Inspection on 23/01/08 for Shepherds Lodge

This inspection was carried out on 23rd January 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

Shepherds Lodge 19/02/07

Shepherds Lodge 02/02/06

Shepherds Lodge 01/12/05

Shepherds Lodge 24/11/04

Shepherds Lodge 19/07/04

Shepherds Lodge 18/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Shepherds Lodge 4 West Mount Barrow-in-Furness Cumbria LA14 5LQ Lead Inspector Ray Mowat Unannounced Inspection 23rd January 2008 8:30 Shepherds Lodge DS0000022629.V352856.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 Shepherds Lodge DS0000022629.V352856.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. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shepherds Lodge Address 4 West Mount Barrow-in-Furness Cumbria LA14 5LQ 01229 431439 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) Mrs Adrienne Beattie Mrs Adrienne Beattie Care Home 6 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: Up to 4 service users in the category LD (Learning Disability under 65 years of age) Up to 2 service users in the category MD (Mental Disorder under 65 years of age) 19th February 2007 Date of last inspection Brief Description of the Service: Shepherd’s Lodge is a large end of terrace house, situated at the end of a quiet cul de sac in a residential area of Barrow-in-Furness. It is registered to provide residential care for a maximum of six people, with up to two people with a mental disorder and four people with a learning disability. The house is located near to a bus route and is within walking distance of the amenities of the town centre and the railway station. On the ground floor of the house there are two lounges and a conservatory, a kitchen/dining room, a separate kitchen and two bedrooms. One is a resident’s bedroom, the other being a staff sleep-in room and office. There are also laundry facilities outside the home at the rear of the property. There are wellmaintained gardens to the front and rear of the home. There are five resident’s bedrooms on the first floor and two bathrooms with toilets and shower facilities. The home supplies information to residents in an informative service user guide including the services provided and the fees, which range from £416 - £966 per week. Shepherds Lodge DS0000022629.V352856.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 inspection visit took place over one day. We (Commission for Social Care Inspection, CSCI) spent time with people living in the home and talking to them about their experiences. We also met with the manager and staff and looked at records relating to the running of the home and how people like to be supported to live their lives. We also sent out surveys as part of this inspection to get feedback from people living in the home, their relatives and representatives and other professionals involved with the home. Before the visit the manager completed an Annual Quality Assurance Assessment, which provided information about all aspects of the running of the home. This included a self-assessment against the National Minimum Standards (NMS) recording what the home does well, what has improved and plans for the future. It also included information about policies and procedures, health and safety and information about the people living and working there. What the service does well: The home works closely with other professionals to make sure they can meet the different and sometimes complex support needs of people. The person centred care plans that have been developed are detailed and give staff a lot of information so they know what care and support people need. The plans are looked at on a regular basis with daily records being written by staff that record significant events and what care and support has been provided each day. The home has a core group of skilled and experienced staff who have got to know people very well and provide a personalised service. The manager works closely with staff and encourages personal development in their role, staff said they felt they “get good support”. Specialist personal and healthcare needs are written down, which support and guide staff in providing a consistent service and maintain a person’s safety and welfare. People get good support from staff to manage their medication. The home has developed good information about people’s nutritional needs and new menus have been put together based on their individual preferences. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 6 The home has a positive approach to risk taking with clear policies and protocols in place to guide staff and ensure people’s independence and choice are promoted at all times. The manager and staff team provide a service that respects the rights and best interests of people at all times. As one person described it “the staff help us to do what we want to do”. All the records examined during this visit were securely stored. The organisations policies and procedures we examined were suitable for purpose and provided good guidance for staff. They were reviewed and updated on a regular basis or as changes occurred. People living in the home are asked for their views about the quality of the service on a regular basis and their responses are acted upon. 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. Shepherds Lodge DS0000022629.V352856.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 Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has improved the admission procedure, with information now being provided in an easy read format including pictures and symbols. People’s needs are fully assessed ensuring the home is suitable for them. EVIDENCE: All the information supplied to people who are considering or actually moving into the home has been improved with the use of pictures and symbols to make them easier for people to understand. The content of the service user guide and statement of purpose have been reviewed and updated to make sure information is up to date and accurate. Other information given to people or displayed in the home has been produced in the accessible format, which ensures people have access to all relevant information they need to make informed choices about moving in. All the people living in the home were referred by Social Workers who supply detailed needs assessments to enable personalised care plans to be developed. The assessments are very informative including health, personal and social care needs, housing related support, financial information and religious and cultural needs, which are invaluable in developing meaningful care plans. In addition specialist assessments from other agencies involved are also recorded Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 9 with specific strategies developed to support people’s individual needs. These included speech and language therapy and psychology assessments, which guide and support staff in providing a consistent service. The home a core group of staff who have worked at the home for a number of years and have completed appropriate training to guide and support their practice. In this time they have developed good relationships with the people living there, who obviously feel comfortable with the staff and relate well to them. Visits to the home for meals or overnight stays are encouraged before someone is asked to make a decision about moving into the home. One of the people I spoke to confirmed they visited the home for an overnight stay, which enabled them to meet the people already living there and get a “feel of the home”. This also enables staff to assess people’s compatibility that is so important in a small home environment. The home recommends a three month probationary period before people or their representative sign and agrees a contract of terms and conditions that explains their rights and the rules of the home. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All personal and healthcare needs are well documented in the person centred care plans. These provide staff with detailed information, enabling them to provide a consistent and reliable service that is based on people’s individual needs and preferences. EVIDENCE: Based on the detailed needs assessments, person centred plans have been developed, which provide staff with relevant information about how people like to live their lives. These are agreed and signed by the individual or their representative and are kept under review to ensure they are up to date. Included in the care plan is a ‘Health Action Plan’, which is used to monitor and record all aspects of people’s healthcare, ensuring they are receiving appropriate services when needs are identified. The home also works closely with a number of other agencies through the assessment and review process including independent advocates and specialist health services to make sure individual needs are responded to appropriately and in a consistent manner. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 11 This is of particular importance for people with complex needs and a dual diagnosis. The person centred aspects of the care plans give an insight and better understanding of people’s personal thoughts and feelings and what is important to them and how they like to live their lives. This information is invaluable to staff enabling them to support people to lead an independent lifestyle of their choice. All staff have recently received training in relation to the Mental Capacity Act. This has increased their awareness of their role and responsibilities in supporting people with decision making in their lives. Independent and family advocates have also been involved if requested to help people with life decisions. I observed staff taking on an enabling role in encouraging independence with tasks around the home such as making drinks and meals and handling their laundry. It was evident from my discussions with people they feel they contribute to the running of the home and feel empowered to make decisions about how they live their lives. Individual risk assessments are completed through the assessment and care plan process that safeguard people whilst promoting their independence both in the home and in the community. This has involved the home working closely with a number of agencies, on some very sensitive and complex issues, to ensure people’s rights were protected and they were safeguarded. All the records examined including both paper and electronic versions, were securely stored but accessible to relevant people in line with good practice guidelines. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are enjoying a full and independent lifestyle that provides them with opportunities to take part in a wide range of vocational, educational and leisure activities. EVIDENCE: All the people living in the home have the opportunity to attend some form of day service or further education establishment during the week, Monday to Friday. One person has effectively retired from formal education and chooses to plan their own time with day trips on the train or just accessing the nearby amenities of the town. Other people have chosen a range of activities that gives them different experiences both vocational and educational or just a social activity. Based on our discussions with people they feel valued and proud of their achievements. They each have developed a good social network of friends and acquaintances outside of the home. One person described how they “like to go on the train to visit my friend”. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 13 Some of the courses attended are providing them with practical life skills, which is increasing their independence. Other activities are purely leisure activities of which the social aspect is most important. Within the home environment personal development is encouraged and supported by staff. This could include household tasks such as making a simple meal or packed lunch, sorting personal laundry or cleaning. Alternatively it may be other life skills such as handling their own finances or learning to access public transport independently. This has been very effective for one person who can independently catch a bus to a nearby town to visit their friends. Staff worked closely with them to assess and then develop their skills and confidence, gradually being less involved before shadowing them to be sure they were competent. This was very important to the person and has enabled them to keep in touch with people who are an important part of their life. The home has recently purchased a ‘people carrier’ style vehicle that can be used by any of the people living in the home and has provided different opportunities for individuals and small groups to access the community. People are supported with their personal relationships if required, which has involved the home working closely with a number of different agencies to ensure people are safeguarded whilst being able to fulfil their emotional needs. One member of staff has taken a lead role in developing a nutritional assessment and food monitoring system. Based on these assessments and discussions with individuals new menus have been developed to reflect individual needs and preferences. These have incorporated a healthy options philosophy based on current good practice and advice. People we talked to were complementary about the choice of food available. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 10, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and healthcare needs are closely monitored and clear records are maintained, which support and guide staff in meeting individual needs. EVIDENCE: As part of the person centred care plan the home is in the process of developing what they call “Residents lifestyle record”. This is designed to assess people’s personal development needs and opportunities. This includes detailed information about how people like to live their lives and what is important to them. Personal goals and preferences will be agreed that people will work toward achieving. Likes, dislikes and everyday choices are recorded, which helps staff to support people, as they prefer. We observed staff taking on an enabling role when encouraging and supporting people with activities around the home. Health action plans have been completed that document all basic and specialist healthcare needs and services people are involved with. This ensures needs are responded to in a timely manner. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 15 Good systems are in place for the management and storage of all medication coming into or leaving the home. Most of the medication is managed through a monitored dosage system that is supplied by the local pharmacy on a weekly basis. We examined the contents of the medication cupboard against the records held and found these to be up to date and in order. All medication is securely stored. Staff responsible for the administration of medication has received suitable training and their competence assessed. A person’s wishes upon death or illness are recorded in the care plan with reference to the involvement of family and friends and any other specific requests. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are safeguarded, with staff working closely with other agencies to maintain their health and well being. EVIDENCE: The complaints policy and procedure has been improved using pictures and symbols to make it easier to understand. This is issued to people in the service user guide when they move into the home. It is also displayed in the home. There have been no complaints recorded since the last inspection. There has been one adult protection referral since our last inspection. This was a complex case and involved different Social Work teams and the police. It involved the home working closely with the Community Health Team and Social Workers to develop strategies and risk assessments to ensure both people involved were safeguarded, whilst having their rights protected. The home has learned from being involved in this case and the staff team have had further training on mistreatment and abuse policy and procedures good practice and the Mental Capacity Act, to ensure they have the skills and knowledge to support and safeguard people in the future. The manager is also working towards a “training the trainer” award to enable her to provide mistreatment and abuse training for new staff. Shepherds Lodge DS0000022629.V352856.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, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Shepherds Lodge provides a homely and comfortable living environment that is decorated and maintained to a good standard. EVIDENCE: The home is well maintained and decorated to a good standard throughout. There is an ongoing programme of repairs and renewals with recent improvements being the decoration of one of the communal lounges and one person’s bedroom, with people being involved in choosing the new decoration and furniture. Improvements have also been made to the rear garden with an old outhouse being removed and the boundary wall being rebuilt. Plans are in place to create a decked patio area to enhance the garden and create an alternative seating area for people to enjoy. In addition there are plans to alter one of the bathrooms to create a fully accessible walk in shower room. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 18 People move freely around the home and were able to spend time alone or socialise with others in one of the communal areas of the home. Access around the home is good. There were no obvious hazards noted around the home and the need for aids and adaptations was minimal. All areas of the home were clean and hygienic with staff supporting people to maintain a clean environment. Shepherds Lodge DS0000022629.V352856.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): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a stable staff team who are aware of their roles and responsibilities and have developed a good understanding with the people they support. They provide a consistent service that responds to individual needs. EVIDENCE: There is a core group of staff who have worked at the home for a number of years and have developed good relationships with the people living there. They work well as a team and have good systems in place to share pertinent information and maintain a consistent and reliable service. There was a suitable number of staff on duty to meet the individual needs of people. Recruitment procedures are in line with good practice, with people who live in the home being involved in the recruitment and decision making process, which is good practice. The home have introduced a new induction process that involves new staff shadowing experienced staff on different shifts and having a mentor through the induction process to support them and consolidate their personal development. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 20 We examined staff files that contained all relevant information including a clear job description, an induction checklist, individual training record and relevant policies and codes of practice. The new induction process is ensuring staff receive appropriate core training with the home arranging specialist courses specific to the needs of people living in the home such as autism awareness. Over 50 of the staff team have completed or are working towards an NVQ2 or above relevant to their role and responsibilities. The manager is aware of personal development needs and encourages and supports staff development. She is currently training/mentoring supervisory staff to take on formal supervision of care staff. Staff said they got “excellent support” from the manager and had “regular contact and discussions about their role and any other issues arising.” The training records were inconsistent and did not reflect sufficient training for some staff. The manager talked about training that had taken place, however it is recommended the home develop an annual training programme that will meet the individual training needs of the staff team. Although staff talked about being “well supported” records of formal supervision were not all in place, therefore it was difficult to assess the frequency and quality of the supervision. The manager should review existing records and ensure they are kept up to date. Shepherds Lodge DS0000022629.V352856.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, 38, 39, 40, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are consulted both formally and informally about all aspects of the running of the home. Staff ensure their rights and best interests are safeguarded at all times. EVIDENCE: The owner/manager Mrs Beattie has continued her professional development, recently achieving her NVQ5 in management. She is committed to maintaining a good quality service that responds to people’s individual needs. She works closely with other agencies to make sure specialist needs are being met. Both the people living in the home and staff said the manager was “approachable” and they felt comfortable discussing any issues or concerns. The manager has a “hands on” approach working closely with staff to ensure the home is Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 22 operating effectively and in the best interests of the people living there. As one staff member described it “people’s views and opinions are valued and guide what happens in their lives”. The annual quality assurance survey sent out by the home has proved effective in providing feedback about the strengths and weaknesses of the service and has influenced future planning. With examples being the development of information in an easy read format and widening the target group of the annual quality assurance survey to include other agencies involved with the home. Policies and procedures have been kept under review annually and are signed by staff when they have read and understood them. Information in the AQAA confirmed that all routine maintenance and servicing of equipment were up to date. Health and safety checks take place as required and appropriate risk assessments are in place to safeguard people whilst promoting their independence both in the home and in the local community. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 X 3 X Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA35 YA36 Good Practice Recommendations It is recommended the home develop an annual training programme that will meet the individual training needs of the staff team. The manager should review existing supervision records and ensure they are kept up to date. Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Shepherds Lodge DS0000022629.V352856.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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