Inspection on 16/11/07 for Highfield Care Home

This inspection was carried out on 16th November 2007.

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

Highfield Care Home 12/06/09

Highfield Care Home 18/11/08

Highfield Care Home 05/09/08

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Highfield Nursing Home Highfield House Woodsetts Road North Anston Sheffield South Yorkshire S25 4EQ Lead Inspector Ivan Barker Key Unannounced Inspection 16th November 2007 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 DS0000070354.V351083.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. DS0000070354.V351083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Nursing Home Address Highfield House Woodsetts Road North Anston Sheffield South Yorkshire S25 4EQ 01919 566055 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) Selvaratnam Balaratnam Sharon Woodcock Care Home 43 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (31) of places DS0000070354.V351083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Highfield Nursing Home is located on the outskirts of the village but within easy reach of local shops and facilities. There are regular bus services from the village to the town. The home is situated in large grounds, which are accessible to people in wheelchairs and those with limited mobility. Accommodation is on two levels. There is a lift to facilitate people getting between the 1st floor bedrooms and the communal rooms, which are located on the ground floor. The fees at the time of the inspection ranged from £343 per week to £482 per week. DS0000070354.V351083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Highfield Care Home with nursing has changed ownership; therefore it is listed as a new service, however the manager, from the previous company remains in post with a stable workforce. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the ‘key standards’), and the previous requirements. The person present at the inspection was: Ms S Woodcock, manager. Within this site visit, which occurred over a four hour period, the inspector toured the building, examined requirements relating to the previous inspection, case tracked 3 service users (Case tracked means looking at the care and service provided to specific service users living at the home; checking records relating to their health and welfare, care plans and other records; by talking to the service users themselves; viewing their personal accommodation as well as communal living areas), and spoke with other service users, and relatives and also 3 staff and examined assessments, care plans, risk assessments, menus, complaint files, staff files and quality monitoring documents. The history of the service was examined prior to the site visit. This included the Self-assessment document, telephone contacts, letters, notifications etc. What the service does well: Service user’s needs were know to the service prior to admission because care management teams and the manager’s assessments were in place. These two assessments ensured that the service have sufficient information. Service users do benefit from the provision of accurate care plans. Service users were satisfied with the care they received. There was evidence that service users were given the opportunity to exercise their right of a choice regarding meals. Service users live in an environment that had been maintained to a good standard to provide a safe, well-maintained environment, which was homely. The manager provided evidence that all staff had received training, including Safeguarding Adults training which made staff aware of their responsibility DS0000070354.V351083.R01.S.doc Version 5.2 Page 6 regarding the protection of vulnerable adults. The training would reflect on the quality of care being delivered to the service users. Positive comments were received from the service users regarding the care, food provision and staff. ‘Its nice here’. ‘They look after us very well’. ‘The care is good’. ‘The meals are good’. (4 service users) ‘They always give me large portions and I only want a bit’. ‘It’s a nice here’. ‘Its always clean and tidy’. ‘The staff are good’. ‘The staff are excellent’. What has improved since the last inspection? What they could do better: Limited activities were organised within the service, which provide some stimulation to service users and enhance their quality of life. On discussing the activities with the service users, their opinions were that; ‘We don’t do a lot’. ‘We do things with the staff now and again’. ‘It depends who is on, some staff try to do things with some of them’. ‘I’m not bothered I watch TV’. The staff recruitment process of obtaining Criminal Records Bureau checks and references should provide protection for the service users. However the examination of the individual’s past posts would provide better information. DS0000070354.V351083.R01.S.doc Version 5.2 Page 7 An experienced manager is in post, however she is performing as manager and administrator. Should the manager receive more administrative support, this will contributed to the effective organisation and operation of the service. Some quality assurance systems were in place this consisted of observations by the manager and the analysis surveys. It was discussed that this is an area, which could be improved. It is clear from the above information that the service users were satisfied with the quality of care that is provided, but when issues relating to the service which include activities outings etc, staffing and service user monies records and operational management issues are examined there are shortfalls that need to be addressed. 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. DS0000070354.V351083.R01.S.doc Version 5.2 Page 8 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 DS0000070354.V351083.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. People who use the 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 user’s needs were know to the service prior to admission because care management teams and the manager’s assessments were in place. These two assessments ensured that the service have sufficient information. EVIDENCE: On examination of the care management assessments within three care plans, it was established that there were assessments from care management. The manager advised that the care management assessments arrived by fax, rather than by post, but sometimes they were received after the manager had been to see the potential service user. It was agreed that it would be helpful to the manager if she had received the information prior to her visit, but it was accepted that no service users were admitted without both assessments being considered. DS0000070354.V351083.R01.S.doc Version 5.2 Page 10 Both assessments detailed the service user’s needs which would assist the service to have sufficient information for them to decide if the service could met the service user’s needs and provided sufficient information for care plans to be drawn up. The manager advised that no intermediate care was provided within the service. DS0000070354.V351083.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use the 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 do benefit from the provision of accurate care plans. Service users were satisfied with the care they received. EVIDENCE: On examination of the care plans, from three service users, it was established that all three care plans were up to date. There were daily entries within the care plans. These entries recorded the care delivered on a daily basis, and the plans had been evaluated on a monthly basis. Risk assessments were included within the documentation and included moving and handling, skin integrity, and other risk factors. These risk assessments had also been reviewed. DS0000070354.V351083.R01.S.doc Version 5.2 Page 12 Service users expressed their views, during the inspection; ‘Its nice here’. ‘They look after us very well’. ‘The care is good’. The storage, ordering, administration and disposal of medication procedures were discussed with the manager. The procedures explained by the manager were satisfactory. The pharmacist had undertaken an audit. There was a signature-checking document, which contained the initials as written on the medication administration document and the member of staff’s signature. On examination of the medication administration records it was found that there were no omissions of signatures. All medication records had been signed when being checked in from the pharmacy. The lack of signatures was raised as a shortfall at the last inspection, and has now been addressed. The manager advised that the medication storage room was also used for other ‘uses’, for example, as a ‘treatment room’. Other people who used the room would include the district nurse and other professionals. The security of the medication room was discussed. A four level lock secured the room. The medication trolley was secured to the wall by a huge chain and large pad lock. The medication was locked away in metal cupboards, Therefore it was accepted that other professions could use the room, and when the room was left unattended then the door should be locked. It was also discussed that service users may wish the district nurse and other professionals to visit them in their own room rather than the medication storage / treatment room. DS0000070354.V351083.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Limited activities were organised within the service, which provide some stimulation to service users and enhance their quality of life. There was evidence that service users were given the opportunity to exercise their right of a choice regarding meals. EVIDENCE: The manager advised that an activities co-ordinator had been appointed but she was still waiting to receive a satisfactory Criminal Records Bureau check. She advised that a form had been sent off the Criminal Record Bureau but the form had been returned and a new form was to be sent to them. Therefore at the moment, care staff were organising activities. The manager advised that the activities took place in the afternoon period and was fitted in around care duties, but this was only an interim measure until the activities co-ordinator was in post. She also advised that since the last inspection 2 members of staff were now responsible for ‘taking the lead’ in organising activities and that the type of DS0000070354.V351083.R01.S.doc Version 5.2 Page 14 activities was directed by the service users choice. No activities were observed during the inspection, however it is accepted that the majority of the inspection was undertaken during the morning. Regarding the previous requirements relating to the activities there was evidence that some activities occurred as this was supported by the comments from the service users. However it was agreed that, more activities and social functions and outings needed to be developed and the situation should improve with an activities co-ordinator in post. On discussing the activities with the service users, their opinions were that; ‘We don’t do a lot’. ‘We do things with the staff now and again’. ‘It depends who is on, some staff try to do things with some of them’. ‘I’m not bothered I watch TV’. On discussing the availability of a choice of meal, the manager advised that cereal and a cooked breakfast was available and a choice was offered at each main mealtime and at teatime sandwiches or a choice of light meals were available. The choice of main meal was displayed on a board at the entrance to the home, close to the lounge. The serving of the main meal was observed. The service operated an ‘over catering’ method, and service users were offered the choice of meal from the kitchen. The serving trays were examined after the meals had been served and there were spare portions of both meals. Therefore it was agreed that the service users had been offered a choice. Positive comments were received from the service users regarding the food provision. The general comments were that; ‘The meals are good’. (4 service users) ‘They always give me large portions and I only want a bit’. DS0000070354.V351083.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service had a complaints procedure, and it was operating according to the company policy, this provided confidence that complaints were taken seriously and acted upon to address any shortfalls in care or service provision. Safeguarding adults training made staff aware of their responsibility regarding the protection of vulnerable adults. EVIDENCE: The service had a complaints procedure displayed at the entrance. Copies were also available in the Service User Guide. The manager had a complaints book, which indicated that there had been 2 complaints relating to care. These issues were in early 2007, prior to the change of owner, and both had been resolved. The CSCI have not received any complaints. Regarding safeguarding adults, the manager explained that although her staff had all received safeguarding training, she identified that she was having difficult accessing further training, as all the course provided by the Local Authority were fully booked. DS0000070354.V351083.R01.S.doc Version 5.2 Page 16 The safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. DS0000070354.V351083.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use the 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 live in an environment that had been maintained to a good standard to provide a safe, well-maintained environment. EVIDENCE: On touring the building, the home was found to be clean, tidy, well maintained and decorated and furbished to a good standard. It was agreed that some areas of the home were showing their ‘age’ particularly in the older part of the home, with marks and scuffs on doors and door frames. The manager agreed to discuss this with the owner and produce an annual refurbishment plan. The front porch to the home, which was an entrance to the home, and accessed by the general public was the allocated ‘smoking area’ for service users. It was discussed with the manager that this area did not comply with the Health Act 2006 and associated Smoke free Regulation 2007. The manager DS0000070354.V351083.R01.S.doc Version 5.2 Page 18 identified that there was a ‘separate smoking lounge’ but because of the reallocation of some rooms, and the creation of a unit for service users with dementia needs, the lounge was now located just within the dementia unit area of the home. It was agreed that service users from both units could use the lounge, if the service users expressed a wish not to use this lounge then another area, which met the smoke free regulations may be needed. Positive comments were received from the service users regarding the home. The general comments were that; ‘It’s a nice here’. ‘Its always clean and tidy’. The service users’ rooms had been personalised and many contained photographs, personal belongings and items of furniture, which the individual or the family had provided. The previous requirement relating to the carpets from the last inspection of the service had been addressed. DS0000070354.V351083.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provided evidence that all staff had received training, which did reflect on the quality of care being delivered to the service users. The staff recruitment process of obtaining Criminal Records Bureau checks and references should provide protection for the service users. However the examination of the individual’s past posts would provide better information. EVIDENCE: On examination of the staff rotas and examination of staff on duty, the following was established: Am shift Pm shift Night shift Plus A manager, An administrator, for 1 day a week. DS0000070354.V351083.R01.S.doc Version 5.2 Page 20 1 qualified nurses and 3 care assistants. 1 qualified nurses and 3 care assistants 1 qualified nurses and 2 care assistants. Ancillary staff included; domestics, catering staff, and a maintenance man. Caring for a present occupancy of 25 service users. A full assessment of the dependency levels of the service users was not undertaken and compared with the indicated staffing levels. On examination of the three staff files, it was established that the application forms contained a small section on the form for ‘Present employer’ and a similar sized section for ‘Past employer’. This meant that staff had entered their present employer and one past employer. This does not comply with Schedule 2 of the Care Standards Regulations, which states that ‘a full employment history’ is required. The manager identified that the forms had been introduced by the previous owner and had been used for some years. It was agreed that the service did have a computer in the office, so a new application could be easily produced. The staff files contained all the required documentation, including Criminal Records Bureau and POVA (Protection of Vulnerable Adults) checks. However the files were difficult to reference and obtain the information. One of the staff files monitored was from staff from ‘overseas’. All relevant documentation had been obtained regarding this member of staff. On examination of the staff training records there were records that indicated the staff had received moving and handling, fire training and other relevant clinical training. The comments from service users were; ‘The staff are good’. ‘The staff are excellent’. During the visit the views of a community nurse was obtained, as she was at the service treating a service user. She identified that; There had been previous problems with the home regarding ‘pressure sores’ (wounds which may be caused by pressure) and communication. However things had improved considerably and the qualified staff and carers communicated well with the community service and the number of pressure sores had dropped significantly. She was of the opinion that the community service and the home were now working well together. DS0000070354.V351083.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced manager is in post, however she is performing as manager and administrator. Should the manager receive more administrative support, this will contributed to the effective organisation and operation of the service. Some quality assurance systems were in place this consisted of observations by the manager and the analysis surveys. It was discussed that this is an area, which could be improved. EVIDENCE: There was a registered manager in post. She advised that she had 30 years experience in care and 12 years in management. DS0000070354.V351083.R01.S.doc Version 5.2 Page 22 Regarding service users monies there was a credit and debit system in operation. The monies held by the service were small amounts often in single figures. The relatives handled the claiming of service user’s monies and monies were given to the manager for safekeeping. The manager produced a huge file relating to the service users monies. It was established that 90 of the file consisted of records, which were previous records or records of previous service users. It was agreed that this file could be dramatically reduced in size. The manager agreed, but identified that it was one of the jobs which had not been one of her prioritises. Regarding Quality Assurance, the manager identified that she walked around the building on a daily basis, she had obtained service user and staff surveys and acted upon an issues raised. An example she gave was that the service users raised an issue regarding the meals and she had resolved this matter. However she accepted that there was no documentation to support this information. The benefits of quality assurance was discussed with the manager, who identified that she would explore the possibility in introducing a monitoring tool for measuring quality within the service. On requesting to exam the supervision records the manager provided the training records and identified that staff had received clinical supervision in the areas detailed in the records. It was discussed that supervision consisted of all aspects of practice and that the supervision to the staff needed to be developed. The manager agreed to review this and produce better supervision documentation. The role of the manager was discussed, as she appeared to be responsible for a considerable number of areas. These areas included the marketing and management the home, the management of the staff, including training and supervision and many of the administrative duties. She identified through this inspection process that she would produce a new application form, reduce the size of the staff and service user monies files introduce a quality-monitoring tool and produce supervision records, as well as run the service on a day-today basis. The role of the current administrator was discussed and the manager identified that her role was more to being a finance person responsible for collecting and managing the fees received by the home. It was agreed that the manager should discuss her role and the administrator’s role with the registered person as the time the manager currently uses for administration could be put to better use to manager the service and introduce new initiates. Regulation 26 documentations, which are a record of the registered person’s monthly visits, could not be located within the service. The manager identified that the owner visited every Monday, so was aware of what was happening in DS0000070354.V351083.R01.S.doc Version 5.2 Page 23 the home, however she accepted that there was no evidence of his visit or that he had covered the issues detailed in Regulation 26. Regulation 37 notices, which are documents that are sent to the Commission regarding untoward occurrences, including falls, accidents etc; have been received by CSCI (Commission for Social Care Inspection). DS0000070354.V351083.R01.S.doc Version 5.2 Page 24 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 DS0000070354.V351083.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? New registration 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 OP29 Regulation 19 and Schedule 2 26 Requirement Timescale for action 16/12/07 2 OP33 3 4 OP33 OP36 24 18 There should be a full employment history obtained from people applying for a staff position. The registered person should 16/12/07 undertake monthly visits and obtain the information stated in Regulation 26 and record such information. There should be a monitoring 16/01/08 system in place to review the quality of care within the service. The staff within the service 16/02/08 should receive appropriate supervision as listed in Standard 36. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000070354.V351083.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000070354.V351083.R01.S.doc Version 5.2 Page 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. 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