Inspection on 28/10/09 for Laburnum Lodge

This inspection was carried out on 28th October 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laburnum Lodge 18/01/10

Laburnum Lodge 16/06/09

Laburnum Lodge 13/01/09

Laburnum Lodge 26/06/08

Laburnum Lodge 03/07/07

Laburnum Lodge 03/01/07

Laburnum Lodge 30/05/06

Laburnum Lodge 20/12/05

Laburnum Lodge 22/06/05

Laburnum Lodge 16/11/04

Laburnum Lodge 12/07/04

Laburnum Lodge 28/04/04

Laburnum Lodge 21/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Laburnum Lodge 2a Victoria Street Littleport, Ely Cambridgeshire CB6 1LX     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janie Buchanan     Date: 2 8 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Laburnum Lodge 2a Victoria Street Littleport, Ely Cambridgeshire CB6 1LX 01353860490 01353860845 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr A Hassaan,Mrs S Hassaan care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Laburnum Lodge is a two-storey house, that includes a single storey extension, which provides accommodation, personal care and support to 22 older people. The upper floor is accessed via stairs or a stair lift. A garden is available to the rear of the building. The home is situated in the centre of the village of Littleport and is close to shops, cafes, pubs and local amenities. A copy of the most recent inspection report is available in the entrance way to the home. The weekly charge is varies between £354 and £424 per week. 1 6 0 6 2 0 0 9 0 Over 65 22 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: For this inspection we (The Care Quality Commission) visited the home over two days and spoke with four residents, four members of staff and the new manger. We undertook a tour of the building to check on health and safety, checked medication storage and recording and viewed a range of documents. We undertook an additional inspection on 16/06/2009 to check that requirements had been met from our previous key inspection. Information from that inspection is included in this report. Ten requirements and six recommendations have been made as a result of this inspection. Care Homes for Older People Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: There is still much this home needs to do to improve its service: Care plans need to be much more detailed and include good information about residents health and social care needs so that staff have the information they need to provide comprehensive and consistent care. Medication recording and procedures must improve so that residents receive their medication as prescribed and so there is a clear and accurate record of what they have received. Fluid charts for residents must be totalled up every day to ensure they are receiving adequate amounts of fluid. Two written references must be received by the home before anyone starts to work there so that only the right people are employed to look after vulnerable adults. We must be informed of any events that affect the well being of residents (such as hospital admissions, medication errors or any injuries sustained by them) so that we can monitor their nature and frequency closely. Information about forthcoming events and activities should be made available around the home so that residents know what is happening and can decide if they want to participate. Staff should remove dangerous jewellery to avoid injuring residents when assisting them. Care Homes for Older People Page 6 of 25 Staff should receive formal supervision of their working practices at least six times a year so their working practices can be monitored, their training needs identified and so they feel supported. All staff must receive training in safeguarding adults so they have a good understanding of the adult protection procedures in their local area and the part they play should the need arise. Hairdressing receipts for residents must be much more detailed so there is a clear date of when their money was spent and also record of their full name so the amounts can be audited more easily. Emergency lighting and fire alarm tests must be carried out as required to ensure they are fully operational in the event of a fire at the home. Fire doors must not be pinned back so that they can close freely in the event of a fire. Important information concerning the nature and handling of dangerous chemicals must be made available to all staff, especially those who use them frequently so they know how to handle them safely and be protected. Since the last key inspection we have had to issue a warning letter (the first step in our enforcement pathway) due to continued breaches in regulations concerning poor quality risk assessments, the failure to appoint a manager and the failure to keep dangerous chemicals safe from residents. Although these requirements have now been met the manager must ensure that future requirements are met within the timescales given. The new manager is clearly keen to improve standards at the home and has a lot to do to bring the much needed change and professionalism this home needs to raise its standards. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission procedures are good ensuring that peoples needs can be met there. Evidence: There is a guide for prospective residents that gives good information about the home, its staff and the services it offers. This has been updated since the last inspection and now includes the new contact details of the Care Quality Commission. Each resident is also given a basic contract describing the terms and conditions of their stay at the home. We checked the file for the most recently admitted resident which showed that their needs had been fully assessed by the deputy manager and a carer before they were admitted to the home. Care Homes for Older People Page 9 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some care plans do not adequately demonstrate that the home is meeting residents needs and medication procedures do not protect residents. Evidence: We checked the care plans for three residents. Two of the plans were good with detailed guidance in them about residents needs and what staff must do to meet them. A visiting social worker told us: I went to review a client there last week I am pleased to say that her care plan was good. However the third plan we looked at was poor. The resident had been identified at high risk of falls but there was no corresponding plan in place of how her risk of falling was to be minimised. This resident had also been identified at high risk of pressure sores but there was no corresponding plan in place giving guidance for staff in how this risk was to be reduced. Information about the residents mobility was confusing and not in enough detail to indicate what aids she needed and when, and information about her night time routines, night checks and emotional health had not been completed at all. Her plan had not been reviewed since she had been admitted to the home three months previously. There was no information about her end of life wishes and no evidence Care Homes for Older People Page 10 of 25 Evidence: that she had seen her plan or been actively involved in decisions about her care. Residents plans did show that they saw a range of health care professionals including GPs, district nurses and chiropodists. Residents are weighed regularly and their nutritional needs are assessed monthly. One member of staff reported that new body maps have been introduced so they can better monitor any marks or bruises that residents acquire. However we viewed fluid charts for two residents: although the amount they drank was being recorded, staff had failed to add up the totals each day in order to properly monitor that their daily intake was sufficient. We checked medication storage and a sample of residents administration records and noted the following shortfalls. On several occasions the number of variable dose paracetamol that someone had been given had not been recorded making it impossible to tell how much medication they had received. On two occasions we noted that staff had changed the prescribers instructions as to when someone was to have their medication, but there was no reason given for this change and staff we asked could not tell us. On one occasion the MAR sheet stated that the resident had refused their tablet but the tablet was not in the blister pack and staff were not able to tell us if the resident had taken it or not. We came across a number of medications (eye drops and gel) in the medication trolley whose labels had been worn off and therefore it was not possible to tell who they were for or what their dosage instructions were. Under one entry on the MAR sheets was written X: there was no explanation what this code meant. We discovered information that showed staff had failed to give someone their medication for a number of doses thereby potentially affecting their welfare. The home failed to notify us of this event. Care Homes for Older People Page 11 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides activities to stimulate residents and mealtimes are enjoyable. Evidence: There are regular visits from Tickle Pink (a theatre company) to entertain residents and also music and exercise classes for residents to participate in. Staff take one resident to bingo every Thursday where she also attends a line dancing class. One resident we spoke to told us he regularly takes the bus to Ely to attend the Aquarius Club where he plays pool and bowls and another resident told us: the church people were in yesterday and I enjoyed the hymn singing. During the summer staff took residents to a garden centre in Huntingdon and other residents to Kings Lynn for shopping. Staff told us residents particularly enjoy what they describe as pamper sessions where they file and polish their nails and give hand massages. However, there is no information available around the home telling residents what activities are happening each day or what forthcoming events there are so that they can plan if they want to attend them. Lunch on the days we visited looked tasty and nutritious and residents we spoke to told us they enjoyed their meals and there was a good variety of things to eat. Care Homes for Older People Page 12 of 25 Evidence: Residents we spoke to told us they chose how they spend their day and what they do. One reported that she now prefers to spend time in her room rather than the lounge as she doesnt get on with some of the residents. Residents wishes are acted upon by staff and one social worker reported about someone she visits: she goes out several times a week and her unwise choices (in relation to eating) are respected. Care Homes for Older People Page 13 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes safeguarding procedures need to improve to ensure residents are protected. Evidence: The complaints procedure is displayed around the home (although not always in places easily accessible by residents) and information about how to complain is included in the homes statement of purpose and service user guide which is given to all new residents on their arrival. Residents we spoke to said they would raise concerns, citing the deputy manager as the person they would to talk to and trust to take their concerns seriously. The home has a policy in place regarding the protection of vulnerable adults, however this is a little basic and does not actually give details of outside organisations involved in protecting people or how to contact them. One staff member had not received any training in safeguarding vulnerable adults and consequently her knowledge about this and who to contact if she wanted to report an incident was very poor. There is no information around the home giving residents visitors or staff information about who to contact should they wish to raise any safeguarding concerns. There have been two strategy meetings held under local adult protection procedures in the last year following concerns about continued poor management of the home. Care Homes for Older People Page 14 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely and clean environment. Evidence: There have been some improvements in the homes environment since we last visited: ensuite toilets have been added to a number of bedrooms; the smaller lounge and dining area have been redecorated; carpets in communal areas and several bedrooms have been replaced, and the office has been enlarged making it a much more suitable and confidential space from which to manage the home and store necessary paperwork. Parts of the home we viewed were clean and tidy and there were no strong odours. We recently received a telephone call from a building control officer who has identified problems with the homes drainage system the owner is aware and told us he is currently addressing the problem. Care Homes for Older People Page 15 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by competent staff in sufficient numbers, however the homes recruitment practices are not robust enough to fully pretest residents. Evidence: Residents we interviewed spoke highly of the staff. One told us: I like my key worker theres real niceness to her and of another staff member: she helped sort out all my finances, it was a huge relief. There are two care staff on throughout the day, and one waking staff and one sleeping staff member at night on duty to meet the needs of 13 residents currently. Residents we spoke to told us there were enough staff around to help them when needed and they didnt often wait long for help. Staff told us that there were enough of them on duty to meet residents needs. However one person told us that two staff had left recently causing shortages in the rota. One member of staff on duty when we visited was not dressed appropriately for her role. She was also wearing a lot of jewellery which could not only harbour germs, but could also tear residents skin as she helps moves them. Two staff have an NVQ level 3 in care and training files we checked for 3 staff on duty showed us they had undertaken training relevant to their job. However there was little evidence to show that recent members of staff had received a full induction in line with the national common induction standards for care and the manager was unaware Care Homes for Older People Page 16 of 25 Evidence: of these important standards. We checked the personnel file for the most recently recruited member of staff. This member of staff had started working at the home with only a POVA first check and inadequate references putting residents at unnecessary risk. Care Homes for Older People Page 17 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a poorly managed home where there are unnecessary risks to their health and safety. Evidence: Management of the home has been unstable for the last year and this has clearly affected the homes performance as well as staffs morale. One member of staff told us: it feels as though the staff have been running this home themselves with no proper management. One resident told us: theres no one at the top anymore, it all feels tossed in the air. Following a warning letter from us and a strategy meeting held under adult protection guidelines the owner has, at last, appointed a manager. The new manager has little experience of running a home for older people and one member of staff told us: shes new to the job and has a lot of learning to do. Although keen to improve standards it was clear there were gaps in her knowledge about recruitment practices, safeguarding vulnerable adults, contract monitoring and staff induction. Care Homes for Older People Page 18 of 25 Evidence: When we arrived at the home for our inspection the manager was not available as it was her day off and neither was the deputy as she had just undertaken a night shift due to staff shortages. It was not clear who was in overall charge of the home and neither staff on duty had been given temporary responsibility and accountability for the running of the home that day. We checked the supervision records for staff we had spoken to during our visit. These showed that two staff had not received any supervision of their working practices since April 2009. Two staff told us they didnt feel particularly supported. We talked to one member of staff who had recently returned from maternity leave. She told us she had just been thrown in at the deep end and had received no supervision or induction on her return despite numerous changes at the home. Another member of staff told us she didnt feel part of the team (we raised issues concerning this particular staff member at out last inspection of 16/06/2009 but there has been little improvement and she has only received one supervision since starting nearly a year ago). The home holds money for some residents. We checked a sample of residents cash sheets and receipts which showed that written transactions were kept of how their money was spent. However, receipts for the hairdressing money were inadequate and sometimes consisted of scraps of paper which had not been dated. During our inspection we became aware of two incidents affecting the well being of residents (one concerning a hospital admission the other a medication error) that the manager had failed to report to us. We checked a number of records in relation to health and safety which showed that the homes fire alarm had only been tested twice in the month of September, and the emergency lighting had not been tested at all that month. We also viewed a fire door that had been pinned back thereby preventing it from closing in the event of a fire. The home has recently written up comprehensive guidelines for dangerous chemicals that are used there. These are good however it was of great concerns that the homes housekeeper who uses many of these chemicals had not been shown any of these data sheets or even knew of their existence.These shortfalls put residents and staff at unnecessary risk Care Homes for Older People Page 19 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Residents care plans must be much more detailed to reflect all their health and social care needs. You must do this so staff have the information they need to provide residents with comprehensive and consistent care. 12/01/2010 2 9 13 Records made when medication is given to residents must be accurate and complete You must do this to demonstrate that residents receive their medication as prescribed. 12/01/2010 3 9 13 Medication must only be given in line with prescribers instructions You must do this to ensure residents receive their medication as intended 12/01/2010 Care Homes for Older People Page 21 of 25 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 18 13 All staff must receive training in how to safeguard vulnerable adults. You must do this so that all staff have a good understanding of the adult protection systems in their local area and the part they play should the need arise. 01/02/2010 5 29 19 Two written references must 01/12/2009 be obtained before anyone starts working at the home. You must do this to ensure that only the right people are employed to look after vulnerable adults. 6 34 17 Detailed receipts of how residents money is spent must be kept You must do this so there is a clear audit trail of how their money has been spent by staff. 12/01/2010 7 37 37 Any incidents affecting the well being of residents must be reported to us. You must do this so we can monitor these incidents closely. 12/01/2010 8 38 23 Emergency lighting tests and fire alarm tests must be carried out as required 01/12/2009 Care Homes for Older People Page 22 of 25 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action You must do this to check that they are operational in the event of a fire 9 38 13 Information about dangerous chemicals must be made available to staff who use them You must do this to ensure that staff have the knowledge to use these chemicals safely. 10 38 23 Fire doors must not be pinned back Youmust do this so they can close freely in the evnt of a fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 01/12/2009 01/12/2009 1 2 8 12 Residents fluid charts should be added up daily so their daily intake can be monitored closely. Information about forthcoming events and activities should be displayed around the home so that residents know what is planned Information about safeguarding vulnerable adults should be easily available around th home so that residents, visitors and staff know who to contact should the wish to raise concerns. Staff should refrain from wearing jewelery that might injure residents whilst they assist them. 3 18 4 27 Care Homes for Older People Page 23 of 25 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 5 29 Staff should receive an induction in line with guidelines issued by the Skills for Care national common induction standards. Staff should receive formal supervision at least 6 times a year. 6 36 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!