Inspection on 18/03/09 for St Davids Residential Care Home

This inspection was carried out on 18th March 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Davids Residential Care Home 11/12/07

St Davids Residential Care Home 06/03/07

St Davids Residential Care Home 23/11/05

St Davids Residential Care Home 11/04/05

St Davids Residential Care Home 24/11/04

St Davids Residential Care Home 21/06/04

Similar services:

Claremont House

Claremont House

Chesham House

Oak Ridge

Argyll House

Oliver Court

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Davids Residential Care Home 36-38 Nelson Road South Great Yarmouth Norfolk NR30 3JA     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: Janie Buchanan     Date: 1 8 0 3 2 0 0 9 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: St Davids Residential Care Home 36-38 Nelson Road South Great Yarmouth Norfolk NR30 3JA 01493842088 01493842088 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Gayatri Verma,Dr Ajit Kumar Verma care home 18 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: One (1) Service User, over the age of 65 years who has a mental disorder and is named in the Commission`s records, may be accommodated. Total number accommodated not to exceed eighteen (18). Up to eighteen (18) Older People, not falling into any other category, may be accommodated. Up to ten (10) services users, over the age of 65 years, who have dementia may be accommodated. Date of last inspection Care Homes for Older People Page 4 of 27 Over 65 10 1 18 0 0 0 Brief description of the care home St Davids is registered as a care home providing personal care and accommodation for 18 older people. The home is a three-storey building with access to the bedrooms by a shaft lift; only stairs can access two of the bedrooms. There are 12 single bedrooms and 3 shared bedrooms some of these have en-suite facilities. The communal rooms are situated on the ground and basement floors. The home is owned by Dr and Mrs Verma and it is located 100 metres from the seafront in Great Yarmouth. It is half a mile from the town centre where local shopping and amenities are found. The home has a small patio area at the front of the premises with off street parking. The weekly charge ranges from #333 TO #347 Copies of CSCI reports are available upon request from the home?s office. 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: For this inspection we (The Commission for Social Care Inspection) visited the home and spoke with the manager, three members of staff and a number of residents. We also had lunch with the residents so we could assess the quality of food and also watch how staff interacted with and helped residents. We undertook a tour of the premises to assess the environment , checked medication storage and recording, and looked at a range of the homes policies and records. We also received 19 completed questionnaires that we had sent to residents living at the home their relatives and staff working there. The home failed to send us their AQAA (annual quality assurance assessment) despite receiving a reminder letter and phone call. This is a serious breach of the regulations and we may consider taking further legal action as a result Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Contracts of residency must be issued to all residents, both funded privately and by the local authority, so that they are aware of the terms and conditions of their stay at the home. Information in these contracts must be updated to give the correct contact details of The Care Quality Commission. Information in residents care plans must be much more detailed so that staff have the guidance and information they need to provide comprehensive and consistent care to residents. Residents should be actively involved in reviewing their care plans so they have say in how there are to be looked after and so that they can agree any changes to their care routine. Records made when medicines are given residnets must be improved to demonstrate that they have been given the medicines as prescribed by their GP. Activities for residents should be more structured and better advertised around the home so that residents know what is happening and when. The complaints procedure should be made widely available to residents so that they know what to do if they want to raises any concerns they have. Information about local adult protection procedures should also be made available to residents their relatives and staff so they know who to contact if they wish to report anything. The use of communal toiletries for residents such as deodorants and shampoos should cease. Residents must have their own toiletries for their personal use. All bedroom doors must be fitted with working locking devices so that residents can lock their doors for privacy and security. The uncovered radiator in one of the bedrooms must be made safe so that the resident living there is not at risk of burning herself. A level access shower should be installed to offer residents a choice in how they wash. Proper pre-employment checks must be undertaken before anyone starts working at the home so that only the right people are employed to look after vulnerable adults. Staff should receive regular supervision so they have the chance to discuss their working practices and have their training needs identified. Care Homes for Older People Page 7 of 27 There should be regular meetings with residents so that their views can be sought about the home and so they have the chance to raise any concerns The accounting of residents monies must improve so there is a clear record of how staff have spent their money The manager needs to undertake the registered managers award so she has up to date knowledge and skills to run a home for older people. Fire doors must not be wedged open so that they can close properly in the event of a fire in the home. Regular checks must be undertaken for the emergency lighting and water temperatures to ensure their effectiveness and safety. We have made a total of nine requirements and six recommendations in light of this inspection. These must be met within the given timescales or we will consider further enforcement action. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission procedures are good ensuring prospective residents know that their needs can be met there. Evidence: The Home has a service user guide which provides good information for residents about the services on offer, the fees payable and the terms and condition of their stay there. However this guide needs to be updated and references to the National Care Standards Commission be removed as this organisation has not been in existence for many years and may confuse readers about the correct regulatory body to contact. Contracts are issued but only to self funding residents, none to those residents who are funded by their local authority and need to be so that all residents are aware of the terms and conditions of their stay at the home. Residents are assessed prior to their admission by the manager or her deputy and we viewed copies of these assessments on the plans that we checked. Prospective Care Homes for Older People Page 10 of 27 Evidence: residents are also invited to spend a day at the home so they have a chance to assess its facilities and decide if it is where they want to live. Care Homes for Older People Page 11 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. Residents health care needs are monitored but poor medication recording means there is not an accurate record of what they have received Evidence: We checked the care plans for three residents. The information they contained was variable. In one plan important information about the persons social an leisure activities, physical health, life history, mental health and nutritional needs had not been completed despite this resident having lived at the home for nearly a year and also being able to communicate her needs well. In other plans the information was far too basic to give comprehensive guidance to staff. For example in one it stated needs supervision with hygiene generally clean, this does not make explicit what kind of help is actually required , what the resident can do for themselves or what exactly generally clean means. In another it stated that the resident be put on a controlled diet but gave no detail as to how the diet was to be controlled, what the person could and couldnt eat and how it would be monitored. A lot of the information in the plans was unsigned and undated so it was impossible to tell if it was current and up to date. Not all the plans had been reviewed monthly and residents told us they had never Care Homes for Older People Page 12 of 27 Evidence: seen or read their plans of care. Residents are weighed regularly to monitor their health, a chiropodist visits the home every 8 weeks and an optical health care company visits every 6 months to check residents eyesight. We spoke with one relative following our visit who told us that staff dealt very well with her aunts mental health problems and mood swings. She told us staff seem to understand her and are very patient despite my aunt being quite demanding at times. We checked the fluid chart for one resident at risk of dehydration. The level of detail which this was completed was very poor and did not give any information about how much the person had actually drunk. Often all that was written was 1/2 tea or a few sips. Daily amounts were not ever added up making it impossible to determine if the resident had received enough liquids. Staff could not tell us how much an older person should have ideally to keep well hydrated. We checked medication storage and a sample of residents medication records. We found the following shortfalls: some tablets had not been signed as having been received so it was not possible if the amount received tallied with the actual amount sent by the pharmacist; there was no record of how many Fentanyl patches were actually in stock for one resident; on a number of occasions staff had signed to say that residents had received their medication,even though their tablets remained in the blister packs; handwritten additions to the MAR sheets had not been sighed dated or double checked by a second person to ensure their accuracy, and the date on which liquid medication bottles had been opened had not been recorded. The home has a medication policy (2003) but it contains very basic information and there is no evidence that it has regularly been reviewed to ensure it meets changes in policy and guidance. Care Homes for Older People Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides some activities to entertain and stimulate residents Evidence: Staff reported that there are activities such as bingo, music and exercises that happen but in a very ad hoc way. There is no structured plan for activities and no information about them around the home so that residents know what is happening on a particular day. There have been no planned outings for residents in the last 6 months but staff occasionally do take some residents out in wheelchairs to the seafront. One resident told us he enjoyed going to the shop every morning to buy his daily newspaper. Residents we spoke to told us that daily routines at the home were flexible and they could get up and go to bed when they wanted. Lunch on the day we visited consisted of ham, eggs and chips followed by sponge and custard. Both courses were served fully plated up: this practice is a little institutionalised and denies residents a chance to decide how much or what they want to eat. One resident who prefers to eat in her room told us: I much prefer a dry meal but am always given gravy no matter what. Other residents however told us they enjoyed their meals at the home and the food was good. One commented: if you Care Homes for Older People Page 14 of 27 Evidence: need more food you just have to ask. Lunch was generally a relaxed and sociable affair, however there was no salt and pepper on the tables for residents to season their food with. We observed one member of staff feeding a resident. This staff member stood awkwardly over the resident above her eye level and just kept putting spoonfuls into the residents mouth without explaining what was for lunch, what was on the spoon or giving any verbal prompting or reassurance at all despite this resident being blind. Care Homes for Older People Page 15 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 home has a complaints policy and residents feel able to raise their concerns. Evidence: Residents who completed our surveys and those we spoke to during out inspection told us they would raise concerns if they had any. They are given information about how to complain in the service users guide however there is no information anywhere around the home explaining the complaints procedure and what to do if residents or their relatives want to raise concerns. The home has a policy on adult protection but this is very basic and not in line with the DOHs (Department of Health) No Secrets Guidance. For example it states all reports of abuse should be investigated by the person in charge and if the suspected victim wants no action this is to be respected. These statements are contrary to what the guidance advises and if followed might not adequately protect residents. There is also no information about local procedures or who to contact if anyone wants to report their concerns. Two of the staff we spoke to confirmed that had received training in protecting vulnerable adults but one told us she hadnt received any. There has been one incident in the last year concerning the care of a resident found on the floor that was investigated by local adult protection agencies. Care Homes for Older People Page 16 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. Residents live in a homely and comfortable environment Evidence: The premises were homely clean and free from strong smells.The home does not have a garden but there is a small area out the front for residents to sit out and enjoy fresh air and sunshine. Residents we spoke to told us that they liked the environment that they lived in. One reported: I like the big windows in my room, it makes it very bright. However the layout of the home is confusing with very few signs and orientation aids to help residents find their way about. None of the bedroom doors have residents names on them and some of the locks did not work thereby denying residents privacy and security. Some areas of the home were poorly lit in the upstairs landing only one of three light bulbs was working making it very gloomy and dark for residents. There was an uncovered radiator in bedroom no 8 which was of concern as the resident in this bedroom sat very near the radiator and could easily burn herself. In one bathroom we found a number of bottles of talc , deodorants and Vaseline. One member of staff told us that these were communal items left over from deceased residents that were used for current residents. This is unacceptable as residents should have their own personal toiletries that are clearly named and only used by them. Care Homes for Older People Page 17 of 27 Evidence: Three members of staff who completed our survey told us that the home should have a shower so they could offer residents a choice in how they washed. Care Homes for Older People Page 18 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by competent staff in sufficient numbers Evidence: There are two members of staff and a manager on duty throughout the day to meet the needs of up to 18 residents, and two waking night staff on duty throughout the night. Residents told us that staff were around when they needed and that they only occasionally waited long for help. The home has a stable group of staff many of whom have worked there for a number of years. Almost all the staff have an NVQ level 2 in care. We requested to see the training and personnel files for three recently recruited members of staff. The manager had great difficulty in finding the files and in two instances was not able to produce any evidence that staff had received all mandatory training or had been recruited in a safe way. It one instance no references had been obtained for one member of staff before she had started working in the home. The manager did agree to send us staff training certificates and evidence of appropriate CRB and POVA checks the following but we have yet to receive them and can only assume they do not exist. Care Homes for Older People Page 19 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. Staff do not have their working practices reviewed reguarly and the homes health and safety systems need to better protect residents. Evidence: The manager has worked at the home for over 13 years and holds a City and Guilds Advanced Management qualification. She has not, however, completed the registered managers award and should do so to keep her management skills up to date. We did not receive the homes AQAA (annual quality assurance assessment despite a reminder letter sent to the manager and also a phone call. This information is vital for us to be able to assess the homes quality. It is also a legal requirement to provide us with the information and failing to do so is an offense under Section 31 (9) of the Care Standards Act 2000. The manager had a very basic knowledge of the national minimum standards and legal requirements and clearly relied on what she picked up at meetings with other managers rather than keeping herself up to date with important changes and guidance in care legislation. Care Homes for Older People Page 20 of 27 Evidence: Staff we interviewed told us that they did feel supported and that there were regular meetings were they could discuss any issues they had. However, staff supervision is erratic with not all of them receiving it as frequently as recommended by the minimum standards. The quality of the supervision when staff did actually receive it was very basic with no evidence that they received feedback about their working practices, that their training needs were identified or policies and procedures discussed had been discussed with them. No meetings are held with residents denying them the opportunity to raise concerns or discuss important issues affecting the home where they live. The home holds money for some residents: we checked the records for one resident and there were no clear records and receipts of all transactions. There was also a small discrepancy in the amount held and the amount spent with no explanation of why this was. We checked a number of records in relation to health and safety which showed the home regularly maintains and services its lift portable electrical equipment and gas systems. However regular temperature checks of the hot water are not undertake to check it isnt scalding for residents and the homes emergency lighting is not tested either to ensure it works properly in the event of a fire. This was raised as an issue in our report of 11 December 2007 but there has been no improvement. We spotted a number of fire doors that had been wedged open (including the managers office door) thereby preventing them from closing in the event of a fire and putting residents at risk. Care Homes for Older People Page 21 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15(2)(b) Care plans must be regularly 29/02/2008 reviewed to ensure that residents needs are monitored. Arrangements must be in place to ensure that staff receive regular recorded supervision sessions. Arrangements must be in place to ensure that appropriate fire testing is in place to protect residents and staff from harm. 29/02/2008 2 36 18(2) 3 38 23(4)(c) (v) 31/12/2007 Care Homes for Older People Page 22 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 2 5 All residents both privately and local authority funded must be issued with a contract so that they are aware of the terms and conditions of their stay at the home 01/07/2009 2 7 15 Care plans must be much more detailed and accurately reflect residents needs. Residents must be actively involved in reviewing their plans so that staff can give comprehensive and consistent care. 01/07/2009 3 8 12 Fluid charts must be much more detailed and added up every day so that there is a clear record of how much residents have drunk 01/05/2009 Care Homes for Older People Page 23 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 9 17 Medication recording and 01/05/2009 administration must improve so that there is an accurate record of what medication residents have received 5 16 13 The homes adult protection policy must be updated so that it is in line with the DOHs No Secrets Guidance and the correct procedure is followed in the event of an incident 01/06/2009 6 24 12 All bedroom doors must be fitted with workable locking devices so that residents are able to lock their doors to provide privacy and security 01/07/2009 7 25 23 Covers for radiators must be 01/07/2009 installed in residents bedrooms so that they do not risk burning themselves in the event of a fall 8 29 7 Proper pre-employment checks must be undertaken before someone starts working at the home to ensure that only the right people are employed and residents are protected 01/06/2009 Care Homes for Older People Page 24 of 27 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 9 38 23 Regular checks of the homes emergency lighting systems and water temperatures must be undertaken to ensure that these systems work effectively and keep residents safe 01/06/2009 10 38 23 Fire doors must not be wedged open so that they can close freely inthe event of fire and protect residents 01/05/2009 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. No Refer to Standard Good Practice Recommendations 1 2 1 16 Information about the home needs to be updated with the correct details of the Care Quality Commission. All residents, staff and relatives should be given information about local adult protection procedures so they know who to contact if they wish to raise any concerns. A shower should be provided so that residents choose how they would like to wash themselves The manager should undertake the registered managers award so that she has the skills and formak qualification to run a home for older people. Regular residents meetings should be held so they have a chance to raise concerns and discuss any issues affecting their home. Staff should receive formal supervision at least 6 times a year that covers all aspects of their practice and their training needs. Page 25 of 27 3 4 21 31 5 33 6 36 Care Homes for Older People Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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!