Care Home: Bridgemarsh

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What the care home does well People were able to choose to live here and had their needs checked before moving in.People are helped to choose what they want to eat.People are helped to go out to day centres, the shops and pubs.People`s complaints are listened to and acted upon.The home is clean and tidy.People are looked after by the same staff that treats them well. What has improved since the last inspection? The care plans have more information in them explaining the amount of help that people need. Risk assessments and plans on how to manage the risks are better.Staff now have clear instructions on when, why and how to give medication that is prescribed for as and when needed.Staff has had a lot more training in the past year.The manager is regularly checking the home`s safety records. Health & Safety What the care home could do better: The care plans need to be signed and dated so that all staff knows that they are up to date and that they contain the right information on how to help people.The duty roster should show who is and is not working.The medication must always be right and it should be checked to make sure that it is. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bridgemarsh 184 Main Road Broomfield Chelmsford Essex CM1 7AJ 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: Pauline Marshall Date: 1 5 0 6 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Bridgemarsh 184 Main Road Broomfield Chelmsford Essex CM1 7AJ 01245440858 01245442239 norman.wagstaff@essexcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Essex County Council care home 28 Number of places (if applicable): Under 65 Over 65 0 6 1 0 learning disability physical disability Additional conditions: One named person, over the age of 65 years, who requires care by reason of a learning disability The total number of service users accommodated in the home must not exceed 28 persons Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 28 persons) Persons of either sex, under the age of 65 years, who require care by reason of a learning disability and who also have a physical disability (not to exceed 6 persons) Date of last inspection 1 9 0 6 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Bridgemarsh provides people with learning disabilities aged from 1865 with permanent and respite accommodation. This is a purpose built home that has different units to meet the needs of different people. Eighteen people live at the home permanently. People also stay at the home for respite visits. There is a local bus route that goes into the town centre and the shops. Care Homes for Adults (18-65 years) Page 5 of 34 The home can also use the community bus. This means that the people COMMUNITY BUS who live at the home can get around easily. Everybody who lives at the home has their own bedroom. Nobody has to share a room. It costs £1246.00 per week to stay at Bridgemarsh and you may need to pay something towards this. You will have to pay extra for some things like the hairdresser, magazines, outings and transport. Care Homes for Adults (18-65 years) Page 6 of 34 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 34 Summary This is an overview of what we found during the inspection. How we did our inspection: This is what the inspector did when they were at the care home We visited the home and looked at some of the files. These included some of the staff files and some of the files belonging to the people that live in the home. We also looked at the policies that explain how the home does things. We looked around the home and spoke to the staff and the manager. We read the information (AQAA) sent to us by the manager. Care Homes for Adults (18-65 years) Page 8 of 34 We sent surveys to people living at Bridgemarsh, their relatives and to the staff to see what they think about the home. What the care home does well People were able to choose to live here and had their needs checked before moving in. People are helped to choose what they want to eat. Care Homes for Adults (18-65 years) Page 9 of 34 People are helped to go out to day centres, the shops and pubs. People’s complaints are listened to and acted upon. The home is clean and tidy. Care Homes for Adults (18-65 years) Page 10 of 34 People are looked after by the same staff that treats them well. What has got better from the last inspection The care plans have more information in them explaining the amount of help that people need. Risk assessments and plans on how to manage the risks are better. Care Homes for Adults (18-65 years) Page 11 of 34 Staff now have clear instructions on when, why and how to give medication that is prescribed for as and when needed. Staff has had a lot more training in the past year. The manager is regularly checking the home’s safety records. Health & Safety Care Homes for Adults (18-65 years) Page 12 of 34 What the care home could do better The care plans need to be signed and dated so that all staff knows that they are up to date and that they contain the right information on how to help people. The duty roster should show who is and is not working. The medication must always be right and it should be checked to make sure that it is. Care Homes for Adults (18-65 years) Page 13 of 34 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Pauline Marshall National Contact Centre 03000 61 61 61 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 Adults (18-65 years) Page 14 of 34 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 15 of 34 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 get good information about the service and know that their needs are fully assessed. Evidence: The Statement of Purpose included information about the provider, the manager and the staff working in the home; there were details of staffs training and qualifications. The document provided information on the deployment of staff and clearly showed the staffing levels in each of the five units. The Service User Guide is written in large print and states that it can be made available in alternative formats such as Braille, pictorial or other languages. We looked at four care files and they all included a Social Services (COM5) assessment. There was no evidence to show that the home had carried out its own pre-admission assessment, however, there were Functional Assessments (COM3) on each of the care files that we examined that were completed by senior staff together with the people using the service and their families. People have the opportunity to Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: stay at Bridgemarsh as part of the pre-admission process. The team co-ordinator said that assessments are carried out from the information in the Social Services assessment (COM5) and that this is shown in the support plans. The support plans examined showed that information from the COM5 had been included. Care Homes for Adults (18-65 years) Page 17 of 34 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follows. 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 receive appropriate individualised care based on identified needs. Evidence: Each of the four care files that we examined contained a personal profile; these showed the contact details of the individuals next of kin, GP, optician and dentist. There were support plans in place for all areas of assessed need and each support plan was detailed and informative. There was some evidence that the support plans had been reviewed and this included entries on a sheet which was named daily progress notes; these showed that the support plan had changed. Three of the four support plans that we examined were not signed or dated making it difficult to assess if regular reviews had taken place. The team co-ordinator said that all of the support plans had been reviewed in the past few months. We looked at some of the care files belonging to other people living in the home and they showed that people living in the home had been fully involved in the creation of their support plan. People spoken with said that their support plans met their needs and that they were involved in writing them. People living in the home have their own individual diaries where their daily notes and Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: activities are recorded. We looked at four peoples diaries and the notes were clear and informative showing what people had been doing and how they felt about it. People spoken with said we have meetings so that we can talk about things that happen in the home and I will always talk to the staff about anything that worries me. There were notes to confirm that regular meetings take place and these showed that people living in the home have their say about various topics such as the food and the activities and the outings. There were risk assessments on each of the care files that we examined and there were management plans to show how the identified risks were dealt with. Care Homes for Adults (18-65 years) Page 19 of 34 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 are well supported to live a lifestyle that meets their identified needs and preferences. Evidence: People spoken with said that they attended day centres and colleges and that they often go shopping in the local town centre; there were entries on all of the diaries that we examined confirming this. People spoken with said I have plenty to do, we have games and do art and crafts, the team co-ordinator said that the home has purchased a Wii games machine and that people often play bowling and tennis on it. People spoken with said that they were encouraged by the staff to keep in regular contact with their friends and families. The registered manager said that the home has an open visiting policy and people spoken with confirmed that they do have visits from their friends and families whenever they want. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: Staff was observed interacting with people living in the home throughout the day and people appeared to be comfortable and relaxed in their presence. When speaking to people living in the home the staff spoke to them respectfully and people spoken with said that the staff treats them well. The homes routine is flexible and people choose when they want to go to bed and when they want to get up; this was confirmed by entries in the diaries and by people living in the home. There is a large kitchen where main meals are prepared and each of the five units has its own smaller kitchen in which staff can prepare light meals and snacks. The permanent cook is currently on sick leave and the kitchen has been run by an agency cook that has worked in the home many times and assists with menus and food ordering, when necessary. The agency cook was familiar with the kitchen documentation and showed us a fully completed Food Standard Agency, Safer Food Better Business folder. The home operates a five week rolling menu that offers people living there a choice of two different lunches and evening meals; there was yogurt, cake and fresh fruit available as an alternative dessert each day. The nutrition records showed that people had a balanced healthy diet and people spoken with said that they chose where they wished to eat. Care Homes for Adults (18-65 years) Page 21 of 34 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . People receive personal care in a way that suits them and their health care needs will be fully met, but may not receive medication safely. Evidence: The support plans clearly showed the level of support to offer and it identified when people were to be asked if they needed the support at that time. Staff spoken with said that they knew the people living in the home very well and that it was important to respect peoples privacy. One person spoken with said staff are good here they do not interfere with what I want to do, they help me when I need it. Each of the care files that we examined contained details of peoples health care appointments and one person spoken with said staff takes me to the GP when I need it; I have an appointment this morning. The home has a health appointment form on each of the care files that we examined; the team co-ordinator said that the information in these enabled staff to track peoples health care appointments. The entries on the form did not correspond with the entries in the support files and according to one of the files examined there had been no visits to the chiropodist in more than a year. We could not locate any information about the persons foot care in the care file; however, the team co-ordinator said that she knew that the person had Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: received chiropody treatment. All staff that administers medication has had their medication training. People that live in the home on a permanent basis have their medication supplied by Boots Pharmacy in a monitored dosage system. A random check was carried out on this system and both the medication and its corresponding records were correct. We checked a random sample of medication that was not in the monitored dosage system and we found that the number of tablets in the box did not correspond with the number of tablets recorded on the administration sheet. People staying at Bridgemarsh on a temporary basis bring their medication in to the home in various forms and staff prepares a medication sheet where all of the medicines and creams are recorded; staff initials the medication sheets to confirm administration. Care Homes for Adults (18-65 years) Page 23 of 34 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 will have their concerns acted upon and they will be protected from harm and abuse. Evidence: The team co-ordinator said that there had been no recorded complaints since the last inspection and the complaints records confirmed this. The manager said in his annual quality assurance assessment (AQAA) the home has a robust complaints procedure in place and ensures that any concerns are listened to and resolved swiftly and in addition to Essex County Councils policy we have produced the procedure in a pictorial format. People spoken with confirmed that they had seen the pictorial complaints procedure. There has been one safeguarding issue raised since the last inspection and the records showed that the manager had dealt with the issue appropriately by following the homes procedure. There was information in the homes team leader’s handover book informing staff of the need to refer any suspicions of abuse to the Local Authority. Staff spoken with had a good understanding of safeguarding and the staff files showed that all staff had been either trained or had an update in their training in the past year. Care Homes for Adults (18-65 years) Page 24 of 34 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 will live in a homely, comfortable and clean environment. Evidence: Bridgemarsh consists of five separate units and each has its own kitchen and lounge in addition to the bedrooms and bathrooms, all five areas were reasonably decorated and furnished. Three of the five kitchens have been replaced and decorated in the past year and the external security has been upgraded; the manager said in his AQAA we now have alarmed locks and fire doors which have improved protection for service users and staff, and this was confirmed at the site visit. The home has a range of specialist equipment such as overhead hoists, assisted baths and a shower trolley and staff has received training in their use. We looked around the whole of the building and the grounds and they were well maintained, clean and tidy, each of the bedrooms was reasonably well decorated and contained many personal belongings. The duty roster showed that three domestic staff are employed by the home and when spoken with one of the domestic staff said I am very happy here and have been for many years, I have recently had training in health and safety and moving and handling and I can see the benefits of this now and how it relates to my job. People living in the home said when spoken with that they were helped by staff to keep their bedrooms clean and tidy. Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: Care Homes for Adults (18-65 years) Page 26 of 34 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People will be supported by well trained staff. Inadequate recording on the duty rota could potentially put people at risk. Evidence: We looked at the duty roster and it showed that sufficient staff works throughout the day to meet the needs of the people currently living in the home. It showed that there was domestic staff in addition to care staff and the manager, and although not shown on the duty roster there are also two administrative assistants working in the home. The team co-ordinator said that the cook had been on sick leave and an agency worker was covering the kitchen duties, this was not shown on the duty roster. The duty roster must show the full names of all of the people that work in the home and the hours that they are working; it must also show when workers that are scheduled to work do not. The manager said in his AQAA that thirteen permanent members of staff have an NVQ level 2 or above, and that more than half of the staff has this qualification and two others are working towards it; the records we examined confirmed this. In the past year a new team structure has been developed and there is now a team co-ordinator that runs each shift, and they are responsible for a team of social care Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: support workers that have a key working role. Staff spoken with confirmed that this is working well and that although difficult at first, they are now getting used to the system. We looked at four staff files, one being the file of a regular agency worker and we found that most of the required documents were kept in them; however, there were some shortfalls on the files of staff members that had worked for Essex County Council for a number of years. The application forms and references for two of these staff were not available for inspection. The manager said that there are five vacancies for social care support workers and that he has just been given authorisation to recruit to them. The three permanent staff files that we examined contained copies of certificates of training in health and safety, risk and conflict management, moving and handling, safeguarding adults, medication, food safety, first aid, report writing and the Mental capacity Act. Staff spoken with said that in the past few months a huge amount of training had taken place and that the health and safety training consisted of a two day course that covered all areas of health and safety including the control of substances hazardous to health (COSHH), the reporting of injuries diseases and dangerous occurrence (RIDDOR) and fire prevention. There was evidence to show that more training was planned over the coming months. The staff files that we examined showed that supervision takes place, however, on two of the files, it was not as often as recommended under the standards. The regular agency staff file that we examined contained a copy of supervision notes and the team co-ordinator said that supervision had just commenced for regular agency staff. Care Homes for Adults (18-65 years) Page 28 of 34 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 live in a well run home that is run in their best interests. Evidence: The manager has worked in social care for more than sixteen years; he has a diploma in management studies (DMS) and is currently working towards his NVQ level 4 in care; he has also achieved the A1 NVQ assessors award. The manager said that he has recently updated his training in first aid and risk and conflict management and he was attending safeguarding training on the day of the inspection. The manager said that regular meetings are held for people living in the home and for the homes staff; there were notes available to confirm that regular meetings do take place and both staff and people living in the home confirmed this when spoken with. There were copies of the providers’ regulation 26 visits that showed that people living in the home are regularly asked their views. The manager returned his completed AQAA in good time and it contained all of the information that we had asked for. There was evidence that regular health and safety checks had been carried out. The Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: manager keeps a monthly check on notifications, accident forms, incidents and RIDDOR (reporting of injuries, diseases and dangerous occurrences). A random sample of safety certificates and records were checked and they were all found to be in place and up to date. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 34 19 (1) (b) (i) To protect people living in 01/09/2008 the home the manager must ensure that all the required employment checks as detailed in Schedule 2 of the regulations are carried out and the relevant documents are kept on staff files. Care Homes for Adults (18-65 years) Page 31 of 34 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 Description 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 Description Timescale for action 1 20 13 The registered manager must ensure that there are arrangements in place for the safekeeping and recording of medication. 31/07/2009 To ensure that the risk of medication errors is minimised. 2 33 17 The manager must ensure that the duty rota shows staffs full names and whether or not they actually worked. 31/07/2009 To ensure that the duty rota shows which staff has worked in the home. 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. Care Homes for Adults (18-65 years) Page 32 of 34 No Refer to Standard Good Practice Recommendations 1 20 It is recommended that healthcare appointments are recorded on the homes health appointment forms to enable ease of tracking and to ensure that follow up appointments do not get missed. It is recommended that all staff receive supervision at least 6 times a year to ensure that they are appropriately supported to do their work. 2 36 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 34 of 34 - 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!