Inspection on 29/05/07 for The Retreat, Plymouth

This inspection was carried out on 29th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Retreat, Plymouth 25/08/05

The Retreat, Plymouth 21/04/05

The Retreat, Plymouth 10/08/04

The Retreat, Plymouth 08/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Retreat Belle Vue Road Hooe Plymouth Devon PL9 9NR Lead Inspector Graham Thomas Key Unannounced Inspection 29th May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Retreat DS0000003516.V331954.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Retreat Address Belle Vue Road Hooe Plymouth Devon PL9 9NR 01752 402566 01752 313074 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.sunshinecare.co.uk Sunshine Care Limited Mr Paul Iverson Constantine Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60 Date of last inspection 25th August 2005 Brief Description of the Service: The Retreat Residential Care Home is a large period house set in its own grounds on the outskirts of the village of Hooe near Plymouth. The home provides accommodation with personal care for up to 20 men and women over the age of 65. The home does not offer care to people diagnosed with dementia or those whose physical mobility is significantly impaired. Nine bedrooms provide en suite facilities. Accommodation is provided over three floors and chair lifts provide access to the first and second floors, although there are a number of steps to some of the bedrooms. The lounge and dining room are on the ground floor. Since the home was last inspected, the registered Provider has changed to Sunshine Care Ltd. Mr. Paul Constantine, a director of the company, is the Registered Manager of the home. People using the service are enabled to access any health and social care services they require and various social activities are organised by the home. The garden is attractive and spacious. The home’s weekly fees are based upon a bedroom “base rate” with additions for the type and level of care needed. These are set out in the Service Users’ Guide. The current minimum charge would be £285 and the maximum £474 The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the Inspection, Mr Constantine provided written information to the Commission. Surveys were sent to people using the service, staff and General Practitioners. Seven were returned by staff, seven by service users and four by GPs. The Inspector visited the home and spent nine hours there. During this time, he: • Toured the building • Spoke with seven people living in the home individually and in small groups • Spoke with two visitors • Interviewed three staff and observed staff at work • Examined the home’s records • Spoke with Mr and Mrs Constantine What the service does well: What has improved since the last inspection? What they could do better: The records about medication need to be improved so that all the medicines in the home can be accounted for. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 6 People with sensory impairments should have the opportunity to be included in recreational activities. Staff need regular supervision so that they have opportunities to exchange ideas and develop their practice. 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 Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking of moving into the Retreat have sufficient information to make an informed choice. EVIDENCE: People considering moving into the home are provided with ample information about the home in a detailed “Statement of Purpose” and “Service Users Guide”. Of seven people who returned surveys to the Commission, all said that they had received enough information about the home before they moved in. One commented that they had “spent a day before actually becoming a permanent resident”. The files of the two most recently admitted residents were examined. Both files contained detailed assessments. The person in charge at the time of the inspection said that both assessments had been completed before the people moved in. The date on one confirmed this, the other was undated. The files The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 9 also contained copies of letters from the registered provider stating that the home could meet their needs. The Retreat does not provide a service for those whose needs are solely for intermediate care. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home generally receive a good standard of care. EVIDENCE: A sample of four care plans was examined by the Inspector. These plans each contained detailed information about the person’s needs. For example, there were details about the support people needed for personal hygiene and continence, skin care, mobility and contact with families and friends. Peoples’ preferences and individual routines were written down in the plans. There were also daily notes with further information. The plans had been signed by the person or their representative. The plan for one person who had recently moved in had yet to be placed on their file. This meant that staff might not have access to all the information they might need about the person. Mr Constantine spoke with the Inspector about proposals to improve the plans by making them more “person centred”. This means that they would be based more upon the particular needs and preferences of each individual. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 11 Of the seven people living at the home who completed surveys, four stated that they always received the care and support they needed and three felt this was usually the case. A relative spoken with during the inspection felt that the standard of care had fallen recently due to instability in the management of the home (see “Management and Administration” below). Another visitor felt that her mother was well cared for and said that the staff would do anything to assist. One person living at the home commented “…staff are very, very caring and seem to love their work. They are a joy to be around” During the visit, a Doctor visited the home to see two people with health concerns. In both instances this demonstrated that staff had monitored changes in the person’s health and had taken prompt and appropriate action. In conversation with the Inspector, People said that they could have access to health professionals when they needed. Four GPs returned comment cards to the Commission. All of these indicated that staff had a clear understanding of people’s needs and that specialist advice would be followed. The Inspector looked at the home’s system for administering medicines. Medicines were securely stored. Evidence was seen in staff files that all receive basic training in medication issues. Senior staff had received further training from the local Pharmacy. Some people managed their own medicines. There were risk assessments in place to make sure this was safe. The person in charge of the medicines during the inspection described how the medicines were given. Later the Inspector watched another staff member giving medicine to a person living at the home. The way this was done was safe and complied with good practice guidance. However, a number of shortfalls were found in the recording system. For example, There was a record of medicines received into the home. This was not always signed by the person receiving the medicine and would make it more difficult to account for any errors. Two people were using Lactulose solution. There was no supply of this medicine available for these individuals though it had been signed as received. In one instance a person had been prescribed one or two Tramacet tablets per day. The record was not clear enough to show whether one or two had been given. This meant that it was not possible to account for the number of tablets taken by the person or left in the home. During the inspection, the Inspector saw staff talking with people living in the home. At all times people were treated with respect and addressed by their preferred names. Staff knocked on people’s doors before entering their rooms and made sure doors were closed when privacy was needed. The people with whom the Inspector spoke felt that their privacy was always respected and that their dignity was upheld in the support they received. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at The Retreat are generally well supported to make choices about their individual routines. EVIDENCE: During the inspection visit, People living in the home were following their own routines. Some spent time alone in their rooms when they wished. Others joined groups in the lounge to chat or watch television or wandered into the garden to enjoy the sunshine. All those with whom the Inspector spoke felt satisfied that they were supported to follow their own routines and make choices about how and with whom they spent their time. One more independent person spoke with the Inspector about his walks to local shops and visits to friends locally. A relative commented “Mum can stay up ‘til whatever time she likes. Staff tell her it’s her home”. Of the seven surveys completed by people living at the home, six stated that there were always activities arranged by the home in which they could take part. One commented that “As I am almost blind there is little I can join in”. During conversation, two people confirmed that they had enjoyed trips to regular church events, to Cornwall and a National Trust Property. On the The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 13 second day of the visit an organist had been booked to entertain people in the home but did not attend. One visitor felt that there were insufficient activities. This visitor felt that staff changes had meant that care staff time had been diverted to cleaning and cooking so there was less time for individual attention. This was confirmed in one person’s survey which referred to “staff shortages”. The Registered Provider was aware of the difficulties occurring during a period of change and was taking steps to address the issues. Visitors attending during the inspection were welcomed into the home. People living at The Retreat felt that their visitors were always made welcome and that they could see them at any time. Comments concerning meals in the home were varied. In the surveys, two people of the seven always liked the meals, 4 usually and one sometimes. Comments included: “There is normally a good choice” “A wide menu is available but I am a very plain eater” “ I don’t like chicken etc but they always try to help me” Menus were reviewed which showed that daily choices were available. An inspection of the kitchen showed that fresh fruit and vegetables were in use and that there were well stocked food stores. The Inspector joined people living at the home for a meal. The dining room had been attractively laid out for the meal and people confirmed that this was usual. Some had chosen a dish of sweet and sour chicken whilst others enjoyed a salad. The person who preferred plain food had a meal prepared and presented in the way she chose. The meal was a relaxed occasion and people expressed satisfaction with their meal. Some people took their meal in their rooms. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can feel confident that their concerns and views will be listened to and that they will be protected from abuse. EVIDENCE: The home has a clear complaints procedure which is accessible to people using the service, their friends and relatives. Other systems are in place to enable people to air their ideas, views and concerns. These include staff and resident’s meetings though these appeared to have been occurring less frequently than in the past. In addition, there is also a “Friends of the Retreat” group. Of the seven people who returned surveys, six stated that they knew who to speak to if they were not happy and knew how to make a complaint. One did not know how to complain. One commented “At the moment staff shortages have caused a few problems but someone will always listen” Complaints received were clearly recorded in the home’s file. The records of staff training showed that staff had received training in safeguarding vulnerable adults from abuse. In conversation staff demonstrated a clear understanding of the action they would take if abuse was either suspected or witnessed. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. High standards of comfort, cleanliness and safety are provided for people living at The Retreat EVIDENCE: The Retreat is situated on the outskirts of Hooe near Plymouth. There are local amenities nearby as well as the facilities of the city of Plymouth a short drive away. Parking is available both within and just outside the home’s boundaries. Well-maintained, attractive gardens, with seating, are available to people living at the home and their visitors. The garden area at the rear of the building has a gravel pathway which the Registered Provider stated had recently been relaid. The gravel was at a depth which might impede access for people using mobility aids such as walking frames. This was discussed with the Registered Provider who was aware of the difficulty and undertook to remove the excess gravel. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 16 The home comprises a large building with rooms on a ground floor and three further floors. Stair lifts provide access to the upper floors. There are 16 single bedrooms and 2 double rooms. Both of the double rooms and eight of the single rooms have en-suite facilities. Communal space includes two connected lounges, a dining room, large hallway and gardens. Toilets are conveniently situated for those without en-suite facilities and near the communal areas. Bathrooms included assisted baths and other aids such as raised seats and toilet frames which were all clean and in good condition. Other aids and adaptations such as grab rails were seen around the home. An assessment of the premises has been made by an Occupational Therapist and was available for inspection. All the rooms were and attractively furnished and decorated in a comfortable and homely style. At the time of the inspection visit, one room was being refurbished. Individual rooms were personalised and contained furniture, ornaments and possessions belonging to their occupants On inspection the home was clean throughout and free from any offensive odours. Each room had a cleaning checklist behind the door. All those living at the home with whom the inspector spoke felt that cleanliness was maintained to a consistently high standard. One commented “The staff work very hard to ensure the home is spotless at all times, with no unpleasant smells” Effective infection control measures were seen to be in place. The home’s laundry had washing machines with suitable hot wash cycles. There is a separate sluicing facility. These rooms were kept tidy and clean. All staff carried antiseptic hand gel and were seen wearing protective clothing for personal care tasks and when handling potentially infected materials. Systems were in place for the disposal of infected waste. Records showed regular and up-to-date safety checks such as those for personal electrical appliances and fire extinguishers. In addition to risk assessments there was also a system for reporting and remedying any hazards identified by staff. A sample of upstairs windows were tested by the Inspector and found to be appropriately restricted. Radiators were covered and the temperature of hot water was regulated at all outlets. High standards in the quality, cleanliness and maintenance of the environment have been maintained for a sustained period. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 to 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at The Retreat are supported by well-trained staff who have been recruited in a way which protects people from abuse. EVIDENCE: People living at the Retreat made many positive comments about the staff. These included: “…staff are very very caring and seem to love their work. They are a joy to be around”, and “…the care given is usually very good” There had been an unusually high turnover of staff since the last inspection. Mr. Constantine thought this was due to some instability in the management of the home which had resulted from the development and expansion of a separate domicillary care business. In response to a survey, one staff member commented “We have experienced a very high turnover of staff and this…..makes it difficult for some service users to get to know their carers sufficiently well” This was confirmed by some people living at the home. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 18 The files of four staff were examined. These included files of staff more recently recruited. The recruitment process for all staff had included checks of identity, criminal records and the “POVA” list. (This is a national list of staff found to be unsuitable for work with vulnerable people). Copies of work permits had been obtained for foreign staff. Each person had completed an application form and supplied two references which had been followed up. Staff confirmed that they had the opportunity to visit the home before recruitment and had also attended for interview. There was evidence in the staff training files of induction training which was being provided to national standards. There were detailed plans and records of individual training as well as an overall staff training plan. This was supported by copies of certificates seen by the Inspector and discussion with staff. The training provided included health and safety topics such as fire safety and infection control. It also included topics relevant to the needs of individual people living at the home such as catheter care. A sophisticated system had been put in place to keep track of ongoing training needs. At the time of inspection there had been a number of staff changes. As a consequence, only two of the 13 staff had achieved a National Vocational Qualification at level 2 or above. However, a further six had been signed up for this training. All staff had received training in the use of medication and safeguarding vulnerable adults from abuse. The company is developing its own training facilities. Staff members made positive comments about the available training which one staff member described as “excellent” Staff with whom the Inspector spoke showed a sufficient understanding of the individuals in their care and their particular support needs. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The previously high standard of management has been compromised by changes in the management arrangements of the home. However, service users can feel assured that the home continues to be managed in their best interests. EVIDENCE: The Retreat has been by Mr and Mrs Constantine for a number of years with high standards of management and care reflected in previous reports. At the time of the last inspection they were living at the premises with ready and consistent access to the home. Since that time they have moved out and have been developing a separate business providing domicillary care. During this period the day-to-day management of the home has been passed to deputy managers. The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 20 However, there has been a turnover of staff at this level which has resulted in inconsistency and a fall in the quality of the home’s previously high standard of management. This was commented upon by staff, relatives and indirectly by people living at the home. One such comment is quoted in the previous section of this report. Evidence of this was seen in such issues as staff supervision and staff meetings, which had not been as consistent. Also shortfalls in the Home’s medication system indicate that monitoring systems were not as effective as had previously been the case. In discussion, Mr Constantine was aware of the difficulties and had appointed a new manager who was due to start working at The Retreat shortly after the inspection. It is planned that this person will be registered with the Commission as manager of the home. Despite the above findings, people living at the home continue to rate highly the care and support they receive. There was also no evidence that health and safety have been compromised. Regular safety checks have been maintained such as those mentioned in the “Environment” section of this report. Other evidence was seen such as circuit testing which took place in early 2007. Records concerning staff and people living at the home met the requirements of the law. Systems for planning, monitoring and the delivery of staff training in health, safety and other topics was sophisticated and efficient. Systems were in place to receive feedback about the service from people living there as well as others and the home received an independent “ISO 9001” award in 2006 The Retreat DS0000003516.V331954.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement Timescale for action 14/06/07 2. OP9 13(2) Records concerning the administration of medicines must be sufficiently clear so as to be able to account for all medicines received, administered or returned. The Registered Provider must 14/06/07 ensure that there is a sufficient supply of all medicines prescribed for people living in the home 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 OP12 Good Practice Recommendations The Registered Person should ensure that suitable arrangements are in place to enable people with sensory impairments to participate in leisure and recreational activities. The Registered Person should ensure that staff receive regular supervision and have opportunities to meet on a regular basis 2 OP36 The Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Retreat DS0000003516.V331954.R01.S.doc Version 5.2 Page 24 - 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!