Inspection on 30/05/07 for Stuart House

This inspection was carried out on 30th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Stuart House 147 London Road Worcester Worcestershire WR5 2ED Lead Inspector Debra Lewis Key Unannounced Inspection 30th May 2007 09:45 Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stuart House Address 147 London Road Worcester Worcestershire WR5 2ED 01905 360140 01905 352116 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) www.shaw.co.uk Shaw Healthcare (Ledbury) Limited Darren William Goodwin Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22.5.06 Brief Description of the Service: Stuart House is registered as a home for 5 adults with mental health care needs and/or a degree of learning disability, some of whom may have associated complex needs and behaviours. It provides accommodation in 5 separate self-contained flats, with some shared facilities as well. It aims to provide support in daily life, within a safe and structured environment; to assist people to become as independent as possible; and to provide opportunities and develop skills. A variety of approaches to care and support are used, according to individual needs; a person-centred approach is used. The home is in a residential area of Worcester, within a mile of the city centre, and has access to local shops and facilities. The registered provider is Shaw Healthcare (Ledbury) Ltd. The responsible individual within Shaw is Mr Peter Nixey. Mr Darren Goodwin has been the manager of the home since August 2005 and was registered with CSCI in April 2006. Information about the home is available in a statement of purpose and a service users’ guide. The home’s current charges are £ 1343.20 to £1677.47. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first inspection of 2007-8. It was a Key Inspection. This means that the inspector checked all of the standards which have most impact on service users. This report includes findings from the visit to the home, as well as any relevant information that has been received about the home since the last inspection. This includes details from a report on the home provided by the registered manager. The inspector was in the home from 9.45 a.m. until early evening. The inspector met and talked with 3 of the 5 service users; with several staff on duty; and with the registered manager. Improvements were noted since the last inspection, and there were no major concerns. What the service does well: The home finds out about people’s needs before they move in, so they can give people the care they need. The home helps people living in the home with all individual needs, including religion and sexuality. Staff in the home know exactly what care people need. People living in the home make their own decisions. People living in the home can live an ordinary life, with some risk involved. People living in the home lead active lives, including working and training, when they want this. They choose their own activities. Staff help them if they need help. The home does not have rules, except what is needed to keep the home safe for everyone. People living in the home have ordinary family and personal relationships. People living in the home choose and make their own food. Staff give support if it is needed. Staff give people the help they need with health care and with looking after themselves. People living in the home feel they can talk to staff about problems. Staff know what to do if someone needs to be protected from harm The home provides a very good flat for each person to live in. people living in the home arrange and decorate their flats how they like. The flats are good places to learn about more independent living. The home is clean and well kept. There are enough staff in the home to give people the help they need. People living in the home generally like the staff. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 6 People living in the home, and staff, like the manager of the home. He is an experienced and qualified manager. Shaw does regular checks on the home to make sure a good quality service is given to people living in the home. The home is kept safe for people living there. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home makes sure it is clear about what care people need before they move in, so the home can give the care that is needed by each person. EVIDENCE: The inspector saw a copy of the home’s statement of purpose, and advised that it should be reviewed to ensure it was clear about the home’s purpose, i.e. whether they are providing a home for life, or a rehabilitation service. It was not fully checked but had included all relevant details when last inspected. Full assessments had been done before anyone moved into the home. Service user plans contained updated details of their needs. Some people living in the home were having their needs reassessed by care managers (social workers) with a view to moving on to more independent accommodation. The registered manager had been actively seeking the involvement of care managers in order to assess how best to meet the changing needs of people living in the home. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff work with people living in the home to develop plans for their care, which are detailed and up to date, so people get the care they need. People living in the home are able to take part in ordinary daily activities, which may involve some risk; the home monitors risks and reduces risks where possible. People living in the home make their own decisions, with support and advice from staff if needed. EVIDENCE: The inspector sampled service user plans and risk assessments, and talked to people living in the home and staff. Service user plans were detailed and up to date, and had input from people living in the home. Some were signed and others had been written partly by the person who owned the plans. People living in the home confirmed that they had input to their plans. They were being reviewed monthly. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 10 Risk assessments were in place for risky activities / behaviours, and were being reviewed monthly. People living in the home were able to undertake ordinary activities, which may include some risks, while the home took action to reduce risks as far as possible without being unnecessarily restrictive on people’s lives. Challenging behaviours were monitored and recorded, with details of what may be causes or triggers for the person’s behaviour. People living in the home were clear that they chose what they did, albeit sometimes with advice or support from staff. One person had begun to feel staff interfered too much at times, but the situation discussed was something with a potential negative impact on other people in the home. This person wanted more independence and the home was working with them towards this aim. The inspector advised that in some cases service user plans would benefit from recording more exact details e.g. of the frequency of a particular activity or staff input. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have good access to the community and to a range of activities of their choice. They get support with relationships and with healthy lifestyles. They make their own choices about everyday life and their rights are respected by staff. EVIDENCE: People living in the home have varying needs and levels of motivation, so their lifestyles vary widely. In general they are quite independent. The home encourages people living in the home to develop skills e.g. by attending food hygiene training. Some people had attended college for varying courses including IT and creative arts. One person was soon to take part in a dance performance. Another person needed support in the home with independent living skills such as cooking and cleaning. Staff worked daily with this person to maintain and develop skills. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 12 Everyone living in the home took part in ordinary activities as part of the community, for example using colleges, sports centres, shops, and restaurants. The home has good access to local facilities. Family involvement was evident. People living in the home described family visits and the staff described working closely with some relatives when the need arose for close liaison. Personal relationships were supported, and if necessary the home obtained specialist advice and support for individuals, relating to sexual health and behaviour. Daily routines in the home were discussed with people living in the home and staff, and were observed. Independence was respected and there were no restrictions, other than those necessary for health and welfare of the people living in the home. People living in the home mainly chose, bought and prepared their own food. Staff monitored whether their diets were healthy and, if necessary, they provided help with cooking skills. One person needed specific professional advice and support with choosing a healthy diet. Staff worked with this person to encourage healthy choices, and a community nurse had also worked with this person for several months to improve their diet. The home was maintaining a fine balance between allowing the person to act and live independently, while still encouraging a healthier lifestyle. Change was being gradually achieved. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home get the help they need with personal care and with health care needs. Staff mostly handle their medication safely, although some improvement is needed with how medications are managed. EVIDENCE: The inspector sampled service user plans and talked to staff and people living in the home. Service user plans contained up to date details of the care needed by people living in the home. This included personal support, such as encouragement with personal hygiene, and healthcare support, such as assistance from staff and from a community nurse with developing a healthy lifestyle (diet and exercise). Records were kept of healthcare appointments, including consultants’ reviews. The inspector saw staff tactfully encouraging someone who lived in the home with their personal hygiene, an approach that worked. Risks associated with health were assessed and reduced where possible. Guidelines for staff were updated regularly. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 14 Medication was mostly being well managed, but the inspector noted some areas for improvement. The instructions on MAR charts (medication administration records) needed to be clearer. For example, some instructions had been hand written, but had not been signed by a doctor or by senior staff, as previously recommended, to ensure the entry is authorised by an appropriate person. A discontinued medication, and another medication which was not for regular use but only for use “as required”, had not been marked as such on the MAR charts, which could potentially lead to unnecessary medication being given. Staff had been using 3 different bottles of one person’s laxative medication, rather than using and finishing one at a time in order to ensure medication in use was within date. Guidelines for one person’s “as required” medication were found on the home’s computer, but the inspector advised that they should be readily accessible to staff when giving out medication. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are ready to listen to complaints or concerns, and people living in the home feel they can tell staff of any problems. Staff know what to do if there are concerns about possible abuse, so that people living in the home are properly protected. EVIDENCE: People living in the home said they would be able to talk to staff, especially the manager, about any concerns they had. An easy read complaints procedure had been made available to people living in the home. The home’s policy was suitable and was being used at the time of inspection. The home had received a complaint and had been investigating it appropriately, including meeting with the complainant. CSCI had not received any complaints about the home during the past year. Staff at the home were aware of adult protection procedures. Most had received training in 2006, but 3 needed updates. The home’s policy was suitable. An easy-read guide to “dealing with abuse” was available for people living in the home. The inspector sampled records of money held by staff on behalf of people living in the home. The records were clear and well kept, signed by the person who lived in the home and by 2 staff. Shaw carried out regular audits on finances as a further safeguard. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each person living in the home has his or her own individual selfcontained flat. The home is kept hygienic and well maintained. EVIDENCE: The home provided excellent individual flats for service users, which were well furnished and maintained. Each was clearly individual. They were ideal for learning independent living skills. No specialist equipment was needed. People living in the home were no longer spending much time in the office, and said they were able to use the shared lounge – although use of this room was sometimes discouraged in response to conflicts arising. It was a fairly cramped space. The home had a very small back yard. Again space is very limited, but good use has been made of this area so it is a pleasant place to spend time. The home was clean and hygienic on the day of the inspection. Staff worked with service users, if needed, to maintain their flats. One person in particular needed support and the inspector noted that his flat was clean and tidy. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has enough staff and people living in the home like them. Staff have basic training, but need more training specific to mental health, to ensure that the best service is provided to people living in the home. The home usually carries out proper checks before new staff work in the home, but does not always have full records of these checks. Staff supervision is not frequent enough. EVIDENCE: Staffing levels were sufficient to allow staff to give individual support as needed. The home did not have the required minimum of 50 of care staff trained to NVQ level 2 in care. Only 2 of the 13 care staff held a NVQ, at level 3, which is higher than level 2. 7 more had started this training and were aiming to be qualified by the end of 2007. The inspector was told that there had been a problem in accessing this training, which had now been addressed by the registered provider. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 18 Service users had generally positive feelings about staff, although one person wanting a more independent placement felt that staff interfered too much at times. The situation discussed had a potential negative impact on other people living in the home if staff had not intervened. There was evidence that service users were normally protected by proper checks on care staff, but not all evidence was available; one staff member did not have 2 written references. The home had a training plan and staff received regular training. However there were some gaps. Staff had still not done any training specific to mental health. Some had been planned for 2006 and was still being investigated for 2007 to cover areas such as dual diagnosis, autistic spectrum disorders and challenging behaviour, but the registered manager had so far been unable to access suitable training. Staff supervision had not been taking place at the required minimum frequency of 6 times annually. The registered manager was still trying to get this up to date and had recently carried out supervision sessions, but was being hampered by the fact that he was responsible for supervising the whole team; Team Leaders were not doing any supervision. It was hoped that Team Leaders would be able to get suitable training in supervision to enable them to share this work with the registered manager. The registered manager had made positive use of supervision in order to establish a consistent approach to working with people living in the home. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good manager. The provider has a working quality assurance system. Health and safety is well managed in the home. EVIDENCE: Staff and people living in the home like the registered manager and describe him as “good, approachable, and very knowledgeable”. He had suitable qualifications and experience to manage the home. He has so far been unable to access specialist mental health training. He had been working in the home for nearly 2 years. He had been prompt in returning required information to the Commission within a shorter than usual timescale. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 20 A quality assurance system was in place, including an internal audit of all systems and interviews with service users. The registered manager provided a copy of the resulting report, which included an action plan which was in progress. The home is also working towards Investors in People accreditation. Fire safety tests and drills were up to date. Records of staff training still did not show whether they had attended the required 4 training sessions annually (only the latest date was shown). Risk assessments were in place as recommended by the NMS (national minimum standards) and were up to date. Health and safety monthly audits were being carried out and were up to date. Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 4 27 4 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Please note that previous requirements have been revised in order to focus on those breaches of regulations that are most likely to lead to enforcement action. 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 YA34 Regulation 17, 19 Requirement Full records must be in place to show that all proper preemployment checks have been carried out on all staff. Specifically there must be records kept in the home of matters detailed in Schedule 4. This is in order to reduce the risk of the home employing unsuitable staff. (Previous timescale of 30/06/06 not met) 2 YA35 18 All staff must receive the training 31/12/07 needed for their work, including training in how to respond appropriately to potentially aggressive situations, mental health training and food hygiene. This is in order to ensure staff give the care needed by people living in the home. (Previous timescale of 31/08/06 not met) Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 23 Timescale for action 31/08/07 3 YA36 18 Staff must have formal supervision at least 6 times a year. This will help monitor staff practice and maintain consistency in the care given to people living in the home. (Previous timescale of 31/01/06 not met) 31/08/07 4 YA42 13 Staff must have fire safety training at a frequency of 4 times per year. This is to ensure they take the correct course of action to best protect people living in the home, in case of fire. (Previous timescales of 31/03/06 and 30/06/06 not met) 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The registered manager should review the home’s statement of purpose to ensure it is up to date and still accurately describes the home’s purpose. A copy should be provided to CSCI when complete. Service user plans could in some cases be improved by the inclusion of more specific details e.g. frequency of interventions. This should be considered when plans are next reviewed. All relevant professionals should be kept aware of ongoing concerns about any aspect of the lives of people living in the home. DS0000067997.V341049.R01.S.doc Version 5.2 Page 24 2 YA6 3 YA15 Stuart House 4 YA20 The home should develop a strategy for enabling service users to take control of their own medication, where possible. (Repeated from December 2005) It is strongly recommended that hand written MAR charts are checked and signed by two members of staff. (Repeated from December 2005) Instructions on MAR charts should be clear and accurate at all times to ensure that staff are clear about exactly which medication is needed at any time. Guidelines for the use of “as required” medications should be immediately accessible to staff when they are giving out medication, to ensure they can be confident whether the medication is required or not. Staff should be provided with sufficient storage space. (Repeated from May 2006, not checked at this inspection) Arrangements should be made to ensure that the required 50 of staff achieve their NVQs, and that this situation once achieved is maintained. The Team Leaders should undertake training in staff supervision to enable them to do this work. The registered manager should undertake appropriate training in mental health. 5 YA20 6 YA20 7 YA20 8 9 YA28 YA32 10 11 YA36 YA37 Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office The Coach House John Comyn Drive Perdiswell Park Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stuart House DS0000067997.V341049.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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