Inspection on 13/09/07 for The Dolphins

This inspection was carried out on 13th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Dolphins 18/04/06

The Dolphins 03/01/06

The Dolphins 06/09/05

The Dolphins 15/03/05

The Dolphins 23/07/04

The Dolphins 27/01/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Dolphins 32 Aylesbury Road Thame Oxfordshire OX9 3AW Lead Inspector Robert Dawes Unannounced Inspection 13th September 2007 10:15 The Dolphins DS0000013077.V348402.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 The Dolphins DS0000013077.V348402.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. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Dolphins Address 32 Aylesbury Road Thame Oxfordshire OX9 3AW 01844 212463 01844 212463 haroon@caretech-uk.com 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) Caretech Community Services Limited vacant Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 6. 18th April 2006 Date of last inspection Brief Description of the Service: The Dolphins is a large detached house with gardens situated in Thame, Oxfordshire. It is registered to provide 24 hr care and support for up to six people with a learning disability. It is run and managed by CareTech Community Services, an organisation with experience in supporting people with learning disabilities. The fee for this service is currently £1056.70 per week. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced site visit, which took place during the day on the 13th September 2007. The Annual Quality Assurance Assessment, three surveys from relatives and one survey from a health professional were returned to the inspector before the site visit. These, together with the site visit, were the main sources of information for the key inspection. During the site visit the inspector interviewed a senior support worker and a support worker; toured the premises; looked at records; case tracked; and observed the interaction between clients and staff. The deputy manager was on leave. No service users were spoken with because of communication difficulties. Twenty three standards were assessed during the site visit of which seventeen were met, four were nearly met and two were not met. Three requirements and five recommendations were made. What the service does well: What has improved since the last inspection? Person centred planning in pictorial format has almost been completed; the manager and staff have started using picture folders to assist residents communicate their views and make decisions about their lives; staff have received training on different techniques to enable residents to communicate more effectively; a relative said the home helps his relative keep in touch with him and is keeping him up to date with important issues about his relative better than they used to; the personal care has improved; and the home is now well decorated, clean and hygienic. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 6 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. The Dolphins DS0000013077.V348402.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 The Dolphins DS0000013077.V348402.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): Standard 2. People who use the service experience good quality outcomes in this area. An admission policy and procedure is in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All five residents were admitted to the home in 1993 so no recent pre admission assessments could be looked at. The home has an admission policy and procedure. The Dolphins DS0000013077.V348402.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): Standards 6, 7 and 9. People who use the service experience good quality outcomes in this area. Residents have an individual care plan, which is person centred and reflects their diverse needs. They are enabled and encouraged to lead as independent lives as possible. Staff are learning techniques and introducing communication tools to enable residents to make decisions about their daily lives more effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the three residents’ files looked at contained comprehensive and detailed individual care plans. They have been reviewed annually with the resident, relatives and professionals and internally in between. Person centred planning in pictorial format has almost been completed. In reply to the question in the relatives’ survey ‘does the care service support people to live the life they choose?’ one relative replied ‘always’ and one replied ‘usually’. In reply to the question in the relatives’ survey ‘do you or your relative get enough information about the care home to help make decisions?’ one The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 10 relative replied ‘always’, one replied ‘usually’ and one replied ‘sometimes, but things improving’. All of the residents have significant difficulties in communication. The manager and staff have started using picture folders to assist residents communicate their views and make decisions about their lives, i.e. meals, indoor and outdoor activities. Residents have chosen the pictures for the lounge and the colour of their rooms. A speech and language therapist has given training to staff on different techniques to enable residents to communicate more effectively. Residents meet with their key workers at regular intervals to express their views about their care. A resident with no contact with his relatives has an advocate. The residents’ capabilities are very limited but they are encouraged and enabled to be as independent as possible i.e. those who are able are supported to make hot drinks and prepare their own meals. Appropriate up to date risk assessments are in place. The Dolphins DS0000013077.V348402.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): Standards 12, 13, 15, 16 and 17. People who use the service experience adequate quality outcomes in this area. The range of appropriate activities and opportunities to access community facilities offered to residents needs to be improved. Residents are enabled to keep in touch with their families and friends; their rights are respected and responsibilities recognised in their daily lives; and they enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Due to the lack of funding for day centre places and the restrictions in taking residents individually to facilities in the community because of their high dependency needs, they spend a high proportion of their time in the home. To provide a sufficient range of appropriate and stimulating activities has proved difficult. The staff team has been trying to increase the range of activities available to residents. An activity chart on a notice board showed activities such as a karaoke evening, walks to the village and market, foot spas, listening to music, bingo, craft sessions, playing instruments, shopping, lunch out, drive to coffee shop and bowling were being offered to residents. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 12 The daily diaries showed the participation of some of the residents has been very limited, either nothing was recorded for several days or the activities consisted of walks, listening to music, drives, shopping or lunches out. Two residents go bowling once a week and one resident goes swimming once a week. The deputy manager is applying for residents to attend appropriate college courses and arranging for horse riding and water massages to be accessible. Staff said there is a need for sensory facilities either in the home or easily accessible in the community. All the residents have gone out together for several outings this summer. Staff support residents to maintain family links. In response to the question in the relatives’ survey ‘does the care home help your relative to keep in touch with you?’ two replied ‘always’ and one replied ‘sometimes with the comment ‘improving’. In response to the question in the relatives’ survey ‘ are you kept up to date with important issues affecting your relative?’ two replied ‘always’ and one replied ‘sometimes’ with the comment ‘improving’. Residents were observed to move freely around the home, except other people’s bedrooms. Residents can choose to be alone. Residents have keys to their own rooms. Residents are encouraged and supported to help with simple tasks around the house such as loading the washing machine and dishwasher. In response to the question in the health professional’s survey ‘does the care service respect individuals’ privacy and dignity?’ the health professional replied ‘usually’. Staff were observed interacting with residents and not exclusively with each other. Residents have a choice at meal times. If residents are unable to communicate their likes and dislikes staff observe and use a picture folder to ensure residents eat what they prefer. A dietician visits the home to advise staff on nutrition and balanced diets. A speech and language therapist has trained staff in eating and drinking techniques so that a resident, who has to have his meals blended, can be appropriately assisted. Staff assist residents, who are able, to prepare meals. The health professional commented in the survey ‘not sure that enough attention is given to meal preparation and nutrition matters generally’. The Dolphins DS0000013077.V348402.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): Standards 18, 19 and 20. People who use the service experience good quality outcomes in this area. People who use the service receive personal support in the way they prefer and require; their physical and emotional health needs are generally well met; and they are protected by the home’s medication procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has individual support plans covering how they should be moved and supported. Staff said residents have the technical aids and equipment they need for maximum independence. The female resident receives personal care from only female members of staff. Times for getting up and going to bed are flexible. Residents choose their own clothes and looked clean and presentable. In response to the question in the relatives’ survey ‘do you feel that the care home meets the needs of your relative?’ two relatives replied ‘always’ and one replied ‘usually’. In response to the question in the relatives’ survey ‘does the care home give the support to your relative that you expect?’ one relative replied ‘always’, one replied ‘usually’ and one replied ‘sometimes’ commenting ‘we had concerns over personal care but it is better now’. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 14 Records showed all residents have regular health checks with their GP, optician and dentist. All residents have health action plans which cover areas such as weight, food intake and seizures. All appointments with health professionals are recorded. Two residents used to have regular physiotherapy but this has now stopped. A resident who was self harming was referred to the community psychiatric unit. In response to the question in the health professional’s survey ‘does the care service seek advice and act upon it to manage and improve individuals’ health care needs?’ the health professional replied ‘sometimes’, and commented ‘there seem to be helpful staff but not enough long term staff who know the clients well’. In response to the question in the health professional’s survey ‘are the individuals’ health care needs met by the care service?’ the health professional replied ‘usually’. None of the service users self-administer their medication. No controlled drugs are on the premises. The medication administration records were in order. Only trained staff administer the medication. Appropriate medication policies and procedures are in place. A pharmacist visited the home in August 2007 to inspect the storage, administration, recording and disposal of the medication. Any recommendations made were responded to appropriately. The Dolphins DS0000013077.V348402.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): Standards 22 and 23. People who use the service experience good quality outcomes in this area. People who use the service feel their views are listened to and acted on; and are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive complaints procedure as well as a pictorial complaints process for residents. The residents have very limited verbal skills and would find it difficult to complain directly. Permanent staff are clear on observing behaviour and interpreting its meaning and this is reinforced by weekly one to one talks between a resident and his/her key worker. Complaints received by the home have been responded to appropriately. No complaints to the Commission have been made since the last inspection. In response to the question in the relatives’ survey ‘do you know how to make a complaint?’ two relatives replied ‘yes’ and one replied ‘I have never been given any information about making a formal compliant’. In response to the question ‘has the care service responded appropriately if you or the person using the care service has raised concerns about their care?’ two relatives replied ‘always’ and one replied ‘recent concerns have been acted upon’. The home has a clear protection from abuse policy. Staff have received safeguarding vulnerable adults training. Each resident has an individual bank account. A member of senior management regularly audits residents’ finances, which are managed by the home. The Dolphins DS0000013077.V348402.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): Standards 24 and 30. People who use the service experience good quality outcomes in this area. The home is comfortable, safe and well maintained. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been a significant improvement in the condition of the home. It is now well decorated, safe, clean and hygienic. New carpets and furniture have been purchased where required. The Dolphins DS0000013077.V348402.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): Standards 32, 33, 34 and 35. People who use the service experience adequate quality outcomes in this area. An effective, competent and qualified permanent staff team, who are appropriately trained, support the residents fairly, without discrimination and in a caring manner. However, a significant number of care hours are covered by agency staff resulting on occasions staff being on duty who do not know the residents very well and are not aware of their needs and conditions. Residents are not protected by the organisation’s recruit procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff interviewed had good understanding of the residents’ needs and conditions. Staff said the standard of care has improved over last six to nine months. In response to the question in the health professionals survey ‘do the care staff have the right skills and experience to support individual’s social and health care needs?’ the health professional replied ‘sometimes’ and commented ‘I doubt many of them have much experience. There seem to be helpful staff but not enough long term staff who know the clients well’. In response to the question in the health professionals survey ‘what do you feel the care service does well?’ the health professional said ‘it is not as good The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 18 as 5/6 years ago. There is no feeling of unity. Make the staff happier so they stay which will benefit the clients’. In response to the question in the relatives’ survey ‘do you feel that the care home meets the needs of your relative?’ two relatives replied ‘always’ and one replied ‘usually’. In response to the question in the relatives’ survey ‘do the care staff have the right skills and experience to look after people properly? two relatives replied ‘usually’. In response to the question in the relatives’ survey ‘does the care service meet the different needs of people?’ one relative replied ‘always’ and one replied ‘usually’. Other comments made by relatives in their surveys: ‘Staff there at present are keen to do things that my relative enjoys and are keen to listen to our opinions’; ‘care for the residents well’; and ‘the permanent staff at present are wonderful. I visit often and am happy with the way my sister is being cared for’. During the week three support workers plus the deputy manager are on duty. At weekends three support workers are on duty. At night one ‘waking’ and one ‘sleep in’ members of staff are on duty. The main problem is maintaining a full permanent staff team. A high percentage of staff have left in the last year. There are only five permanent members of staff including the deputy manager, which necessitates relying heavily on agency staff to cover the vacant care hours. Some of the agency staff work regularly in the home but others only occasionally. On the day of the inspection one agency worker was on duty. He was experienced but it was only the second day he had worked at the home. Records showed the organisation complies with the recruitment regulations except for one new member of staff’s file that had no record of references being received. All new staff undertake an induction and foundation training programme. All permanent staff have either received or been booked to attend basic training and training in key areas of their work such as safeguarding younger adults, first aid and responding to epileptic seizures. Refresher training of key areas of work takes place. Of the five permanent staff, including the deputy manager, two have a NVQ 2 or above and two members of staff are currently studying for a qualification. All staff had training profiles. The Dolphins DS0000013077.V348402.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): Standards 37, 39 and 42. People who use the service experience adequate quality outcomes in this area. The deputy manager, with support from senior management, has managed the running of the home satisfactorily. However, it is almost a year since a registered manager, who had a legal responsibility for the running of the home, has been in post. A quality assurance and quality monitoring system is in place to measure the standard of care received by the residents. Residents’ health, safety and welfare are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been no registered manager since October 2006. The deputy manager, with support from senior management and managers of other homes, has been running the home. Comments made by relatives in their surveys were ‘in the last six months there has been a great improvement in the care at The Dolphins’ and ‘my relative appears to be happy with the current level of care and attention’. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 20 A care standards audit of the home takes place twice a year. A ‘Top Team’ assessment covering such topics as, residents’ involvement in the home, menus, and life and leisure, takes place every six months. A relatives meeting for all the homes in the organisation takes place annually. Staff meetings take place every month. ‘Talk time’ between residents and their key workers takes place every week. A development plan has been produced for 2007. The inspector found no record of satisfaction questionnaires being sent to relatives and visiting professionals. Records showed all health and safety checks and inspections are up to date and completed as required. Necessary health and safety policies and procedures are in place. There is a home’s fire risk assessment. A health and safety audit of the home takes place every month. All the service users’ files contained appropriate up to date risk assessments. All the permanent staff have received the necessary health and safety training including first aid. The Dolphins DS0000013077.V348402.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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 1 35 3 36 X 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 2 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 3 X X 3 X The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 YA12 Regulation 16(2)(m)(n) Requirement Timescale for action 31/12/07 2 YA34 19 3 YA37 8 The manager must continue to consult with each resident about their personal interests and make arrangements for each resident to be provided with opportunities to take part in interesting and fulfilling social and leisure activities, in the home and in their local community, taking into account their needs and wishes. (This requirement was made at the previous inspection) Two references must be 30/09/07 received before a new member of staff commences work in the home. The organisation must appoint 31/12/07 a qualified, competent and experienced manager in order that the home’s stated aims and objectives are met. The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 23 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 Refer to Standard YA17 YA19 YA22 YA32 Good Practice Recommendations Ensure residents’ nutritional needs are assessed and meals provided reflect their requirements. Reintroduce physiotherapy for two residents to enable them to maintain as much movement in their limbs as possible. Ensure all relatives have a copy of the complaints procedure so they are clear about how to make a complaint. Recruit more permanent members of staff in order that the residents are cared for by staff who are aware of their needs and conditions, and have developed a positive relationship with them. Send satisfaction questionnaires to relatives and visiting professionals to provide information that can inform the annual development plan. 5 YA39 The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House, 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 The Dolphins DS0000013077.V348402.R01.S.doc Version 5.2 Page 25 - 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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