Inspection on 05/12/07 for Highfield Farm

This inspection was carried out on 5th December 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highfield Farm 08/08/06

Highfield Farm 13/12/05

Highfield Farm 09/06/05

Highfield Farm 07/12/04

Highfield Farm 15/06/04

Similar services:

Grayling

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

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

CARE HOME ADULTS 18-65 Highfield Farm Knowle Road Worsborough Barnsley South Yorkshire S70 4PU Lead Inspector Cathy Howarth Key Unannounced Inspection 5 December 2007 10:00 Highfield Farm DS0000049850.V339221.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 Highfield Farm DS0000049850.V339221.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. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Farm Address Knowle Road Worsborough Barnsley South Yorkshire S70 4PU 01226 287 111 01226 248 434 highfieldfarm1@tiscali.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) Voyage Limited Richard Price Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The minimum staffing levels must be maintained at, at least, the level required by the `Residential Forum Care Staffing in Care Homes for Younger Adults` published by Residential Forum April 2002. A minimum of one waking plus one sleeping in member of care staff must be on duty between 22:00 and 07:00 hours. 8th August 2006 Date of last inspection Brief Description of the Service: Highfield Farm is a care home for younger adults providing personal care and accommodation for eleven people with learning disabilities. There is a main house accommodating eight people and a further three ‘studio’ type bedsits with their own gardens within the grounds of the main house. Voyage Limited owns the home. The home is situated on a small road off Sheffield Road, about one mile from the town centre and is close to shops, pubs, and other amenities; the home is close to a main bus route. The home has two levels, with the bedrooms upstairs. All bedrooms are single and have en-suite facilities. The premises stand in large gardens and grounds with parking space. A swimming pool is attached to the home; residents can access the pool with staff supervision only. Fees range from £1,165.92 to £3,299.53. Additional charges include hairdressing, chiropody, toiletries, activities, magazines and newspapers and transport. Prospective residents and their families can get information about Highfield Farm by contacting the manager. The home will also provide a copy of the Statement of Purpose and the latest inspection report. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken using information obtained from the manager of the service in the form of a self-assessment document, responses to questionnaires sent out to people living at the home, their relatives and other professionals involved with them. The inspector also made a visit to the home, met with people living there, staff and the operations manager. One relative visiting on the day also spoke with the inspector. Overall, it was found that the home is adequately meeting the needs of people but there are some areas where the quality of care can be improved. The absence of a full time manager for the home means that developments are delayed in some areas. The inspector would like to thank all involved for their assistance with this inspection. What the service does well: What has improved since the last inspection? What they could do better: All staff must be given adult protection training and guidance. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 6 The arrangements for charging people for transport must be reviewed to ensure they are not being taken advantage of. Fire safety needs to be improved. The registered person must inform the Commission in writing when there are changes to who is managing or carrying on the home. People should be fully involved in their admission to the home. Any decisions about family visits should be taken in full discussion with individuals concerned. Managers should monitor physical restraints carefully. The curtains missing throughout the home should be replaced. The area under the stairs should be cleared without delay. Staff support through meetings and individual discussions need to be improved. 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. Highfield Farm DS0000049850.V339221.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 Highfield Farm DS0000049850.V339221.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): 2 People who use the service experience adequate outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People get a full assessment before moving to the home but the extent of their involvement needs to be clearer. EVIDENCE: For the purposes of assessing this outcome area, the inspector looked at the file of one person who had been recently admitted to the home. It was clear that an assessment had been carried out and there was a reasonable level of detail about the person available from their previous placement, which is another home owned by Voyage. There was little evidence, however, of the person’s involvement in the admission planning and of visits to the home before moving there. Staff told of several tea visits and that the person’s family had been involved in the planning. Another person, who had been admitted to the home since the last inspection, told the inspector of how she had been involved in this process and had made an active choice to come to live at Highfield Farm. She was very clear about why it suited her better than other alternatives she had seen. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience adequate outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People benefit from clear care plans and are mainly involved in developing these. Some improvements are needed in involving individuals where there may be behavioural issues to address. EVIDENCE: Three files for people living at Highfield Farm were seen on this visit. All had detailed plans in place giving a good picture of how people’s individual needs were to be met, including if they had any behavioural issues that might result in the need for physical intervention. Risk assessments for each person were also seen which indicated that any risks are carefully considered and actions implemented to reduce risks. There was one issue which was identified, where one person had been prevented from going home because of his behaviour. This was not outlined in the care plan and should only have been decided as an agreed and Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 10 documented approach with clear outcomes for the benefit of that person. In the recordings, and from discussions with staff, it would appear that it was used more as a punishment for behaviour and the approach was not agreed in advance with the person or their family. This is not acceptable. In other respects it would appear that people’s decisions and choices are respected. People indicated that they are generally involved in planning their own care and review meetings but not all choose to attend. This should be actively encouraged. Relatives said that they are usually invited. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 People who use the service experience good outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People living at Highfield Farm have a good range of opportunities for personal development and to choose their lifestyle. EVIDENCE: This area was found to be generally good. Staffing levels support this by ensuring that there are enough staff on duty to enable people to be well supported. Daily shift planning and allocating staff to individuals helps people to understand that they can make choices and get the support they need to do things they want to. People attend college courses and day services as well as leisure pursuits such as bowling, pubs or a weekly club. Holidays are supported by staff, some people have been to Disneyland and Bridlington this year. Several people have Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 12 regular home visits, so that they can maintain good relationships with their friends and family away from Highfield Farm. Two relatives visited on the day of this inspection and it was clear that relationships between relatives and staff are generally good. There is a weekly menu chosen by individuals within the home. This is printed and displayed in the kitchen. The menu is displayed in pictures as well as words so that people can recognise the food without having to be able to read. This is good practice. The menu showed a wide variety of foods offered and was seen to offer a fairly healthy, balanced diet. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People’s personal and health care needs are well met overall. EVIDENCE: It was found that health care and identification of personal needs for individuals was good overall and staff are good at making records of visits to health professionals so that people can trace when people have had appointments and what occurred. However, tracking appointments needs to improve so that routine health screening such as dental and optician appointments are kept up to date. For example, by trawling through records it emerged that one person had not visited the dentist for 18 months. This information should be more easily accessible so that key workers can see this easily and keep such appointments up to date. There was evidence of people getting referred for specialist support when it‘s needed, such as community psychiatric services. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 14 Medication storage handling systems and records were examined as part of this inspection. All were found to be in good order and stock levels were accurate. Staff are no longer putting medications ready for the day as they were at the last inspection. This is an improvement and prevents people being put at risk. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 15 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 People who use the service experience adequate outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People are listened to and their welfare is largely protected but some steps need to be taken to improve this. EVIDENCE: There are satisfactory complaints procedures. None have been received since the last inspection. There have been three safeguarding referrals made and dealt with appropriately. One staff member was successfully referred to the Protection of Vulnerable Adults list (POVA list) because of issues relating to safety of individuals within the home. One area of concern has been the high number of physical interventions in the home but these appear to have been reducing. They were being monitored by the manager for patterns but this has not occurred since the manager moved to his new job. This needs to be done monthly so that any further rises can be acted upon to address issues. This would seem to be particularly important given the absence of a full time manager. Staff are clear about use of, and when not to use, physical intervention and made good notes about incidents in general. Those who have not yet been trained sign a form to indicate they have been given guidance instructing them Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 16 not to become involved in physical intervention until they have been trained and agree to comply. This is good practice. Staff training in safeguarding vulnerable adults has been improved a little since the last inspection but some staff still need training or updating in this area. This was a requirement at the last inspection and still needs to be fully actioned. Another area of concern was in relation to charges made to individuals relating to transport. People pay a variable means tested amount each week as a contribution to the home’s vehicle. However, this contribution bears no relationship to use of the vehicle and indeed, because out of 22 staff there are only two who are able and willing to drive, this means that the use of transport is severely limited. This needs to be reviewed as a matter of priority to ensure that people can get value for money from this arrangement. Highfield Farm DS0000049850.V339221.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 People who use the service experience adequate outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The living environment for people is homely and clean. Some improvements in décor and in furnishings are needed. EVIDENCE: Since the last inspection the home has had the benefit of three ‘Villas’ built on the site, next door to the existing house. This offers individual ‘bed-sit’ type accommodation for people and is envisaged as a stepping-stone to independence for some people who may be able to benefit from this. At the time of this visit only one was occupied and was seen. All areas of the home were found to be generally clean and tidy and homely on this visit. The worn lounge furniture noted at the last inspection has been replaced with new leather sofas, which look good and are easy to keep clean. The home is awaiting new curtains fitted with Velcro so that they can be easily Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 18 put back if they are pulled down. The lack of curtains gives a poor impression and this needs to be achieved soon as the home has been without these for several months. Three people showed the inspector their rooms. Each was entirely individual to that person and reflected their personality and interests. People told the inspector that they had been involved in choosing décor and furnishings and that they are involved in keeping their rooms clean and tidy if they are able to do this. In some areas, an accumulation of clutter was evident. In particular, under the stairs where people hang their coats, there were black bags filled with old clothes and also three floor cleaners. Hanging a coat up was made quite difficult by these items and they do constitute a fire risk. It was agreed this area would be cleared without delay. The home’s annual service review identified that the dining furniture needed to replaced. This is planned. Highfield Farm DS0000049850.V339221.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, 34, 35 and 36 People who use the service experience good outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People living at the home benefit from good staffing levels and staff are mainly well trained. Improvements are needed in support for staff and in developing teamwork. EVIDENCE: Staffing levels at the home were seen to be good. There are generally 5 or 6 staff on each shift. Shifts are planned so that staff are clear what is expected of them and who they are working with. At weekends, staffing is reduced slightly as several people go for home visits. Staff have access to training opportunities provided by the organisation and longstanding staff have, for the most part, had basic training in important areas of practice. The training records indicated that a number of staff need to be updated in areas of practice such as safeguarding (protection of vulnerable adults) and crisis intervention. The requirement for staff to have training in protection of vulnerable adults is outstanding from the last inspection and is Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 20 particularly important given the safeguarding incident that was dealt with since that time. Staff have the opportunity to complete NVQ2 training within the home. The manager stated that, in addition to the six staff already qualified, another six have completed the qualification and are awaiting their certificates. This would bring the number qualified up to 50 , which meets the National Minimum Standards. A sample of recruitment records were seen as part of this inspection and were found to meet requirements. On the sample seen, employment history had been fully explored which is an improvement since the last inspection. Staff support systems include supervision, appraisal and staff meetings. From records seen, it was clear that some of these systems have been less than adequate in the last 18 months. However, it was noted that, after a considerable gap, staff have now begun to receive more frequent supervision. Staff meeting minutes show that meetings have been held approximately quarterly in the last year. The content of these meetings appeared to be limited and more as information passing from managers to staff than a discussion of issues and a means for the team to develop consistent approaches to individuals. This could be improved. It was clear, however, that the meetings have been used to remind staff about the importance of whistleblowing if they observe poor practice. This is positive. Highfield Farm DS0000049850.V339221.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 and 42 People who use the service experience adequate outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The management of the home is undermined by the lack of a full time manager. Some areas of health and safety need to be addressed. The home’s plan for improvement needs leadership for it to be actioned. EVIDENCE: The registered manager of the home, Mr Richard Price, has recently been promoted to be the Operations Manager for the area. This means that the home is currently without a full time manager although Mr Price is still involved with the home on a day-to-day basis. A new manager is needed and being sought by the organisation to replace him. In the meantime, senior staff are taking responsibility for the day to day running of the home in his absence. Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 22 The lack of a consistent manager is evident in some of the areas highlighted throughout this report and it is clear that this is an important factor in helping the service to make the improvements needed to become a good service. The Commission for Social Care Inspection was not informed of the absence of the manager as required. Any future absences should be notified as prescribed in regulations. There are mechanisms for reviewing the quality of the service. The organisation has a system for carrying out monthly visits. Unfortunately, the person doing these at present is also the registered manager so this does not give the independent view necessary to safeguard people. There is also an Annual Service Review carried out covering all areas of the home’s operations. This includes getting feedback from people using the service and other stakeholders. This was completed in October 2007 and identifies some areas to be actioned in order to improve the service. Health and Safety issues within the home were generally found to be addressed satisfactorily. However, the frequency of fire testing was not as frequent as it should be and the fire risk assessment in relation to staff in the main house accessing the Villas in the event of a fire was not adequate. This was because keys for the doors were not ordinarily being kept readily to hand for staff in the house at night, when the Villas are not staffed. It was agreed that this be reviewed as a matter of priority and arrangements put in place to ensure that everything possible is done to ensure the safety of individuals living in the Villas. It was noted during this inspection that, although portable appliance tests had been carried out fairly recently, there were a number of appliances that appeared to have been missed in the routine test. It was agreed that there should be an audit to check which ones were missed and arrangements made to test these outstanding items. Highfield Farm DS0000049850.V339221.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 X 2 2 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 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA23 Regulation 13 Requirement All staff must be given adult protection training and guidance. (Previous requirement 31/01/06 unmet) The arrangements for charging people for transport must be reviewed to ensure they are not being taken advantage of. The fire risk assessment needs to be updated to ensure that the arrangements for the safety of anyone living in the Villas is properly considered. The registered person must inform the Commission in writing when there are changes to who is managing or carrying on the home. Timescale for action 29/02/08 2 YA23 13(6) 31/01/08 3 YA42 23(4) 31/12/07 4 YA37 39 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good3 practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highfield Farm DS0000049850.V339221.R01.S.doc Version 5.2 Page 25 1 2 3 4 5 6 7 YA2 YA7 YA23 YA24 YA24 YA36 YA36 It would be good practice for people’s involvement in their assessment and the admission process to be evidenced. Any decisions taken regarding people’s family visits should be agreed in advance with the people concerned as part of an overall care package. The analysis of incidents of physical restraint should be kept up to date so this can be effectively monitored by managers. The curtains missing throughout the home need to be replaced without further delay. The area under the stairs should be cleared without delay. Staff should receive supervision at least 6 times per year. Staff meetings should be used more positively to discuss practice issues and develop team working. Highfield Farm DS0000049850.V339221.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 Highfield Farm DS0000049850.V339221.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!