Care Home: Ashleigh

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What the care home does well People living at the home are cared for in a safe homely environment, and they are encouraged to personalise their rooms with their own possessions and furniture. The home has a relaxed atmosphere and people were positive about the care they receive and the warm and relaxed relationships they enjoy with the staff. A lot of the staff have worked at the home for a long time and they have developed close relationships and patterns of care that are individual to the people concerned; they have worked hard to diminish any sense of `institutionalisation`. Leisure and recreational needs are identified, and people living at the home are encouraged to join in; the importance of maintaining links with family, friends and the community is also recognised and supported. People were positive about the meals provided at the home, and they stated that they were provided with choice and variety. Similarly they were positive about the standards of cleanliness and hygiene around the home and about the care given by staff. Staff work in planned ways and have clear documentation to help them care for and support people in their day to day needs. People`s needs are properly assessed and their healthcare needs are effectively met. Staff have a good understanding of older people and ongoing training about caring for the needs of people suffering from dementia has been planned for later this year. In addition staff said that they have received a good amount of training in the past year, which helps them do their jobs more professonally and consistently. What has improved since the last inspection? The home`s management have continued to maintain a good standard of service and individual care. Improvements have been made in the physical environment of the home and there are plans for further improvements. Staff training has been continued to a good standard and staff are able to demonstrate how this has improved the quality of their work. What the care home could do better: One statutory requirement has been made as a result of this inspection which requires the home to make its medicines management systems completely safe and there are good practice recommendations that relate to indirect aspects of care and people`s lives. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashleigh 15 Gladstone Road Chesterfield Derbyshire S40 4TE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brian Marks     Date: 1 1 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ashleigh 15 Gladstone Road Chesterfield Derbyshire S40 4TE (01246)235162 01246275523 ashleighrh@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Adele Doxey,Miss Claire Helen Doxey care home 25 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Plus Three (3) Day Care Places Date of last inspection Brief description of the care home Ashleigh is situated near to the centre of Chesterfield. The accommodation is on two floors accessed by two stair lifts. There are a total of 21 bedrooms with two double rooms. One bedroom has an en suite toilet and shower facility and there are also bathroom or shower facilities on both floors. On the ground floor there is a lounge dining room and a further two separate smaller lounge areas near the front entrance. Community support services are in available, with a choice of General Practitioner, visiting Chiropodist, Dentist and Optician. The home offers in-house activities and trips out. A safe and well-kept garden is at the rear of the property. Fees for accommodation range from 352 to 405 pounds per week. There are additional charges Care Homes for Older People Page 4 of 27 Over 65 25 0 Brief description of the care home for such services as hairdressing and chiropody, and items such as toiletries and newspapers/magazines. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a Key unannounced inspection that took place at the home over one day. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, records held by us, the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection, and surveys that had been previously sent out to the homes staff and the people living there. All of the above material assisted with the preparation of a structured plan for the inspection. From the surveys that were returned before the inspection, the information supplied was analysed and the outcomes included in the inspection process and reflected in this written report. At the home, apart from examining documents, files and records, time was spent speaking to one of the homes owners, who was in charge of the home during the visit. We also spoke to most of the staff working on the early day shift. The Care Homes for Older People Page 6 of 27 care records of three people who live at the home were examined in detail and they were interviewed along with a number of others. The relatives of two more were also spoken to. No other inspection visits have been made to the home since the last Key unannounced inspection on 9 August 2007 and the assessment was made against the key National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not come to live at the home without the care they need being properly identified but more attention being paid to their social world and background history would help staff provide person centred care for everybody. Evidence: In the AQAA we were told that the homes managers receive full assessments of new residents, including those coming to the home for respite care, and that this helps to ensure that they are able to meet the needs of the person concerned. They also told us that they are encouraging people to spend a day at the home and to move in on a trial basis before a final decision is made. We looked at the care records of three people who had been living at the home, including somebody who had moved in about six months before the inspection. Within these records, there were assessments of the physical care needs of the person concerned and these assessments were carried out at, or before, the person came to Care Homes for Older People Page 10 of 27 Evidence: live at the home. They also contained information supplied by a care manager from the Councils Adult Social Care Department in all cases. They were completed to the same standard and the information had been obtained from the person concerned, from their family, or from outside professionals. However the amount of information about the psychological and social worlds of the people concerned was variable, and in most of the files we looked at was very brief. This does not fully support the intention to provide person centred care for everybody living at the home. All of the care records looked at contained an assessment of the risks related to their lives and were covered in detail where they had been identified as an issue; they included falls, skin integrity, and mobility as well as any general issues relating to the immediate environment. They were not compeleted as a matter of routine for everyone, if identified as not relevant. The home does not provide intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at the home have care and risk assessment records that promote safety and consistency, and staff work in ways that respect individuality, privacy and dignity. Evidence: In the AQAA we were told how the care plans of people living at the home are developed from the assessments that are made when people move in, and that they make sure these are acceptable to the resident and their family. We were also told about plans to update the documentation being used, but that implementaion will occur when it is cost effective. The three care records that we looked at all contained a detailed care plan prepared by the homes managers, and these were supported by more general care plans from the sponsoring Adult Social Care Department of the Council. All of this documention gave clear descriptions of the areas where people need help and all included evidence that they were looked at and evaluated regularly; this was not done more than three monthly. As before, none of the records contained detailed descriptions of the persons Care Homes for Older People Page 12 of 27 Evidence: social history and interests, which would fulfill a complete person centred approach. All the care plans that we looked at indicated detailed actions for staff to carry out, and staff told us that the care documentation helped them carry out their duties properly. There was an additional computer printout document on each record that duplicated a lot of the information held elsewhere. There were clear records of the medical and health needs of residents being regularly monitored, and also of visits by outside professionals such as G.P and district nurse, and by the chiropodist, optician and dentist. Additionally in the written records and from the direct comments and written feedback we received, it was clear that the staff at the home work hard to care in sensitive and dignified ways, and to keep people as independent as possible: Since Ive been here Ive improved a lot and I go out for a long walk by myself every day. If I need anything they get it for me. If Ive got a problem they come to me right away. The staff look after me sensitively and take care of me in a proper way. Its very nice here and staff make it like a proper family. My mother has been much better healthwise and has put on weight since moving in, which is a very good sign for her. My immediate needs for physical care and attention have been met. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these were generally satisfactory and that entries in the written records had been made properly. Medication is stored securely and the home uses a Monitored Dosage System for organising administration. A report from a recent visit by the homes pharmacist was positive. The arrangements for managing controlled drugs was generally satisfactory with secure record keeping and storage; we did note however that the written entry in the record book for one medicine was missing for two days before the inspection. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home enjoy lifestyles and routines that suit them and have good opportunities to take part in organised leisure and social activities. Evidence: In the AQAA we were told that there has been a range of activities for those people who want to take part, and that there have been regular musical entertainment and outings for people to enjoy. We were also told that new menus have been introduced and that family members are encouraged to stay and have a meal at the home. The manager told us about the activities that had been organised, although she felt that the current group of people living at the home had become increasingly dependent and difficult to get involved. Outings recently organised for small groups had included shopping trips, Chatsworth House and a day trip to the East Coast. Additionally there had been a monthly professional entertainer, regular bingo sessions, indoor games and quizzes, and gentle exercise sessions with staff. The hairdresser is a weekly visitor. The people we spoke to confirmed that they are happy with their lives at the home and that they are able to do very much what they like. They develop their own Care Homes for Older People Page 14 of 27 Evidence: routines, including spending their time in the communal areas or in their rooms; the former is the choice of most people although we saw a number who were in their rooms out of choice or because of illness. We spoke to one person who showed us her room and told us that I am always in my room or in the garden, although I go down for my meals; I like my own company. We also received written feedback from our own surveys and were told that there are always or usually activities for people to take part in. We also spoke individually to people around the home and to some of their visitors: Im a very regular visitor to my gran and she is happier, healthier and stronger that she has been for a long time. The home is very friendly and the staff are always around to talk to us and if we have any questions. Its relaxed, happy and very homely here. I go out to church on Sundays and watch my own television in the evenings, like I would do at home. My mum used to live here, so I came for care during the day because its so nice here. I feel at home here and I always find things to do. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a four week menu is being followed. The cook described how a choice at the main meals of the day is available and that a hot option is regularly available for breakfast and at teatime. People were generally positive in their feedback about the standard of food at the home with several mentioning good quality and quantity. Arrangements for purchase, storage and stock control were satisfactory. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic, vegetarian, gluten free and softened, the arrangements for which indicated a careful approach to individual needs. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. Evidence: In the AQAA we were told that the homes policies and procedures in relation to complaints are given to people in the homes Statement of Purpose and are on display in the home. We were also told that answers to the homes questionnaires indicate that people are aware of how to make a complaint. The AQAA indicated that there had been four formal complaints since the last inspection and our examination of the homes records indicated that investigations had been properly carried out and recorded. In the feedback that we received everybody said that they knew about making a complaint and were confident that they would be listened to: The staff are easy to approach if we have any problems. We know where to go if we have any problems . The AQAA told us that the home has continued to train staff in the responsibilities to protect vulnerable adults in their care, and the records we looked at supported this. Staff have received refresher training annually in their responsibilities to recognise and alert others to suspected abuse, and this subject had also been covered in more detail for those who had completed a National Vocational Qualification (NVQ). The policies and procedures in place are in line with the statutory procedures on safeguarding adults and the records we looked at indicated that there have been no situations at Care Homes for Older People Page 16 of 27 Evidence: the home that have required investigation under those procedures since the last inspection. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical aspect of the home has been maintained to a good standard and people continue to enjoy a comfortable environment suited to their physical needs. Evidence: In the AQAA the manager told us that they provide a comfortable and homely environment close to local amenties and also about the improvements that have been made during the past twelve months. From a brief tour of the building with the proprietor and visits to some of the bedrooms we saw how good standards of decoration and furnishing have been maintained and we saw the changes and improvements that have been made: The stairs and upstairs corridors have been redecorated. The bathrooms and two front lounges have been redecorated. Six bedrooms have been redecorated. New curtains have been fitted to various communal rooms and bedrooms throughout the home. We also noted that bedrooms had good levels of personalisation to suit individual residents and which create a sense of personal space, and that there was a good range of equipment for staff to help people with mobility difficulties. Comments from people living at the home and relatives were positive about the standards of comfort and cleanliness offered: The home is clean, well lit and nicely decorated. I really like my room which is very comfortable. They helped me change rooms and Ive now got it the way I want it. All the recommendations made at the last visits by the Fire and Care Homes for Older People Page 18 of 27 Evidence: Environmental Health Officers have been carried out. On the day of the inspection the home was clean, tidy and free from odours and everybody spoken to was complimentary about the service provided by the laundry. Comments previously made by residents about the latter have now been addressed and things have been improved. All residents observed in the home were seen wearing clean and well presented clothing at the time of the inspection. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has adequate numbers of staff to carry out the physical care needs of the people living there and they have been recruited and trained to do their jobs properly and in a professional way. Evidence: In the AQAA we were told how the home has maintained good staffing levels, in spite of current problems with long term sickness amongst some of the more experienced staff. We were also told that nearly all the staff have achieved the key minimum qualification and some have progressed to higher levels of the National Vocational Qualification (NVQ) levels 3 and 4. During the inspection we interviewed most of the staff on duty, including the carer who was the last to be appointed during 2009. She described how she had received basic instruction and training at the start of her employment and how, because of her lack of previous experience, she had originally worked under an Age Concern training programme with the local college. She told us how she had been instructed in basic care techniques, working under the supervision of the experienced staff. Additionally other staff told us that we get regular training through updates and use video and small group discussions to learn about any changes that have occurred. We were able to confirm this through sampling of individual staff files but the absence of an overall training record for the whole team meant that it was difficult to get a complete Care Homes for Older People Page 20 of 27 Evidence: picture. Records confirmed the high proportion of staff with an NVQ, which the manager described as a recent priority for the home and the homes success in this area is to be commended. The manager described how a programme of staff training about caring for people who suffer from dementia will be commenced later this year. The files of two recently appointed staff that we looked supported that their recruitment had been carried out properly with the right checks being made; these included two written references from previous employment and a check by the Criminial Records Bureau (CRB). Examination of the duty roster and discussion with staff indicated levels of staff on duty that were generally satisfactory and the proprietor described current problems with long term staff sickness that has meant a regular reduction to three care staff on duty on the morning shift when the preference was for four. Staff told us that the impact of this was for a workload that was very varied; sometimes busy and sometimes very steady. We dont feel very pressured because we all work well together. In the written feedback we received from people living at the home and their families, we were told that there is always or usually enough staff on hand to meet peoples needs and that: The staff strive to meet everyones needs and are very flexible in the way they work to get things done. Others said that the home should: provide more staff when needed and that more staff would be a great advantage. The people we talked to told us: Staff work very hard and help me in the mornings. I ring the bell and sometimes I have to wait a few minutes but its never a problem. Theres always somebody to take me up to my room when I want to go. The staff spoken to were positive about working at the home; they told us that: Ive only worked here for a month, its a case of so far so good. Ive enjoyed working here very much. We all get on well together, its very positive experience working here. Im very happy here and its a nice atmosphere. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a well-managed and safe environment in which to live and work. Evidence: In the AQAA we were told that the home has an experienced management team which has been running the home for many years and who are willing to delegate and let senior staff play an active role in the smooth running of the home. The home is owned by a family team, one of whom is the Registered Manager, and they are both routinely available in the home most days and are well known to everybody living there. The manager has completed the required qualification and has continued to access training to support her own knowledge as well as that of the staff team. There have been irregular meetings for the staff group in the past year, and planned meetings between manager and individual staff, supervision, have been occurring, but not regularly enough to meet the National Standard. However, the staff we spoke to were positive about the way the home is run and how the management team supports them if they have any problems: The management is supportive and very Care Homes for Older People Page 22 of 27 Evidence: responsive. The managers are here most days and are very hands on. Theyre also at the end of the phone and will come in to help out at any time. Theyre here for us if we have problems and we can always speak to them. The feedback, both verbally and in writing from people living at the home and their relatives, was positive about the general aspects of how the home is run, with comments about the welcoming approach and homely atmosphere. The homes owner has also commenced more formal activities of monitoring the quality of the homes service and surveys have been sent out to people living at the home and their relatives. The results of this years survey has been audited by an independent consultant and indicates a positive response about all aspects of the way the home is run. People mostly rated the home as good. Generally good record keeping and management systems are in place, and the deputy manager is largely responsible for the administration aspects of the home. The systems in place for looking after residents money were found to be satisfactory at the last inspection and remain unchanged. The AQAA told us about good standards of health and safety activity at the home and about the regular servicing of equipment, and we examined records of the latter as part of this inspection, which supported this. Additionally observations made around the building and of fire safety and equipment records indicate that the home was hazard free at the time of the inspection. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The recording of medicines administration must be carried out at all times according to legal procedures. So that the system is safe for all people living at the home. 30/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 Assessments of the needs of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. The care plans of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. The manager should develop an overall record of staff training achievements to improve monitoring and evauation of activity in this area. 2 7 3 29 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 4 36 All staff should receive formal individual supervision from their line manager, at intervals of every two months. This will ensure the opportunity for regular consultation about and monitoring of their work. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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