and investigate. Given the scenario of a staff member hitting a service user, she said she would talk to the service user and look for bruises, before contacting the police or the local authority adult services. The home does not have a copy of Hampshire County Councils, Safeguarding Adults/Adult Protection Policy. We looked at the homes own policy which was dated October 2007. The first stage of the procedure for the person in charge to follow is to immediately investigate and establish consent to take the issue forward. If consent is obtained, social services can be contacted. The homes policy does not follow Hamsphire County Care Homes for Older People Page 15 of 27 Evidence: Councils guidelines or national guidance provided by the Department of Health. The homes procedure has a contact number for social services, but this was actually the number of the Commission, which is not staffed 24 hours a day. Therefore, telephoning this number would not protect service users in the short term. The lack of appropriate procedures means that service users may not be adequately protected if there was an allegation or suspicion of abuse. Care Homes for Older People Page 16 of 27 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, 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. 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 happy with the environment but the home would benefit by there being a maintenance plan in place. Evidence: We walked around the home, looking at the communal areas and some bedrooms. The dining room and lounges were well maintained. There were three bathrooms, two of which are narrow. The manager said staff managed to use the baths in the limited space. The manager has been waiting for a spare part for the downstairs bath since June, and regularly contacts the company. The downstairs bathroom, (which includes a toilet and basin) is also used as a hairdressing salon and chairs and upright hairdryers are stored there. The manager said this room had always been used for hairdressing. The front of the building, as approached from the car park, needs some repair. Window frames are flaking and the roof leaks in parts. The manager said there was a plan for the roof to be repaired but the weather needed to be good for four days at a time when the person doing the repairs was available. There are empty attic rooms directly under the roof so leaks do not directly affect service users. The majority of the building does have double glazed windows. The manager said the provider is aware of the work needed on the building but there is not a planned maintenance programme in place. Care Homes for Older People Page 17 of 27 Evidence: Some parts of the home have radiators which service users can control themselves. We spoke to two residents about the temperature of their room and they were happy with it. They were also content with the decoration of their room. However, some rooms and corridors have scuffed paintwork, because of wheelchairs. Where there are no windows, lighting in hallways is dull. We spoke with the manager about this who said 60watt bulbs were in place, often because of the requirements of the lightshade. The home has a laundry which is in part of the building not accessed by service users. Liquid soap and paper towels were available and the home was clean. Care Homes for Older People Page 18 of 27 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users needs are supported by enough staff who have received training in various areas. The lack of recruitment checks for new staff does not protect service users from potential harm. Evidence: The rota is designed to ensure there are four care staff in the morning, along with three domestic staff and one chef. In the afternoon, there are three care staff between 3pm and 6pm, then a fourth from 6 to 10pm. There are two staff during the night, who are both awake. Two chefs work 8.00am to 5.30pm, covering the week between them. A maintenance man works in the afternoon, Monday to Friday and a gardener visits weekly. We spoke to service users about the staff and they said the staff were, very nice and, polite, you can have a laugh with them. One also said that staff came quickly if they used the call bell. We looked at the recruitment files for three new staff. The manager told us that new staff only worked in the home after the Protection of Vulnerable Adults check, (PovaFirst) and two references were in place. However, the records did not evidence this. One staff member started work without the PovaFirst check being received before the start date and there was no Pova check for another one. There was a Pova check in place for the third staff member before they started work. There was no record of Care Homes for Older People Page 19 of 27 Evidence: when references were received - only the date they were signed by the referee. One staff member had a reference dated after they started work, the other reference was dated before they started work but there was no received date on it. A second staff member had references dated one and two days before they started work, so it was possible they were received before they started work. The third staff member had three references on file: one reference dated before they began work, but the other two dated after they started work. The lack of recruitment checks together with the lack of supervision and staff meetings, as detailed in the Management standards, and the inappropriate safeguarding adults procedures, detailed above, mean that service users are not adequately protected from possible harm. The manager has a card system for ensuring that training is completed. Staff have received up to date training in moving and handling; first aid; infection control; food hygiene; abuse and understanding dementia. However, there has not been any training with regard to managing challenging behavior which may benefit staff working with a current service user. The home has a strong commitment to staff studying for National Vocational Qualifications in care, (NVQ). Of seventeen permanent care staff and two bank care staff, thirteen have achieved NVQ2 in care, one has NVQ3 and three more have enrolled to do NVQ2. These figures exceed the National Minimum Standards. Care Homes for Older People Page 20 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst there are some good outcomes, other aspects of the home are not well run. Service users financial interests are protected and there are systems in place for service users to give their views. Evidence: The manager is registered and has worked at the home for many years. Whilst there are some good outcomes for service users, there are also some adequate and poor outcomes, indicating that the overall management of the home is of concern. The manager holds service user meetings every three months. We asked to see the minutes from these meetings but the manager could not find them. The manager said a service users survey was completed last year but has not been undertaken this year. The operations manager visits the home on a monthly basis, unannounced, to monitor the quality of care provision and provides the manager with a copy of his Care Homes for Older People Page 21 of 27 Evidence: report. The home looks after personal money on behalf of service users. We looked at the records and money for three service users and found that everything matched. The manager does not have a system in place to ensure staff have formal, one to one supervision, six times a year. We saw the records of supervision dates for two staff: one new staff member had received one supervision session in seven months, the other had four sessions since March 2006. The manager told us that staff do not always attend planned sessions, saying that they have nothing to talk about. Similarly, there has not been a staff meeting in six to eight months as they are poorly attended the most recent date had to be cancelled as so many staff said they could not make it. Cleaning fluids were not visible around the home apart from a bottle of disinfectant cleaner which had been left in an upstairs bathroom and was removed when it was pointed out to the manager. There were also two razors in the bathroom, which were removed. We tested the temperature of hot water in a bath and communal and ensuite basins. The bath was running at correct temperatures but the thermometer showed basin taps to be running at the same temperature, although they felt much hotter to the touch. There was only one thermometer as the other had been broken and the manager not told. There was a weekly record of temperatures which showed the basins running at 55 degrees. There are signs above the basins, which state, hot water. However, many of the service users are confused, frail or have dementia. The manager said she had raised this as a concern with the provider, but had been told to use the signs. We asked if there were individual risk assessments in place for the hot taps and the manager told us there was. However, what was provided was not an individual risk assessment, but a general, undated template for the use of en-suite bathrooms, which the home does not have. Fire records were maintained and showed that alarms are tested weekly and lighting and extinguishers are tested monthly. Staff have received regular training in fire safety. Food was labelled and stored appropriately. Equipment such as hoists are maintained regularly. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 23 of 27 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 Requirement 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 Requirement Timescale for action 1 7 15 Care plans must cover all aspects of individual service users needs, including mental health needs and any associated strategies. There must be robust reviewing systems in place to ensure care plans are accurate. To ensure each individual has personal choice about the way care is provided. To minimise confusion through consistent care. 09/12/2009 2 10 13 Medication administration records must be accurate. It must be possible to ascertain if medication has been given or not. It must be possible to audit how much medication is in the home. 09/11/2009 3 10 13 Care plans must be in place 09/11/2009 for medication administered, when required. Care Homes for Older People Page 24 of 27 To ensure consistency in administration and to ensure medication is given as a last resort. 4 16 13 The homes safeguarding 09/11/2009 adults procedure must be reviewed and amended with reference to the Department of Healths, No Secrets and Hampshire County Councils, Safeguarding Adults/Adult Protection Policy. To ensure that any allegations or suspicion of abuse are dealt with in a way which does not compromise a service users safety. 5 29 19 The registered person must ensure that new staff do not work in the home until recruitment checks, as per Schedule 2 of the Care Homes Regulations 2001, have been completed. Service users must be protected from staff who may not be suitable to work with vulnerable people. 6 36 18 All staff must have supervision sessions, at least six times a year To monitor and support staff performance which in turn benefits service users. 09/11/2009 30/10/2008 Care Homes for Older People Page 25 of 27 7 38 13 Individual risk assessments must be undertaken regarding the hot water in basins and action taken to minimise identified risks. To protect vulnerable service users from burns. 09/11/2008 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 Care Homes for Older People Page 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!