Inspection on 05/12/06 for Broadway Lodge

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Broadway Lodge 07/11/07

Broadway Lodge 20/03/07

Broadway Lodge 14/02/06

Broadway Lodge 22/08/05

Broadway Lodge 15/02/05

Broadway Lodge 05/08/04

Broadway Lodge 08/03/04

Broadway Lodge 10/02/04

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

CARE HOME ADULTS 18-65 Broadway Lodge Totterdown Lane, Off Oldmixon Road Weston Super Mare North Somerset BS24 9NN Lead Inspector Nicola Hill Unannounced Key Inspection 5 & 8th December 2006 09:30 th Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 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 Broadway Lodge DS0000020317.V319026.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 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. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadway Lodge Address Totterdown Lane, Off Oldmixon Road Weston Super Mare North Somerset BS24 9NN 01934 812319 01934 815381 paulinebissett@broadwaylodge.org.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) Broadway Lodge Limited Mrs Pauline Bissett Care Home 55 Category(ies) of Past or present alcohol dependence (55), Past or registration, with number present drug dependence (55) of places Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 33 Primary Care and up to 22 Secondary Care persons with alcohol and drug dependency, eating disorder or codependency. Staffing Notice dated 15/12/2000 applies. Manager must be a RN on part 1 or 12 of the NMC register. Broadway Lodge may accommodate up to two residents who are over 65 for the rehabilitation programme. Date of last inspection Brief Description of the Service: Broadway Lodge is a charity set up to provide treatment for individuals suffering from alcoholism, chemical dependency, eating disorders and codependency. The home provides detoxification services and residential primary and secondary care within the framework of the 12 Step Recovery Programme. The residential primary care is sited in the main building and is also able to offer nursing care support. The residential secondary care is within a domestic type house and bungalows situated within the grounds of the property. The mission statement for the home is: To provide the highest quality treatment for people suffering from alcoholism, chemical dependency, eating disorders or co-dependency. To treat everyone with respect, taking into account individual needs, offering hope and freedom. Broadway Lodge is situated on the outskirts of Weston-super-Mare and can be easily accessed by public transport. There are nearby shops, which residents are able to visit and residents can use the local primary care health centre services. The home has established strong links with the local AA and NA groups, which residents attend at appropriate times in the programme. The range of fees charged at the home is from £795 per week to £1456 per week. This would include any charges for detoxification. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection of Broadway Lodge took place over two days, the first day of inspection concentrated on discussions with management and reviewing records, and speaking with staff. The second day the inspector focused on speaking with residents in both primary and secondary care. At the time of the inspection the new chief executive officer, Graham Menzies was undertaking his induction with Pauline Bissett, the retiring chief executive officer. The inspector discussed with them the future plans for the home, and gave feedback from the inspection. The home has been assessed as providing a good level of service; several areas exceed this, particularly the nursing care. What the service does well: What has improved since the last inspection? The home have introduced a comprehensive computer system that is accessible by all members of staff, therefore all records are in one place and kept up-to-date as events occur. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 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 Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent making admission to the home personal and well managed. Before agreeing admission the service carefully considers the needs assessment for each individual and the capacity of the home and client group. EVIDENCE: The home has a detailed Statement of Purpose, which is available to all potential residents. It provides details of the homes philosophy, therapeutic programme, facilities and timetable of activities. The inspector and management discussed how to present the information in a simplified way, with emphasis on a person centered programme. Residents consulted during this inspection felt that the information provided reflected service provision, although the majority relied on personal recommendation, to make the choice regarding admission to the programme. One resident stated that hearing the home followed the 12 step programme was daunting as it is synonymous with God and a strict regime, however, they stated that the reality was very different and that everyone was treated as an individual. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 9 A telephone referral normally starts the process to admission to the home and the programme. Referral forms and assessment forms for 10 residents were seen as part of the inspection process. Some residents visited the home prior to admission whilst others from greater distances were unable to. Those who visited were able to stay for a meal and meet other residents. Those who were unable to visit had their admission assessment completed on arrival and were made to feel welcome, and were allocated a buddy. Evidence was seen that the home had clear criteria for admissions; the home look to maintain a gender balance within the client group, and limit the number of residents under a DTTO. Where required staff will liaise with other health professionals in deciding whether a placement is appropriate. There is a residential contract for clients, which is very clear that any patients who test positive for mind-altering substances are discharged. The residents who spoke about this stated that this contributed to them feeling safe at Broadway Lodge; however one recent discharge was felt to be unfair as another resident heavily influenced it. Currently the home has no relapse policy but this may be an area for review. At the time of the inspection there were 19 male residents, and 13 female residents. The age range of the residents was 26-63 years; the majority of residents were of white UK or black UK origin. The home does not routinely ask residents about their sexuality, although this may be raised when completing a social history. Clients sign a declaration for the collection and retention of data by the home. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The plan is reviewed regularly; all members of staff regard the plan as a working tool, they understand it, and support residents to achieve the desired outcomes. EVIDENCE: The records were in paper form and computerised, the plan is that all records will be held on the computer and are therefore accessible to all staff. Data protection measures are in place to protect confidentiality. Ten individual residents’ care records were seen. They included client identification and assessment forms together with photographs of residents. A comprehensive assessment had been undertaken and care records confirmed regular 1:1 meetings with counsellors. Pre-printed treatment plans which relate directly to the stages in the programme are used, and plans are reviewed as a resident progresses through the programme. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 11 The residents’ rights and responsibilities are clearly set out in the clients contract. Care records seen indicated that these are fully discussed with the individual residents. Residents consulted indicated that the house rules and boundaries imposed are necessary and fair for their well being and safety. The day-to-day activity of the home is delegated to the residents in regard to the daily programme and therapeutic duties. The residents have responsibility for themselves and to the group to attend sessions. Regular house-meetings are held to reflect on the way the group are working and interacting with each other, and to discuss duties placed on the residents. One resident is allocated group leader and they liaise on a daily basis with management. Individual risk assessments were seen in the care records examined, however the risk assessments do not appear to be very detailed, and for those who are subject to disciplinary discharge the risk assessment must include discharge advice i.e. safe drug use. As more complex referrals are made to Broadway Lodge then risk assessments should reflect the level of risk and any additional control measures needed to those already in place. The inspector discussed disciplinary discharge is with the management; if boundaries are compromised residents will receive a verbal warning. If they continue to break the boundary rules then a written warning follows. If they continue to break rules they would be discharged. Instant discharge would happen if residents used drugs, drank alcohol or had a relationship with another resident. There is a possibility of readmittance once the peer group has left primary care, but no place of safety for residents to stay for this period of time. As stated in the previous section the management may review this. Care records were stored in a confidential manner and residents know that they have a right of access to them. Policies were in place stating this. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has strong commitment to enabling residents to develop their skills; individuals are supported to identify their goals and work to achieve them. EVIDENCE: Residents told the inspector that they have the day-to-day responsibility for each other (group support) and undertaking therapeutic household tasks. Throughout the week there is a restriction on television viewing supporting residents to spend time focused in peer support and group activities. Initially contact with family is restricted but subsequent arrangements for visits and telephone calls are introduced as part of the overall care programme; the home continued to run the family program at the weekends. Residents confirmed that this was very supportive to enable families to understand addiction and what rehabilitation entails. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 13 There are restrictions imposed during the programme to protect the interests of the individual and the group. House rules are made explicit on admission and breach of these usually leads to exclusion to the programme. Residents told the inspector, that the rules were fair and essential to the integrity of the programme. The restrictions on liberty were raised, one resident stated that they had more freedom when they were in prison, however the importance of developing the skills to deal with difficult situations i.e. being tempted to use drugs or alcohol and being trustworthy, are all part of the ethos of the house rules. There is a four-week menu and residents assist in the kitchen. Evidence was seen of a regular supply of fresh fruit and vegetables. All the residents consulted praised the provision of food. The residents confirmed that there was a choice of meal and this included vegetarian food. As the stated the quality of the food is good and there is sufficient quantity, some residents complained about gaining weight. In secondary care patients purchase their own food to a mutually agreed and planned menu. This facilitates service users to develop self-care skills. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff ensure that personal support is flexible, consistent and responsive to the changing needs of the residents. EVIDENCE: The home is registered to provide nursing care to support residents through the detoxification programme. During this time residents may require limited assistance with personal care. The home has a designated area for residents whilst detoxing, to allow them privacy. The inspector asked residents about their experience of the detoxification programme at Broadway Lodge, one resident said they could not remember it, however they suffered no unpleasant side effects. Another resident confirmed that throughout their detox the support received from the nursing staff was exceptional, they were treated as an individual and felt that the nurses cared about them. The nursing staff were also praised for their skills in alternative therapies such as massage, auricular acupuncture and use of Hopi candles. The personal care received through the counsellor team was well received by residents who were able to see a counsellor daily for the first week of their Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 15 treatment programme. The residents stated that the counsellors knew their job, and were able to support residents to identify their own strengths to work through problems. The management of medication administration was good. Residents at the time of this inspection had their medication administered by the staff. Clear and accurate records were maintained in regard to administration. Currently one resident has a wound that requires regular dressing; the records for this care were clear and provided a clear treatment pathway. In order to ensure that the latest techniques were employed, the nursing staff were liaising with the community specialist nurse. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and others associated with the service demonstrate a clear understanding of how to make a complaint, as they are aware of what can be expected to happen including response times. EVIDENCE: All residents receive a copy of the home’s complaints procedure as part of their contract. Residents consulted told the inspector that they did not have any complaints and were able to talk through any concerns with the counsellors and nursing staff. They were confident that genuine concerns would be acted upon. The residents also have the opportunity to raised concerns at the house meetings or directly to the appointed house/group leader. The home has a complaints record book and there had not been any recorded since the last inspection. Policies were in place for the protection of vulnerable adults. There had not been any adult protection issues raised. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the residents. EVIDENCE: At the last inspection the environment was fully assessed. Residents praised the domestic staff that clean the main building which was always seen to be clean and tidy. Resident’s smoking facilities were raised, as an issue with the inspector. Currently there is a designated lounge area for persons wishing to smoke after 8 p.m., otherwise smokers must leave the building. The manager stated that plans of the need for an external shelter to be erected away from the building, which should arrive in the near future. In the longer term plans are for an extension to the coffee lounge, so that there is an internal non-smoking and smoking area. The laundry facilities at the home are sufficient for the number of residents. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 18 Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34,35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a highly developed recruitment procedure that has the needs of people who use the service at its core. The service is a highly selective with the recruitment of the right person from the job being more important than filling a vacancy. EVIDENCE: The staff of the home is large and is divided into teams according to their role. The teams gel together to provide a comprehensive service for residents, for example, representatives from each team take part in house meetings. The nursing team provide the 24-hour support residents and are the staff team identified by residents as being invaluable. The inspectors able to review personal files for the newest recruits to the teams; specifically evidence of the recruitment and induction procedures, training and supervision records were reviewed. The induction book for staff is comprehensive and is used over a period of time for new staff to be able to experience all aspects of how the home works. Inspector suggested that induction book should be reviewed periodically by the management to ensure they are being completed. The training records were available for some staff, but the counselling staff records were not up-to-date. The manager will Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 20 remind all staff of their responsibilities in maintaining their training record. Supervision and appraisal has been implemented for all staff. The counselling team received management supervision as a group, however there are no written records of these meetings. The manager was advised that records must demonstrate managerial as well as professional supervision for the counselling staff. The inspector talked with some members of staff who confirmed that Broadway Lodge was a good place to work. The staff are well supported in their roles with close team structures, and good integration of the whole staff group. The staff also confirmed that supervision and appraisal was taking place on a regular basis, and that specific role training was available in addition to the statutory training. The care assistants all have NVQ2 or above in care, and may be able to access additional units specific to rehabilitation centres through DANOS. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the qualifications and experience to run the home. EVIDENCE: The management of Broadway Lodge at the time of the inspection was in a transition period with the established chief executive officer (CEO) Pauline Bissett, due to retire and the new CEO, Graham Menzies, being inducted into the role. Graham Menzies will also act as registered manager for the home. The inspector discussed aspects of the service with the managers, in particular the review of the processes relating to discharges from the programme, and the more complex referrals received by the home. The new manager will be undertaking a review of programme, processes and structures with a view to meeting National Treatment Agency service specifications and responding to findings from research. The new manager has an NVQ 4 in management and Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 22 may supplement this with specific training for managers of rehabilitation centres through DANOS. The inspector and manager agreed that as changes were planned, a random inspection of the service will occur in the New Year. Residents and staff spoke highly of the management of the home. Residents felt that the programme was intense and rigorous and that the home was managed appropriately and in a way that safeguarded the interests and welfare of the group. The responsible individual visits the home and makes reports under Regulation 26. The trustees also visit the home but on a less frequent basis. As part of their quality assurance the home asks residents to complete questionnaires before they leave to gain their views on the conduct and usefulness of the service provided. The responses are subject to analysis and will inform the business plan for Broadway Lodge. The heads of department (teams) undertake audits of premises and services and report back to the manager. The fire log indicated regular periodic checks and tests are undertaken. Fire fighting equipment was checked weekly alongside the fire alarms. The fire alarms and annual fire check of the home and equipment were completed, and there was evidence of regular drills. Staff had received appropriate fire awareness training and as recommended at the last inspection the names of the staff that have received training should be recorded, this includes new staff. The maintenance of the home is good, and the records of routine checks of lifts, boilers etc. were available. The inspector reviewed the accident reports with the manager, the majority of the accidents were caused by human error, and any serious incidents were reported to the Commission. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA35 YA9 YA1 YA36 Good Practice Recommendations Induction of staff should be evidenced on individual staff files. Risk management should reflect the complexity of the needs of referred clients. Information about the home should be reviewed and potentially simplified. The supervision for counselling staff should be recorded with a clear distinction between professional and management supervision. Broadway Lodge DS0000020317.V319026.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Broadway Lodge DS0000020317.V319026.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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