CARE HOMES FOR OLDER PEOPLE
St Bridgets 14 East Avenue Talbot Woods Bournemouth Dorset BH3 7BY Lead Inspector
Debra Jones Unannounced Inspection 25th October 2005 09:50 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 St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 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. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service St Bridgets Address 14 East Avenue Talbot Woods Bournemouth Dorset BH3 7BY 01202 291347 01202 291347 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) Mr A L Howell Mrs Joanna Ethne Hills Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home may accommodate a maximum of 2 persons in Room 23. Date of last inspection 11th May 2005 Brief Description of the Service: St Bridgets home accommodates 12 older people in need of nursing care in a large converted house. It is on a corner plot set back from the main road, in mature gardens with a small car park to the rear of the premises. The home is in the residential areas of Talbot Woods within easy reach of shops, bus routes and community facilities. The residents accommodation is arranged over the ground and first floor. A passenger lift is available between floors. Two of the bedrooms are single and 5 are double. None of the bedrooms have ensuite facilities but communal bathroom and toilet facilities are on the ground and first floor. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 2 and a half hours and was the second of the two anticipated inspections of the year. The 10 recommendations and 11 requirements made at the last inspection were followed up to see if the home had made any progress towards meeting them. Progress had been made in some areas but not in others. In addition standards not inspected at the last inspection were assessed. The Inspector looked around the building and a number of records were inspected. The Matron, and 6 of the residents were spoken to. All residents expressed contentment saying how pleased they were to be at the home. The matron and staff were praised as being caring, knowledgeable and responsive. What the service does well: What has improved since the last inspection?
The offensive odour in one room noted at previous inspections is much improved. The home is not involved in the finances of residents. The home is regularly checking their fire equipment and keeping appropriate records of this. At the last fire evacuations the home made more detailed records of what happened. The home is now complying with the Water Supply (Water Fittings) Regulations 1999.
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 6 What they could do better:
After someone from the home has carried out a pre admission assessment the home needs to confirm in writing that the home is able to meet the potential residents’ needs to give them the necessary reassurance that the home is right for them. Every resident should be issued with a statement of terms and conditions at the point of moving into the home. Generally medication is well handled at the home to promote the health and well being of residents. Where there is a choice of dose of medication the home must always record how much was actually given. The home must obtain a thermometer to monitor and record the maximum and minimum temperatures of the refrigerator they use to store medicines. The adult protection policy must be updated to acknowledge the introduction of the Protection of Vulnerable Adults list which has implications in respect of recruitment and is the list that unsuitable staff should be referred to as appropriate. Staff must be trained in this area to ensure the protection of residents. As there are a number of issues in respect of the premises that are being brought to the attention of the registered people, not for the first time, the owner is required to prepare a plan as to how they are to be addressed. These include minimising the risk of harm to residents from hot radiators and pipework, and hot water from hand basins. All bedrooms must be fully curtained. It would be good if the home would consider refurbishing the upstairs bathroom which is currently not used by residents. It would also be good if the home got someone who had the right professional training to carry an assessment of the premises to confirm that it was suitable for the people living there. Criminal Record Bureau disclosures and POVA checks must be completed for all staff employed at the home, and proof of the person’s identification obtained. This is to protect residents from unsuitable staff potentially working at the home. Documentation must also be in place to show that staff from abroad have the right to be in this country and to work at the home. It would be good if more care staff had an NVQ level 2 qualification in care. This would make care staff more knowledgeable about the job they do and potentially improve the quality of care delivered to residents at the home. Staff also need to have training regularly to ensure that they can do their jobs well. Some training is mandatory and currently not all staff are up to date. Given that the number of requirements has gone up at this inspection and limited progress has been made to address requirements and recommendations made at previous inspections it would be good if the
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 7 manager was given the support to address the shortfalls identified in this report. The home carries out surveys of residents’ views every year and also asks other people that visit the home what they think in order to improve services for the residents. It would be good if the home would pull all the responses together and write a report about what they have found. Staff are supervised on a daily basis but it would be good if staff had the opportunity to sit down with their manager 6 times a year to talk about their work and what training they need to do their jobs better and provide a better service to the residents. Records should be made of any supervision meetings. All staff are to be fire trained at regular and specific intervals to protect residents in the event of a fire breaking out in the home. An external contractor carries out checks of the fire equipment every 3 months. The certificates issued by the contractor must be kept and be available for inspection. These certificates provide reassurance that the fire equipment has been checked and that any work that needed doing as a result of the check has been done. 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. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 8 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 St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 4. (Standards 1, 3 & 5 were met at the last inspection. 6 does not apply). The home does not assure prospective residents in writing that their needs can be met and terms and conditions / contracts have not been issued to new residents. EVIDENCE: At the last inspection it was noted that whilst the home clearly gathers all the information they need to decide if they can provide care for a prospective resident this assessed ability to care is not confirmed to the prospective resident in writing. The home have devised a standard letter to send to prospective residents that have been assessed as suitable for the home but it has not been used yet even though residents have moved into the home in the last few months. New residents have also not been issued with contracts. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 & 9. (Standards 7 and 10 were met at the last inspection) The health needs of the residents are well met with evidence of good support from community health professionals. The medication at this home is generally well managed promoting the good health and well being of residents. EVIDENCE: It was clear from discussions with the matron and from documentation on file that residents have access to health services in the community. There was evidence to show that residents get support from General Practitioners when they need it. The home was also working with the tissue viability nurse in respect of the care of one resident and looking at the important relationship that nutrition plays in improving health. Information about conditions that residents suffer with is available for staff and pertinent policies are helpfully placed on files to remind staff of how they are to do things e.g. oxygen policy. Residents spoke positively about the health care they received at the home and the contribution that staff at the home made to their well-being.
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 11 A robust system for the ordering, administering and recording of medication is in place at the home. Medication at the home is only administered by the qualified staff who are all confident in carrying out this task. Medication records sampled were up to date and properly completed with the exception of where there is a choice of dose e.g. where the prescription says ‘one or two to be taken’ x times a day when required’ it was clear how many times a day medication was administered but it was not always clear how many were being taken each time. Staff record the date that medicines are opened/ brought into use. Medicines and dressings were tidily stored in appropriate places e.g. the medication cupboards and the trolley. The maximum and minimum temperature of the fridge used to store medication is not currently monitored – the actual temperature is. Only flu vaccines are being stored there at present. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14. (Standards 13 and 15 were met at the last inspection). Some social activities are available in the home and residents are able to make choices as to whether they take part in them or spend their days in pursuit of individual interests. Residents are helped and encouraged to exercise choice in their daily lives at the home. EVIDENCE: As part of the assessment process residents are asked about their interests, hobbies, social and family networks and religious needs. These are then catered for when people move into the home. The home organises some activities in the home, there is a regular exercise class and occasionally entertainers come to the home. Over the summer the home hosted a summer party for residents, their relatives and residents from their sister residential home. Residents can choose whether to join in with organised events or not. Residents have radios and televisions as they wish. Daily papers are available. The library service visits. A local priest regularly comes to the home to administer communion. The hairdresser was visiting on the day of inspection.
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 13 On the ground floor there is are two lounges giving residents choice as to where they spend their days if they wish to come out of their rooms. Residents are encouraged and supported in making choices about their daily lives. They are able to get up and go back to bed when they wish; have what they want to eat and drink, where and when they want it; spend time in the communal areas / their bedrooms as they choose; do as they wish in the day and see visitors as it suits them. Staff are made aware of the importance of respecting the individuality of residents at their induction. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 (Standards 16 and 17 were met at the last inspection). The home’s adult protection policy demonstrates an understanding of abuse and of how residents are protected, but needs updating in light of the Protection of Vulnerable Adults list. Residents would benefit from all staff being trained in adult protection matters. EVIDENCE: The home has an adult protection policy to guide staff as to how to recognise signs of abuse and to tell them what to do about it if they do. The policy has not been updated since the implementation of the Protection of Vulnerable Adults list which has implications in respect of the recruitment of staff and the potential referral of unsuitable staff to the list. Records showed that a significant number of staff had not had abuse training at the home. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21,22,25 and 26. (Standard 23 was met at the last inspection). Adequate facilities are available to meet the number of the current residents. Residents enjoy living in a clean and pleasant smelling home. Some progress has been made to ensure that the home is suitable and safe for residents. EVIDENCE: The home is decorated in a homely way, although remains décor and some furnishings are ‘tired’. Communal facilities are spacious for the number of people living at the home with a dining / lounge area and an additional large lounge being available. Residents’ bedrooms are adequately furnished but some of the furniture is in need of repair/ replacement. Some residents have brought in personal possessions into the home with them. There are an adequate number of communal bathrooms and toilets, with aids and adaptations, available in the home for the number of residents living there. The bath in the first floor bathroom is not used and ideally this bathroom would contain a facility more useful to staff and residents e.g. a shower. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 16 A programme of routine maintenance and renewal of the fabric and decoration of the premises has not been produced. The home has not been assessed by qualified persons, including an occupational therapist. One bedroom has a number of windows. One smaller side window has only net curtains. A full curtain to block out the light should be fitted so the resident can choose if they wish it to be open or not. The temperature of the water in the baths is controlled but not the hand basins in residents’ bedrooms or the communal bathrooms. In respect of this it has been required at previous inspections that to prevent risks from scalding pre set valves, of a type unaffected by changed in water pressure and which have fail safe devices, be fitted to provide hot water close to 34 degrees centigrade. This has not been done. There are a number of radiators that are not covered in the home. The risk to residents is minimised by the positioning of furniture but the risk remains and needs to be addressed. The matron said that some covers had been purchased but not fitted. Progress has been made in eradicating the offensive odour in one bedroom mentioned at previous inspections. The rest of the home remains clean and odour free. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29 and 30 (Standard 27 was met at the last inspection). Limited progress has been made in the standard of vetting and recruitment with appropriate checks not being carried out potentially leaving residents at risk from unsuitable staff working at the home. Gaps in staff training leave residents at some risk. EVIDENCE: At the last inspection it was noted that the home employs some workers from abroad. When checked it was seen that some files contained the right sort of information about people’s rights to work in the country and any restrictions on that work, but not all. The home was advised to get hold of a recent publication issued by the Home Office to inform them of the documents they need to see and copy before they employ foreign nationals. This guidance should also be reflected in the recruitment procedure. The procedure could also include the guidance offered by the previous inspector in respect of verifying written references, not accepting testimonials and being vigilant about the type of referees provided. This has not been done and the requirements and recommendations are repeated. Staff files are kept for staff and at previous inspections it has been noted that much of the information required in law is on file. The two files sampled of staff new to the home did not contain all the information and copies of documents required e.g. files lacked CRBs and POVA 1st checks. One file showed that the staff member had a visa entitling her to be in the country but this was out of date.
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 18 Not all staff have been issued with contracts of employment. Out of the 9 health care assistants employed at the home 4 members of care staff are doing NVQ level 2 in care and 4 other staff are hoping to start the course in the New Year. Information held about staff training showed that staff have access to training such as emergency aid, health and safety, food hygiene, moving and handling and abuse. Records showed that not all staff had had the basic training that they need or that staff were up to date with mandatory training / refreshers. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38. The matron is capable of managing the daily care of the residents well but the number of shortfalls identified in this report and recent reports indicate management failings that if not addressed will potentially adversely affect the care and well being of the residents. Records still do not demonstrate that residents would be safe in the event of a fire breaking out. EVIDENCE: The home is managed by Jo Hills who is an experienced nurse and manager. Ms Hill has a hands on approach to her job and this has a positive impact on the home in that she leads staff by example and residents know her well and speak highly of her. The annual quality assurance survey and report have not yet been completed this year. Once done this report can then be circulated to any interested parties.
St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 20 The home is not handling any money belonging to residents. Staff are supervised on a daily basis but the formal supervisions are not yet at the desired regularity. Staff meetings take place every 5-6 months. The period that the insurance certificate on display covered had expired. Fire records were in place and internal checks are being carried out at the required regularity. An external company carries out quarterly checks. Although there was evidence of some of these visits (most recently May 05) not all certificates for even the last 12 months were available, as they should have been, at the inspection. Fire training records for staff did not show that all staff had had fire training at the required intervals. Records made of the last fire evacuation contained appropriate information in the right level of detail about what happened at the evacuation, when it took place, who took part and how long it took. The home has been inspected by the water board to see if they complied with the Water Supply (Water Fittings) Regulations 1999 and a letter was seen confirming that they had. St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 21 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 2 x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 4 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 2 x 2 2 x 2 1 3 STAFFING Standard No Score 27 x 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 2 x 2 St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4 Regulation 14 Requirement The registered person must confirm in writing to the resident that having regard to the assessment the care home is suitable for the purpose of meeting their needs in respect of health and welfare. (previous timescale 1/7/05) The home must obtain a thermometer to monitor and record the maximum and minimum temperatures (normal range 2-8°C) of the refrigerator, used to store medicines, daily when in use. When the dose varies the actual dose given must be recorded on the medicine record chart. The adult protection policy must be updated to include details of procedures for referring staff to POVA (Protection of Vulnerable Adults) list when required. A plan as to how the requirements and recommendations in respect of the premises, made in this and previous reports, are to be addressed must be produced.
DS0000020497.V261560.R01.S.doc Timescale for action 01/11/05 2. OP9 13(2) 01/12/05 3. 4. OP9 OP18 17 (1) (a) 19 01/11/05 01/04/06 5. OP19 23 (2) 01/12/05 St Bridgets Version 5.0 Page 23 6. 7. OP24 OP25 16 13 8. OP25 13 9. OP29 19 10. OP29 19 11. OP29 19 12. OP30 18 13. OP38 23 14. OP38 23 All external bedroom windows must be fitted with curtains (not just nets). To prevent risks from scalding the temperature of water must be controlled, in hand basins that could be used by residents, to about 43 degrees centigrade. (previous timescale of 31/3/05 not met) Where residents are at risk of harm through contact with radiators and pipework this must be addressed e.g. by them being covered or replaced by low surface temperature heat emitters. All staff records required by law must be held on file i.e. proof of identification, CRB disclosures and POVA and POVA 1st checks. (previous timescale 1.7.05) Documentation for foreign nationals must be in place to demonstrate that they are allowed to work in the home. (previous timescale of 31/12/04 not met) All staff should be issued with contracts of employment. (previous timescale of 31/3/05 not met) The registered person must ensure that staff working at the home receive training appropriate to the work they are to perform. Staff fire training must take place at the required intervals i.e. 3 months for night staff and 6 months for day staff and records be kept. (previous timescale 1/6/05) External checks of fire equipment must take place every 3 months and the certificates issued by the contractor made available for inspection.
DS0000020497.V261560.R01.S.doc 01/12/05 01/12/05 01/12/05 01/12/05 01/12/05 01/12/05 01/04/06 01/11/05 01/11/05 St Bridgets Version 5.0 Page 24 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. 3. 4. 5. 6. Refer to Standard OP2 OP21 OP22 OP28 OP29 OP29 Good Practice Recommendations Each resident should be provided with a statement of terms and conditions at the point of moving into the home. It is recommended that consideration be given to the refurbishment of the upstairs bathroom to ensure the facilities in the home meet the needs of residents. It is recommended that an assessment of the premises be undertaken by qualified persons, including an occupational therapist. It is recommended that 50 of care staff achieve NVQ level 2. It is recommended that recruitment procedures are updated in line with the Home Office guidance for employers to prevent illegal working. It is recommended that recruitment procedures are reviewed in respect of verifying prospective staff references e.g. verifying written references, not accepting testimonials and being vigilant about the type of referees provided. It is recommended that the manager be given sufficient support to be able to comply with the requirements and recommendations listed in this report. It is recommended that results from quality assurance surveys be analysed and a report be compiled. It is recommended that care and qualified staff receive formal supervision 6 times a year. 7. 8. 9. OP31 OP33 OP36 St Bridgets DS0000020497.V261560.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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