Inspection on 07/06/06 for Argyle House

This inspection was carried out on 7th June 2006.

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

Argyle House 08/02/10

Argyle House 22/06/09

Argyle House 01/08/08

Argyle House 07/01/08

Argyle House 15/03/07

Argyle House 28/09/05

Argyle House 09/05/05

Argyle House 07/09/04

Argyle House 20/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Argyle House The Avenue Dallington Northampton Northants NN5 7AJ Lead Inspector Mrs Moira Mosley Unannounced Inspection 7th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyle House Address The Avenue Dallington Northampton Northants NN5 7AJ 01604 589089 01604 589423 argyle.house@ashbournelimehomes.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashbourne Homes Limited Mrs Mary Teresa Billings Care Home 87 Category(ies) of Old age, not falling within any other category registration, with number (87), Physical disability over 65 years of age of places (20), Terminally ill over 65 years of age (20) Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 20 Service Users receiving Personal Care will do so by virtue of old age and will not fall under any other category Service Users with Physical Disability may be aged 18 and over. A Total number of 87 Service Users of either sex may be accommodated in the home. No one falling within the category of TI(E) may be admitted to the home when there are already 20 persons of category TI (E) already in the home. No one falling within the category of PD(E) may be admitted to the home where there are already 20 persons under the category of PD(E) already accommodated within the home 28th September 2005 Date of last inspection Brief Description of the Service: Argyle House is a purpose built facility, providing accommodation for up to 87 service users in both single and double rooms. Nursing care is provided at the facility. Accommodation is provided on four floors. The facility is located off the Harlestone Road in Northampton, partially secluded by trees. The building is set in well-maintained grounds. There is good access to public transport via a bus route into the town centre. The current weekly fees for the home are: Residential – private: single room - £500, shared room £400 and use of a double room as a single - £600 Nursing bed fees – private: £650 for a single room, £550 for a double and £750 for use of a double room as single occupancy. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection by one inspector. The inspection process included the collation of information and pre-inspection planning to gather information and then seven hours were spent in the home. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. This is achieved primarily through the process of ‘case tracking’ which involves reviewing the care of specific residents including looking at their records, talking to them and their families or representatives where possible and talking with the care staff who provide the personal care to those selected residents. The care of five residents was reviewed on this inspection to include care plans, risk assessments, medication and other records. In addition discussions were held with ten residents, eight members of staff and three visitors to the home and a period of observation undertaken. The Commission received comment cards from twenty-one residents and two relatives prior to the inspection. Telephone feedback and discussions held with the Responsible Individual and Registered Manager for the home following the inspection. What the service does well: What has improved since the last inspection? Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 6 Requirements made at the last inspection have been met, these included more detailed recording about the care of residents with catheters, dressings and Percutaneous Endoscopic Gastrostomy (PEG) feeds, to ensure health care needs were being met. 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. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s are being fully assessed to ensure their needs can be fully met prior to being admitted to the home. EVIDENCE: Twenty of the twenty-one comment cards received from residents all stated they had received sufficient information about the home before they moved in. Residents and families spoken to confirmed that the manager had been to see them and they had the opportunity to visit the home prior to being admitted. The care plans for the resident’s whose care was tracked contained assessment details that demonstrated a full consideration of needs including religious, cultural and social care. National Minimum Standard (NMS) 6 was not assessed, as intermediate care is not provided in this home. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the residents are not being fully met, specifically with healthcare assessments and care plans being inadequate and putting residents at risk. EVIDENCE: Five resident care plans were reviewed. One resident was assessed as being very independent in their assessment document and no care plans were evident, despite needs being identified for the care of their diabetes. It was evident from daily notes that nurses were monitoring blood sugar levels and checking insulin injections before the resident self administered, but there were no plans to clearly direct the staff in this role. A second resident was assessed as needing care plans for nutrition, pressure ulcer prevention and falls. Core care plans were in place, which did not specify the individual needs of the resident or clearly direct staff on what action was required. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 10 Several care plans were not reviewed in the past month and one for nutrition that had been reviewed stated no change, despite daily notes and the risk assessment evidencing that weight had been lost. Relatives spoken to confirmed they had been asked to sign care plans when their relative was first admitted 18 months ago, but had not seen any plans since then. There was no evidence seen of any resident or their relatives’ involvement in the development of care plans. None of the 10 residents spoken to were aware of their care plan records. Healthcare assessments for pressure ulcers and nutrition are completed on the three nursing floors, although as stated above the resulting care plans did not clearly identify what specific action was being taken. However residents were seen to have pressure ulcer equipment in place. On the third floor residential unit, there were no healthcare assessments and staff stated they did not use them. A resident was identified who had had frequent falls out of bed documented and who had injured himself requiring a hospital visit at the weekend. The relatives stated they had asked about bed rails in February, but had no feedback and these had not been provided. This resident was now being cared for predominately in bed due to his injury and has developed reddening of the sacrum, a precursor to development of pressure ulcers. There was no evidence within his file of any assessment or referral to the District Nurse in relation to falls or pressure ulcer assessment and an immediate requirement was made. Medication was reviewed and the Medication Administration records (MAR) were cross-referenced to the medication stored. There were policies in place for the safe ordering, storage, administration and disposal of medication. The treatment room where medication was stored was being monitored for temperature as required at the last inspection, however the past weeks recordings showed temperatures between 28 – 34 degrees Celsius, with no evidence of action to reduce the temperature to a safe one for medication storage. Eye drops with instructions to discard after one month of opening were in the fridge with no date of opening recorded. There was no clear audit of medication coming into the home as the total balance was not being calculated and this prevents an audit to ensure medication is being given as prescribed. Residents and relatives spoken to along with comment cards received all stated that the residents felt their needs for privacy and dignity were maintained. Observations demonstrated staff having positive interactions with Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 11 residents and efforts made to protect dignity, for example when using the hoist. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are not being provided with sufficient activities to provide daily interest and choice is being restricted due to staffing levels. EVIDENCE: Four of the residents spoken to stated that there are not sufficient activities within the home. Four of the comment cards from residents stated there were insufficient activities, nine stated there sometimes were activities that were suitable and seven stated they were happy with the current level of activities. There were no activities at the time of the inspection. In the month of May there were four activity sessions arranged with external entertainers visiting the home, which the residents said were very good. There is no activities organiser currently working at the home and the residents stated they used to enjoy the daily in house activities, such as quizzes, bingo, arts and crafts and skittles etcetera, which they said staff do not have the time to run at present. Relatives and residents all stated that contact with family and friends is supported and visitors are always made welcome in the home. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 13 Three of the resident spoken to stated that their ability to make choices about their daily activities is restricted due to staffing availability. One resident stated she often had to wait until 11.30 pm to go to bed as the hoist and staff were not available and the only other choice would be to go to bed really early before handover. Another spoke about staff getting her up at seven and using the hoist to put her into a wheelchair, but then having to wait until eleven before staff could wash and dress her. The third told of asking if he could go to his bedroom to rest but was told no with no explanation, there was no evidence in his care notes of any restriction in place. The kitchen was not seen on this inspection, however the lunchtime meal was observed and looked nice. The residents spoken to in the dining rooms all said the food was good and they were able to make a choice from the menu. Care staff helped residents who needed assistance and specific requests were catered for. Records were completed for those who were being monitored for dietary intake. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all complaints are being fully documented and investigated and this puts residents at risk of not having needs met. EVIDENCE: The complaints procedure was displayed on the notice board and the comment cards received all stated that residents and relatives knew how to make a complaint. The complaints log was not available as the Manager was not in the home, however the pre inspection questionnaire indicated that there had been 10 complaints made with 2 fully substantiated and 8 partially substantiated. Discussions with staff showed they had received training on complaints and the protection of vulnerable adults and they demonstrated a good understanding on what abuse was and how they would deal with any concerns they may have. It was evident through discussions with residents and their families that they have raised concerns with staff over what they see as small issues, examples given were missing clothes, batteries not being replaced in remote controls, having to wait for call bells to be answered and delays in assistance for toileting. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 15 The staff were aware of these and some were recorded in the residents daily notes, but are not being recorded as concerns and complaints and there was no evidence of any action taken to remedy the issues or the outcome. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of specialised equipment is restricting timely interventions to meet needs of residents. EVIDENCE: A tour of all communal areas over the four floors was undertaken to included lounges, dining rooms, some bathrooms and four bedrooms were seen. The premises were clean and well maintained, with satisfactory reports from the fire and environmental health departments’ available. One resident spoken to shared a bedroom with another male resident, whilst he stated he did not really mind, he said there was no choice about it and he had never been offered a single room. His shared room was not evenly divided due to the amount of equipment and furnishings of the second resident and he said it was difficult for the staff to get the hoist in to get him in and out of bed. There were no records within the care files of the agreement to share a room. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 17 There was one hoist available on each floor and a number of different slings were also seen, however one resident spoke about how it hurt her when she was hoisted, there was no specific guidance in her manual handling risk assessment as to what sling was appropriate. There was only one stand aid available in the home and it was observed that staff were constantly moving this from floor to floor by the lift to transfer residents, often resulting in lengthy waits for the resident. The responsible individual for the home has spoke by telephone to the inspector and states a second stand aid has been approved and will be delivered to the home shortly. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are not having all their needs met due to the staffing issues in the home. EVIDENCE: Comments from relatives included • “there is often only one care assistant on the floor” • “it is obvious there is a shortage of staff, they are kind, but can’t attend to something’s that really should be attended to” • “they have to rush everything, especially in the evenings there is only one girl to give out the food to the whole floor and this includes four who need feeding” • “they are obviously short staffed, this causes my mother anxiety as she doesn’t like to bother the staff as they are so busy” • I have asked about staffing levels but told its covered, not a satisfactory answer, when you see things not getting done” Fifteen of the twenty one comment cards received form residents all raised concerns about the number of staff on duty and discussions with residents gave the following examples of concern about staffing levels: • • “I am not incontinent, but now sit on a pad as the staff can’t always toilet me regularly” I have to sit in this chair (wheelchair) for longer than I’d like, but there not enough staff and only one stand aid to move me” DS0000012599.V298188.R01.S.doc Version 5.2 Page 19 Argyle House • “I am kept sat on the toilet for too long, because there are no staff and they tell me I have to wait”. Observations around the home evidenced that staff were busy up to nearly lunchtime bathing and changing residents, there were long periods when no staff were available in communal areas. One resident was observed to be brought into the lounge in a wheelchair and informed that as soon as they could get the stand aid and another member of staff she would be moved, she waited for 45 minutes. At the time of the inspection there were 3 care staff and 1 registered general nurse (RGN) on each nursing floor and 3 care staff on the residential floor, which both staff and relatives stated was reasonable. It was reported by residents and staff that on several occasions there were only 2 carers on duty with 1 RGN covering 2 floors and at night there have been occasions when there was only 1 carer on each floor with 1 RGN covering all floors. Telephone discussions with the manager and responsible individual of the company following this inspection were held and assurances given that staffing levels will be reviewed. The manager states that the current staffing is for the 3 carers per floor as found on the day of the inspection with 6 care staff and 2 RGN staff at night and this is being maintained following recent recruitment. Staff confirmed that there is a detailed recruitment procedure and a newly appointed member of staff spoke about the process before starting the post, which included references and Criminal Records Bureau (CRB) checks to ensure they are suitable to work in care. Training plans were available and covered all statutory training and other training to enable staff to carry out their roles, staff spoken to confirmed that training is available and all spoken to said they were up to date with statutory training. The pre inspection questionnaire completed by the registered manager confirmed training and that currently the home has 34 of the staff trained to National Vocational Qualification (NVQ) level 2, staff stated that further NVQ training is planned. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33.35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place for the safe management of the health and safety of residents. EVIDENCE: The manager has been in post since July 2005 and has been registered with the Commission as the registered manager. It was evident through the pre inspection questionnaire submitted by the manager and records seen in the home that regular audits are carried out to assess if the home is meeting standards. Regular meetings are held with residents, relatives and staff and dates of the manager’s availability are displayed on the notice board. Relatives who expressed a view stated that they did not always feel they were fully informed about what was happening with their relative and would like more involvement in the planning of care. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 21 None were aware of a regular quality assurance exercise, for example questionnaires, where the home would seek the views of residents, relatives and other stakeholders. The manager was not available at the time of this inspection to discuss this further and will be looked at in more detail on the next inspection. Most residents spoken to stated either they or their relatives managed their finances and those who had money kept in the home said it was well managed and they could access it when needed. Staff stated that regular supervision has not been happening due to staffing problems. Manual Handling plans were available in resident files, however as identified previously the level of information to direct the care was not always sufficiently detailed, for example the resident who said the sling on the hoist hurt her, her manual handling assessment only stated to use a hoist or stand aid with no further information to ensure the appropriate equipment was used. A maintenance person is employed to oversee the routine maintenance and upkeep of the premises and no health and safety concerns were identified on this inspection. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X 1 2 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? 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 OP8 Regulation 13(1)(b) Requirement Immediate Requirement: The resident identified must be referred to the District Nurse for an assessment in relation to falls Immediate Requirement: The resident identified must be referred to the District Nurse for a pressure ulcer assessment. Care plans must be written for all assessed needs. Care plans must give clear direction for staff on how to meet resident needs. A record must be maintained of the totals of medication kept in the home. Sufficient manual handling equipment must be available to ensure residents’ needs are met. There must be sufficient staff on duty to meet resident needs Timescale for action 08/06/06 2. OP8 13(1)(b) 08/06/06 3. 4. 5. 6. 7. OP7 OP7 15 15 13(2) 13(5) 18(1)(a) 30/07/06 30/07/06 09/07/06 09/07/06 09/07/06 OP9 OP22 OP27 Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard OP7 OP9 OP12 OP16 OP22 OP33 OP36 Good Practice Recommendations Residents or their representatives should be involved in the care planning process. Action should be taken to reduce the temperature in the treatment room for the safe storage of medication. Activities should be available to suit resident needs. All complaints and concerns raised by residents or their relatives must be documented and evidence of outcome available. The use of shared bedrooms should be monitored with evidence of resident agreement to sharing. Quality assurance should included seeking the views of residents and relatives Regular staff supervision should be provided. Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Argyle House DS0000012599.V298188.R01.S.doc Version 5.2 Page 26 - 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. 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