Inspection on 16/12/08 for Southwater Residential Home

This inspection was carried out on 16th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Southwater Residential Home 07/01/08

Southwater Residential Home 24/07/07

Southwater Residential Home 12/12/06

Southwater Residential Home 08/03/06

Southwater Residential Home 20/01/06

Southwater Residential Home 17/03/05

Southwater Residential Home 14/07/04

Southwater Residential Home 25/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stella Lindsay     Date: 1 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG 01803524140 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Mary Lamont,Mr Thomas Lamont Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 The home may accommodate two named service users with the category DE(E) Date of last inspection Brief description of the care home The previous inspection took place on 7th January 2008. Southwater Residential Home is registered to provide accommodation and care for a maximum of eighteen people in the registration category of `Old Age, not falling within any other category. It is made up of three houses joined together with a conservatory running along the entire front of the building, and a small but pleasant garden behind. There is a stairlift to the first floor. Two bedrooms are up a flight of stairs with a stairlift, but with three steps at the top. There is ample car parking space at the front of the house. Southwater is in a residential area of Paignton and is close to the town centre and the bus and railway stations. Information is available from the home on request in the form of a written Statement of Purpose and a Service Users Guide. Copies of inspection reports are kept Care Homes for Older People Page 4 of 27 Brief description of the care home at the Home and are also available on the CSCI website. The current fees range from #330 to #400 a week, although additional charges may be made for hairdressing, newspapers, clothing and all other items of a luxury or personal nature. Care Homes for Older People Page 5 of 27 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: one star adequate 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: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This inspection took place on Tuesday 16th and Friday 19th December 2008. Prior to the unannounced inspection we sent questionnaires to people who live at the home, and to people who work there. Ten residents and six staff completed and returned these. The Home owners sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us the information we asked for. The AQAA is a selfCare Homes for Older People Page 6 of 27 assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. During our visit we spoke to eleven people who were living at Southwater, the Home owners, and five other staff members. We case tracked two people who use the service. Case tracking means we looked in detail at the care three people receive. We spoke to staff about their care, looked at records that related to the residents, met with them and made observations if they were unable to speak to us. We also met other residents, and shared a meal in the dining room. We looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. All this information helps us to develop a picture of what it is like to live at Southwater. What the care home does well: What has improved since the last inspection? What they could do better: The Home owner should have accurate information readily available for prospective residents. Guidance for staff and encouragement for residents should promote the use of the powered bath seat, in order that the people have confidence to use it, which would give them choice in bathing facilities. Some but not all staff have received essential training. Training for some staff is needed in the Protection of Vulnerable Adults, Moving and Handling, Fire Safety and the Safe Administration of Medicines. Hold-open devices had been fitted to doors, but some were not working. Fire doors must not be propped open, as this would not allow for the occupant to be protected from smoke inhalation in the event of a fire. We saw one heater in a private room, and one radiator in a communal toilet which did not have safety covers. Unguarded heaters must not be in places where residents may come into contact. Care Homes for Older People Page 8 of 27 The home owner should have support in covering night care needs, to maintain the service safely into the future. All checks must be consistently made when recruiting new staff, to protect residents from potential harm. There should be a manager in place who is qualified to deliver the service in line with current regulations and new legislation. The home should have a quality monitoring system, in order to monitor its own achievements in meeting its aims. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were seen to be having their needs suitably met. However, good information about the home was not readily available, and not all the new residents had benefited fully from the admission procedure. Evidence: Good information about the service had been prepared by the homes administrator in time for the last inspection. However, the home owner could not supply a copy during this inspection. Two people had recently moved into the home. One had visited the home with a relative, then come in to join an afternoon activity before moving in for a short stay so that the family felt able to go away on holiday. She told us that she had, since then decided to stay at Southwater long term. Ive made up my mind to stay, she said - shes a wonderful woman (the Home owner) and nothing is too much trouble. The other recent arrival had come with some information from another care home. A relative had visited to make the decision. The Home owner had not met the Care Homes for Older People Page 11 of 27 Evidence: person in order to complete her assessment of whether the home could meet their needs. The Home owner did not accept a request for an emergency admission that was made during this inspection, which was good practice as she had insufficient time to make a proper assessment of the persons needs. We found that the people currently living at Southwater were having their care needs suitably met at the home. Care Homes for Older People Page 12 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good personal and health care was given, though there was still room for improvement in consulting with residents about their care plans, in providing choice in bathing arrangements, and training in medication. Evidence: Each resident had a care plan, with information about their care needs. A good clear summary had been written for each, at the front of each plan, to enable staff to quickly understand the persons needs. Care plans had been reviewed and up-dated. While we did not see residents signatures on all these documents, we found they they were consulted - They take notice of what I say, said a long term resident. Charts were completed monthly to assess the persons needs. These showed where changes were taking place. One persons needs were shown as increasing, and now two carers were needed for transfers, which had been put into practice. Their nutritional needs assessment showed improvement. Another persons chart showed increased dependency but in their case no action plan had been drawn up in response. We saw Care Plans on display in residents bedrooms. These were lists of tasks for care staff, Care Homes for Older People Page 13 of 27 Evidence: and not written for each individual. These should not be displayed unless the resident wishes. There was evidence of residents being assisted to access Eye Clinics and receiving care from specialist health workers in the home. A resident who had become immobile had been visited twice a week by District Nurses. Consistent personal care had maintained their skin in good condition throughout their illness. A good record was kept of outpatients appointments and GP visits. Residents were enabled to retain their independence. One had recently been to the GP surgery independently, another still walks to their chiropody appointments. One residents mobility had improved since their admission to Southwater. Another had suffered a fall, and now was nervous of using the stair lift. We saw evidence that medical investigations had been requested following the fall. Access had been improved so that all residents would be able to get to a shower or bath. Some were able to use their en suite facilities, some were independent, and some had accepted help to use the shower on the first floor. Daily records showed that some had a strip wash every day. The Manager had obtained a bath seat suitable for use in the bathroom, but it had not yet been used. It would be good practice to promote residents confidence in its use, so that residents with mobility problems feel they have the choice of a bath. All residents were seen to be capable of using a call bell, and able to reach it. Most but not all said either that they had not yet needed to use it, or that it is answered very promptly, night or day, Mary (the Manager) would help with anything said one resident. One resident was managing their own medication following assessment for safety. They showed us the locked drawer where it was kept, and were able to tell us what each tablet was for. The homes medication cabinet where Controlled Drugs were stored had been fixed to the wall in accordance with current regulations. The Manager had given in-house training to carers to give them the competence to witness administration of Controlled drugs. This enabled the Manager to give and record the medication at the correct time. A monitored dose system is in place, to make it safer for staff to give tablets to residents. We did not see any errors or gaps in recording. Training from the pharmacy was still needed for staff who administer medication. This must be provided to ensure that the good health of residents continues to be promoted. Care Homes for Older People Page 14 of 27 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. Staff practices promote individual choice. Good quality meals are served, with choice and variety. Evidence: Residents told us they had choice in where they took their meals. One said they could have had a kettle in their own room, but did not want to bother. Another said their last hot drink is brought to them at 6.30pm, and that they could have another if they wanted. We saw they had plenty of fresh fruit in their room. Another resident showed us the flask they kept in their room so that they could make a cup of tea at 9pm. The afternoon cook had visited residents in their rooms to discuss their favourite foods. Six residents were in the habit of joining together for meals and social activities, while the others stayed in their rooms. All but one said this is their choice. One had lost confidence in using the stair lift following a fall, and said they would like to move to a ground floor room if they did not get their strength back. The Home owner told us that the Befriender role that they introduced last year has proven to be a great success. A staff member has dedicated time to spend with residents, in particular with those who choose to stay in their room. Activity records showed that staff had spent time with residents in their rooms, doing simple crafts, playing board games and sitting and Care Homes for Older People Page 15 of 27 Evidence: listening. One resident said they enjoy playing musical instruments in their room - I play to raise my spirits, they said. One staff member leads activities in the conservatory during the afternoons for those who choose to join in. These are normally board games, quizzes and bingo. This person was on leave at the time of this visit. A classical guitarist was booked to play during this unannounced visit, and we saw six residents enjoying this entertainment in the conservatory. We were told that staff had held a lovely birthday party for two of the residents recently. One resident attends Church on Sundays, while another had stopped going due to health problems. They now join in the weekly ecumenical service in the home, where they have bible readings and prayers, and had particularly enjoyed the Advent hymns and Carols at this time of the year. Two residents told us of regular visits by family and friends. They had plenty of chairs in their room for visitors, and said the home owner would offer refreshments. All the residents said they enjoy their meals, and one said in a survey, the meals are really wonderful here. They come and ask you what you want, we were told, you have choice for breakfast and tea. One person was supplied with a satisfactory glutenfree diet. During this visit the lunch was roast chicken with a variety of vegetables, stuffing and gravy. For sweet, a choice of melon, rice pudding, pears and cream or ice cream were offered. Care Homes for Older People Page 16 of 27 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 staff and manager had shown good practice in listening to residents. Recruitment checks were not prompt or robust, and staff awareness of protection issues had not been promoted, thus leaving residents potentially at risk. Evidence: There is a notice on display in the entrance hall about the homes complaints procedure. All ten residents who returned surveys said that they knew how to make a complaint, nine said they knew who to speak to if they were unhappy, and one said, The owners and staff are always available. The Home owner had kept a record of the one formal complaint that had been received since the previous inspection. The Commission for Social Care Inspection had not received any complaints. Some staff had received training in the Protection of Vulnerable adults, but not all. The Manager said that she would arrange for this to be delivered. There was no evidence that the Manager or staff had received training with regard to the Mental Capacity Act. The checks needed during recruitment to assure that residents are protected from potential harm had not been carried out thoroughly. Care Homes for Older People Page 17 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, light and warm. Accessibility and facilities are being improved, but some issues of safety and accessibility remained. Evidence: The location of this home is good, as it is close to the town centre and seafront. Its layout is homely and attractive, and comprises three houses joined at the front along the conservatory. There are three staircases. The one to the far right of the home has a stair lift fitted. A new stairlift had been installed on the staircase to the left of the building, leaving three steps to be climbed. We saw that residents who needed a call bell had one that they could reach. There are a large bathroom and a shower room on the first floor. Some residents have en suite facilities, and one resident uses a communal bathroom at the other end of the house. All residents had access to bathing facilities, but not all were using them. A powered bath seat had been obtained, and was in the spacious bathroom, but still had its wrappings on. Residents may need to see it in action to gain confidence and promote their choice and ease of bathing. The dining room is bright, and the lounge comfortable. Residents were using the conservatory for social activities during this visit. The garden looked more accessible for residents than at our previous visit, as we saw Care Homes for Older People Page 18 of 27 Evidence: benches and neat pathways. Residents told us they had been out there during the better weather. One resident was pleased with the freedom given by the patio door in their private accommodation. We saw an unprotected heater in a residents bedroom, near to where they were sitting. It had sharp edges and was a potential hazard. There was a radiator in a first floor toilet, where there was not enough space to allow a cover to be fitted. he Home owner said that it was not used, and would be removed. We saw that the laundry was clear and in good order. The house was clean and sweet smelling - the only odour was in a vacant room. Liquid soap and paper towels were provided in communal toilets. Clinical waste is collected under a contract. Care Homes for Older People Page 19 of 27 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. Staff have a good understanding of residents care needs, and have formed positive relationships with residents. Good practice had been supported by training, though further updates were needed. Night staff should be available to provide a sustainable service, and to ensure that safety is maintained. The recruitment procedure had not been followed, thus exposing residents to potential harm. Evidence: We found the number of staff on duty by day was sufficient to meet residents personal and social care needs. The home owner was on-call every night. Residents said that if they need help, she is normally there very quickly. We consider this is not a safe or sustainable situation, and arrangements should be made for other staff to cover night duties. We looked at staff records. We found that of four files we examined, three contained no written references, and one had only one. Criminal Records Bureau clearances were seen on two files. The necessary documents had been gathered by the recently recruited member of staff and the application sent during this visit. She was still accompanying experienced carers when working with residents. Improvement had been made in the accomplishment of NVQ qualifications, and of the Care Homes for Older People Page 20 of 27 Evidence: six regular care staff, four now have at least NVQ 2 in care, which represents good progress. Three were working towards NVQ3. Staff told us they felt more confident, and the Home owner said they felt that the staff team had improved morale as a result of their achievements. Staff had been given guidance in the safe administration of medication, so that they could assist the Home owner to administrate drugs according to the correct procedure, and were awaiting training from a pharmacist. The records showed that some staff were in need of Moving and Handling training and the Protection of Vulnerable Adults training, and fire safety. The Home owner said she had plans for booking this training. Health and Hygiene, Control of infection, and First Aid training had been provided. Training specific to the needs of the residents should also be provided. Care Homes for Older People Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team needs to be strengthened in order to maintain a service that meets the residents needs according to current standards and regulations, and assures their safety. Evidence: The registered providers, Mr and Mrs Lamont, have been running Southwater for twenty one years, and live on the top floor of the house so are available at all times. They are fully involved in the life of the home. Mrs Lamont provides care full time, and Mr Lamont works as chef as well as maintaining the building. They need assistance to fulfil administrative duties and meet regulations as well as to incorporate new legislation. People who had been supporting them were not working at the home at the time of this inspection. They told us they were considering the appointment of a part time manager to support the existing management team. There was no formal quality assurance system in place. The home had not reviewed its performance through a programme of consultations, or sought the views of staff, Care Homes for Older People Page 22 of 27 Evidence: residents, their families or representatives, although the home owners are available every day for discussion. Restrictors had been fitted to windows on the first floor. However, we found that they could be easily detached and put out of action, therefore not providing the protection that vulnerable residents need. Hold-open devices had been fitted to residents bedroom doors where they wanted to be able to keep them open. However, we saw some that were not working and were being propped open, which means that the fire protection system was not fully working. The Fire safety records showed that the alarm system had been professionally serviced on on 27/11/08. Care Homes for Older People Page 23 of 27 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 24 of 27 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 25 13 Unprotected heaters must be made safe to protect residents from potential harm. 27/02/2009 2 29 19 The registered person shall not allow a person to work at the care home until she has obtained the documents in respect of that person as required by the regulations in order to protect residents from potential harm. 28/03/2009 3 38 23 Fire doors must not be propped open and the holdopen devices must be effectively maintained so the fire doors will close in an emergency and protect the occupant from smoke. 27/02/2009 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. Care Homes for Older People Page 25 of 27 No. Refer to Standard Good Practice Recommendations 1 1 It would be good practice to dispose of the previous unacceptable versions of the Statement of Purpose and Service User Guide, and to keep copies of the accurate information readily available for service users. The Manager should ensure that full pre-admission assessment is carried out for all prospective residents. When assessment shows that a residents condition has changed, the plan should be altered promptly to show how this affects their care needs. Training should be provided promptly for staff who administer medication to ensure consistency in promoting good health. All staff should be up to date with training in Protection of Vulnerable Adults, so they can recognise any form of abuse and take appropriate action. The Manager and Senior staff should undertake training in the Mental Capacity Act, so that they understand when there are issues around residents ability to give consent, and know what action to take. The staff and manager should promote residents confidence in the assistive bath seat, to give residents a choice in bathing facilities. Staff should be available by night, to provide a sustainable service, and ensure continued safety of residents. The mandatory training should be provided in a timely way, and further training in the particular needs of residents made available. A suitably qualified and competent manager should be registered with the Commission for Social Care Inspectionin order to assure the safe management of the home. A quality assurance system should be in place, to measure the homes achievements in meeting its aims. 2 3 3 7 4 9 5 18 6 18 7 22 8 9 27 30 10 31 11 33 Care Homes for Older People Page 26 of 27 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!