Inspection on 22/07/08 for Lowmoor Care Home

This inspection was carried out on 22nd July 2008.

CSCI found this care home to be providing an Good service.

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

Lowmoor Care Home 30/09/09

Lowmoor Care Home 25/08/09

Lowmoor Care Home 18/04/07

Lowmoor Care Home 25/04/06

Lowmoor Care Home 20/12/05

Lowmoor Care Home 09/08/05

Lowmoor Care Home 03/02/05

Lowmoor Care Home 17/08/04

Lowmoor Care Home 09/02/04

Lowmoor Care Home 02/10/03

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Lowmoor Care Home Lowmoor Road Kirkby In Ashfield Nottinghamshire NG17 7JE Lead Inspector Brian Marks Unannounced Inspection 22nd July 2008 08:45 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 Lowmoor Care Home DS0000024647.V368807.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. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lowmoor Care Home Address Lowmoor Road Kirkby In Ashfield Nottinghamshire NG17 7JE 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) 01623 752288 01623 752288 Lowmoorcarehome@msn.com Lowmoor Nursing Home (Kirkby) Limited Mr Thiyagraja Govindaraju Care Home 50 Category(ies) of Dementia (50), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (50) Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th April 2007 Brief Description of the Service: Lowmoor is a privately run, purpose built two storey 50 bedded care home for people with dementia and mental heath needs. Qualified nursing care is provided throughout the 24-hour period. The home is situated in a semi residential area within half a mile of local amenities and the town centre of Kirkby-in-Ashfield. It can accommodate up to 50 people in 40 single bedrooms and 5 double bedrooms; 10 of which are en-suite. However, it has been the recent policy of the home to only offer single accommodation so the current maximum people living at the home would be 45. The home has an enclosed garden and a car park for visitors and staff and there is a passenger lift linking the two floors of the home. There are lounges on the ground and first floor and bathrooms are fitted with adapted facilities. Information about the service is provided in the statement of purpose and service user guide, which are given to people at the start of their stay at the home. The current range of fees at the time of this inspection is £348 to £476 per week, as specified by the registered manager. There are additional costs for hairdressing and chiropody. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a Key unannounced inspection that took place at the home over one day. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, records held by us, the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection, and surveys that had been previously sent out to the agency, its staff and the people receiving help. All of the above material assisted with the preparation of a structured plan for the inspection. Fourteen resident and relative surveys and two care worker surveys were returned before the inspection and the information supplied in this way was analysed and the outcomes included in the inspection process and reflected in this written report. At the home, apart from examining documents, care files and records, time was spent with the manager of the home, who was in charge during the visit, and we also talked to eight of the staff working on the day shifts. The care records of four people who live at the home were examined in detail and one of these was interviewed along with three others. Six relatives who were at the home on the day of the inspection were also spoken to. No other inspection visits have been made to the home since the last Key unannounced inspection on 18 April 2007 and the assessment was made against the key National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. What the service does well: The home provides a comfortable, homely and relaxed environment for people to live in and provides a good standard of care. This is reflected in residents’ and relatives’ positive comments about the home and the staff. They can follow their own routines as long as it is safe to do so, and can decide when they get up or go to bed. They are able to take part in activities and go on outings if they wish, and are offered a choice of food. Those service users who were unable to verbally express how they felt looked clean, well-dressed and well cared for, and staff were observed treating them with dignity and respect. The manager is regarded as approachable and responsive by people living at the home and by staff, and the latter feel supported by him and that their training and induction is well organised. The home has been generally well maintained and there were satisfactory standards of cleanliness throughout. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People do not come to live at the home without the care they need being properly identified. EVIDENCE: Since the last inspection the manager has improved the care records in use at the home and all those looked at were completed to the same standard, including the file of somebody who came to live at the home during the previous month. They all contain an assessment completed by the manager before people move in, as well as those supplied by outside professionals, and then further information obtained as they settle down. Additionally all files contain assessments of the general and specific areas of risk that are relevant to people individually, such as the smoking in the home, self harm, safe moving and handling, skin breakdown and pressure sores, falls and nutrition. The people spoken to said that their needs are met, that staff ‘are all very good at looking after me and are very helpful with my wishes’ and that ‘I get looked after well and like all the staff who help me’. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 9 Family members also told us that ‘my wife suffers from dementia and she is always supported in all of her needs’ and that ‘she has a complex set of medical needs and problems and the home manages everything very well’. The home does not provide intermediate care so Standard 6 does not apply. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at the home have care plans and risk assessment records that promote safety and consistency, and staff are encouraged to work in ways that respect individuality, privacy and dignity. EVIDENCE: The manager told us in the AQAA how the plan to meet individual needs is prepared and how residents or their families are involved in the nursing process. We were told how care plans are presented and written in a style that is accessible to the residents or their families, and how they are agreed and signed by the resident or family member whichever is appropriate. These aspects of the system were confirmed from our examination of four care records. They all contain clear and comprehensive descriptions of the areas where people need help or where they experience risk, as well as the areas in which they are independent, and the care and nursing activities to be carried out by staff are identified. However the description of social interests and life background is very brief, the expansion of which would allow the home’s staff to see the person in terms of their positive achievements rather than just the problems they are facing at present. A standard form has been included in Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 11 each care file that indicates that consent has been given for a number of activities including the use of bedrails. The care plans are looked at monthly, to make sure that all information is correct and up-to-date and the staff spoken to described how care plans are ‘useful in broad terms of how we help people; other communication systems such as the daily handover and diaries are also important’ and that ‘getting to know them as people allows us to work better’. The care records looked at confirmed that contact with external healthcare services is regular, particularly the local doctors and members of the local psychiatric services, as well as general hospital clinics. From the written records and direct comments from people, the staff at the home work hard to care in sensitive and dignified ways, and to keep them as independent as possible: ‘I am full of admiration for the staff; a difficult job which they appear to do well’. ‘I struggled and fought to care for her at home but now she is well looked after and now has some dignity’. ‘Staff look after me properly, are sensitive and respect my privacy and dignity’. Examination of the arrangements for the receipt, storage and administration of medicines indicated these are generally satisfactory and all entries in the written records had been made properly, apart from a small number of gaps in the signed administration record and the absence of photographs to help identify individuals. Medication is stored securely and the home uses a Monitored Dosage System for administration. There are a number of people living at the home who are using ‘controlled’ drugs and storage and administration arrangements for these are satisfactory. There are also a number of medicines for ‘occasional use’ (PRN) but specific instructions for their administration were not included in the records. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home enjoy lifestyles and routines that suit their varying levels of ability and have the opportunity to take part in organised leisure and social activities. EVIDENCE: In the AQAA the manager told us about the employment of a full-time activities coordinator at the home who arranges one-to-one activities such as reminiscing, as well as musical entertainment and in house games for groups of residents. We were told about seasonal parties at New Year, Easter, Halloween, Christmas and how relatives and friends are invited to join the festivities. Individual birthdays are celebrated if the resident wishes and there is a summer fete and regular barbeques. Outings for small groups are arranged and a church choir and church service are regular events. Records held by the coordinator support this and during the morning of the visit a clothes sale was held in the dining room that was well attended by residents and some family members. The home has access to the community bus to transport residents into the community on trips and outings. The manager informed us that a second organiser is due to start at the home during August 2008. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 13 The relative of one resident did comment that the activities on offer did not meet his wife’s individual interests, and the absence of little in the way of written material in assessments and care plans (referred to above) does not help staff to help people achieve their full potential. The people spoken to confirmed that they are generally happy with life at the home and relatives described how the relaxed atmosphere of the home and the attitude of staff made a positive impact: ‘Although my wife is difficult to involve, staff are very good with her and she has settled since she came here’ ‘Although he had a lot of difficulties at the last two homes, the staff are brilliant with him here and keep him occupied; he’s much more settled’ ‘She’s a lot calmer than she was and staff are always on the ball; they’ve found out that she loves Karioke which we didn’t know about!’ The family members spoken to also talked about the welcome they always receive from the staff: ‘When I ring up there’s always a friendly reception’. ‘They keep us very well informed and I get a warm welcome at every visit’. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 3-week menu is being followed; this indicates a choice at the main meals of the day and a hot option sometimes available for breakfast, with generally a cold option only available at teatime and supper. People spoken to confirmed that they enjoy their meals at the home. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and softened. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. EVIDENCE: The AQAA told us how the home’s residents and their relatives are given information about how to complain and how the procedure is enclosed in the service users guide and also displayed in the reception area. We were told how all the staff are given training on handling complaints and how day-to-day matters that arise from residents and relatives are resolved through informal discussions, meetings and during care reviews. Records indicated that there had been one formal complaint made about the home in the past year and how this was dealt with by the proprietor. All the people spoken to were clear about how to get problems resolved and confident that they would be listened to. Staff records and the AQAA indicate that the manager has arranged for staff to receive training in their responsibilities to safeguard the vulnerable people living at the home and only a small number of new staff have not attended the annual top-up training. The policies and procedures in place are in line with the statutory procedure on safeguarding adults, and we were aware of four referrals that had been made to Social Services by the manager earlier this year, the outcomes of which were discussed. Three of these had involved disputes between residents and the third had involved a staff member who had Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 15 been disciplined. Actions taken by the manager indicate a clear understanding of the responsibilities of himself and his staff in this matter. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home has continued to be maintained and improved, and provides residents with a homely place to live. EVIDENCE: The AQAA told us how the home has a programme of routine maintenance and refurbishments in place, and that records of all work done are kept in the logbook. We were told that the home has a full time handyman who undertakes all maintenance work externally and internally and is accountable to the manager, and how the grounds are kept tidy, safe, attractive and accessible to residents. From a brief tour of the building and visits to some of the bedrooms we saw that new carpets, curtains and furniture had been purchased for the communal areas of the home and that two aquaria and caged birds have been provided for residents to enjoy. The manager also described how each bedroom is redecorated and fitted with new furniture and furnishings as they become Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 17 vacant, and some bedrooms have already been provided with modern furniture as part of the home’s improvement plan. All locks have removed from the outside of bathroom and toilet doors as required at the last inspection. The relative of one of the residents raised an issue about the use of the call system in his wife’s bedroom and the manager agreed to review this matter with him. At the last visit by the Fire and Environmental Health Officers a number of recommendations were made and these have been dealt with. On the day of the inspection the home was clean, tidy and free from odours and whilst most of the people spoken to had no complaints about the laundry service, a relative voiced concerns about their clothing getting ‘lost’ or turning up in other residents’ rooms. That aside, all residents observed in the home wore clean and well-presented clothing. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has adequate numbers of staff on duty that support a safe environment in which to live and work, and they have received training that helps them do their jobs in a more professional way. EVIDENCE: The AQAA indicated a low turnover of care staff in the past twelve months and also told how staff are arranged on duty and about levels of qualification of care staff being in excess of the national target. We were told that all (new) staff have induction training when they start, and how this continues to foundation training and NVQ; as an organisation they recruit in a fair and open way ensuring they employ the right people. This information was confirmed by the staffing records that we looked at and from what staff told us. Examination of the duty roster and information provided in the AQAA indicated satisfactory levels of care staff on duty during the week of the inspection, although one staff felt that levels of staff on duty were regularly affected by staff sickness and leave. All the residents and family members spoken to felt that ‘there are always a lot of staff around’ and that ‘when I am in the lounge it is never more than a few minutes that staff aren’t present to make sure everything is safe and sound; I can’t remember the last time we had to wait’. Although the programme of NVQ training (referred to above) has been the main focus for attention since the last inspection, we were told that updates in the required heath and safety subjects have continued regularly and a nurse Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 19 spoken to told us that they benefit from regular instruction about a range of health related topics. However training records indicated that not everybody had received training in some of these key topics particularly about the caring for people who suffer with dementia. We looked at the files of two recently appointed staff for evidence of the procedure that had been followed for their recruitment, and they contained safe and satisfactory information showing that proper checks had been carried out. These included two written references and a check by the Criminal Records Bureau obtained before they started work. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a well-managed and safe environment in which to live and work. EVIDENCE: The AQQA told us how the manager has been in post for some years and has a wealth of skills, knowledge and experience in the operation of care services for older people. He holds the required qualification for managers and we were told how he creates an open, positive and approachable atmosphere where staff and residents feel that they have a say in how things are done. Since the last inspection the manager has started to delegate a number of jobs that were reducing effectiveness and there is now an administrator in the home who is also responsible for some elements of staff training, particularly new staff. There is also a new deputy manager in post who has taken on key tasks of staff support and supervision and, although the system for meeting with staff is in place, the arrangements are not yet occurring regularly enough to meet the National Standard. People spoken to were positive about the Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 21 influence of the home’s management team and how the manager ‘made time for us on our first visit to the home which gave a very favourable impression’ and that ‘this is a well run home working well for the people who live here’. Staff also said that ‘the manager is very supportive, he’s a good listener’ and that ‘the manager is always involved and we see him around the home all the time’. Since the last inspection the manager has started to introduce amore systematic approach to assessing how well the home is being run and getting people’s views on this. Surveys sent out to relatives were not returned in great numbers but he has commenced regular audits of the home’s services and the AQAA told us about plans to form a residents group and a carers group with the help of Alzheimer’s society. We were also told that the proprietor is in regular contact with the home, and has been very supportive and committed to the home. As required at the last inspection the manager has changed the systems for the safe keeping of residents’ personal spending money and an individual cash float is kept for everybody at the home to use, as they require it. The AQAA indicated good standards of health and safety activity and regular servicing of equipment; the home’s handyman makes sure that any problems are dealt with quickly. Observations made around the building and a sample of fire safety and servicing records indicate that the home is hazard free. Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Safety in the administration of medicines should be achieved by the use of a photograph of each resident at the front of their medicines record, and there should be a detailed description of the procedure to be followed for the administering of individual ‘occasional use’ (PRN) medicines. The manager should review the operation of the call system in resident bedrooms to make sure that everybody can operate them safely and successfully. Staff supervision should take place every two months and include career development needs, and philosophy of care in the home. 2. 3. OP19 OP36 Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Lowmoor Care Home DS0000024647.V368807.R01.S.doc Version 5.2 Page 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. 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