Care Home: Evelyn Wright House

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What the care home does well People using the service are afforded the right to privacy and dignity by a staff team that is very dedicated to their work and consistent in their approach. People using the service will be enabled to maintain their independence with choices being an integral part of the philosophy of the service. The service is always run in the bets interests of people living at Evelyn Wright House. The loyal staff team was very knowledgeable about the needs of people using the service and demonstrated that they had a good understanding of the homes policies, procedures and good practice at the home. A staff team that has been appointed through a robust recruitment and selection process supports people living at the home. There is a good range of activities/facilities available at the home to enrich the lifestyle of people using the service. The home is maintained to a good standard with a range of communal areas to choose from and a garden to sit in when the weather permits. People living at the home were very satisfied with their accommodation and support. What has improved since the last inspection? No requirements were made at the last inspection. What the care home could do better: It is recommended that staff should receive a minimum of six supervisions a year. Records should be maintained to evidence that supervision is an ongoing process and part of a staff members development programme. Health and safety records must be maintained and up to date Confidential healthcare records must be kept in a secure cabinet. Key inspection report Care homes for older people Name: Address: Evelyn Wright House 32 Badby Road Daventry Northants NN11 4AP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Judith Roan     Date: 2 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 26 Information about the care home Name of care home: Address: Evelyn Wright House 32 Badby Road Daventry Northants NN11 4AP 01327703140 01327312775 shhunt@northamptonshire.gov.uk www.northamptonshire.gov.uk Northamptonshire County Council care home 29 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) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: No person falling within the category DE(E) can be admitted where there are 14 people of category DE(E) already in the home No person falling within the category OP can be admitted where there are already 29 persons of category OP already in the home. No person falling within the category PD(E) can be admitted where there are 4 people of category PD(E) already in the home To be able to continue to accommodate the named person of category MD(E) who was accommodated in the home prior to registration in 2002 Total number of service users in the home must not exceed 29 Date of last inspection 0 0 0 Over 65 14 29 4 Care Homes for Older People Page 4 of 26 Brief description of the care home Evelyn Wright is a care home providing personal care and accommodation for up to twenty-nine persons, who may have associated conditions, which may include dementia and physical disabilities. The home is easily accessible by private or public transport, and is located closed to the town centre of Daventry. The twenty-nine single bedrooms are without en-suite facilities. All accommodation is provided on the ground floor, communal areas include a lounge and dining room in addition there are three distinctive areas named, The Willows, The Brambles and The Laurels each catering for individuals with similar needs and benefit from having a dedicated communal and bedroom facilities. The home has a patio and garden area with mature plants and shrubs. Information is located on site detailing the range of services offered, which includes the Statement of Purpose, Quality Assurance Audit and a copy of the Commission of Social Care Inspections, Inspection Reports, which are located on a table in the entrance lounge. Care Homes for Older People Page 5 of 26 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: three star excellent 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: The quality rating for this service is 3 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was case tracking which involved selecting three people who use the service and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CQC. The registered manager has now left and a new acting manager is in post who we met later to inspect Care Homes for Older People Page 6 of 26 staff records that were not available on the first day. The inspection was unannounced and took 7.5 hours. The homes policies, procedures and records in relation to staffing recruitment and training, concerns and complaints, medication management, and general maintenance and upkeep of the home were viewed. The current fees range is available from the manager at the care home. There are additional costs for individual expenditure such as Chiropody, Optician and hairdressing services, and the fee will depend on the services received. People using the service said that I feel very safe living here The staff are always helpful and polite My room is comfortable and kept as I would like it to be There is a wide choice of meals and we can have breakfast in our room if we prefer There is always an activity going on and we have a choice to join in Care Homes for Older People Page 7 of 26 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 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 26 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 26 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. Good information and pre-admission assessment ensures that the personal care needs of peoples using the service can be met. Evidence: Copies of the statement of purpose and service users guide are available within the home. New residents and their relatives are made aware of these documents or are given copies to read prior to admission. All new service users are welcomed into the home by key staff and given a tour and explanation of the homes facilities. On speaking with a relative they confirmed that they had received extensive information about the home prior to their family members admission. In discussion with a new resident at the home they said that We were shown around the home and invited to join them in a meal which gave us an opportunity to meet everyone. The person also spent time speaking with other people using the service before making the final decision to move in. During this time the staff at the home also used the opportunity to assess their needs and confirm whether they could meet them. In viewing the care Care Homes for Older People Page 10 of 26 Evidence: file on anew resident we found that a full assessment of need had been completed prior to their admission. Staff said that they were very satisfied with the information gained within the assessments, as it gave them a good pen picture of the persons needs. In reviewing the care files an assessment of need was undertaken prior to admission gaining information about their needs and social history. The care file also contained a signed contract. Care Homes for Older People Page 11 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can expect that their health and personal care needs will be fully met. Evidence: The care plans of three people that use the service were case tracked. Plans are developed from the assessments of need undertaken on admission and or via the review process used within the service. Preferences in relation to gender of the carer to support with personal care is promoted and respected. Evidence was found on files that plans are reviewed monthly or more often as required. In case tracking one person who had recently become ill requiring bed rest, we found that the care plans had been updated and gave good instructions to staff on how to meet the persons additional needs. Care plans are supported by risk assessments. We also found evidence across the files that falls, pressure area care, nutritional and fluid intake was all being monitored. Care plans could be made person centred by writing them in the first person as if the person had written their own plan. It is evident that health care needs are met by having a positive working relationship Care Homes for Older People Page 12 of 26 Evidence: with local healthcare professionals who visit people at the home at an individuals request or when a staff member has identified concerns/needs. However we did note that healthcare records could be stored more securely. In discussion with the new manager they agreed to review the storage facilities and practices within the home for visiting District nurses. In observation of care practices during the inspection carers were seen to be respectful in their approach and supported people to maintain their dignity by being discreet in how they approached people when personal care was being offered. In speaking with people that use the service they all commented that the staff were professional and maintained their privacy. Staff were fully aware of the needs of people they supported and aware of good practice in relation to personal care. Medication profiles are in place and manager monitor administration practice to ensure that medication is handled, stored and administered in accordance with the Royal pharmaceutical society guidelines. CQC has received one notification of a medication error, which has been investigated and steps taken to review the practice of the staff member concerned. Care Homes for Older People Page 13 of 26 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 using the service have a choice of a wide range of activities that leads to an enriched lifestyle. Evidence: The range of activities open to people living at Evelyn Wright House is wide and with individuals having a choice of both private and communal areas to spend their day. In talking to people throughout the inspection they said that they could choose to take part in the activities on offer. They all enjoy the film night once a week. Individuals were seen to be reading, chatting to peers and listening to music. There is a lively atmosphere within the home that is promoted by staff attitude and approach. Lounges have access to large TVs so that visibility is improved from most areas of the rooms. The AQAA confirms that Evelyn Wright House offers a flexibly run home enabling service users to make choices as to their daily lives.We encourage residents and their families to help us complete a life history form that includes things they like to do including hobbies and interests, which are then incorporated into their daily social activities. We operate an open door policy whereby all senior staff and the manager are available to service users, relatives, staff and visitors. Residents are assisted and encouraged to maintain contacts with families and friends, accessing Care Homes for Older People Page 14 of 26 Evidence: clubs in the community, exercising their right to vote, visiting the local shops or attending a local church service. Gardening activities have been increased with residents this year growing tomatos and melons under the supervision of the handy person We hold 3 monthly residents meetings where we can discuss various aspects of life in the home and address issues raised as appropriate.We also gather residents views about the activities provided, at residents reviews and surveys and incorporate issues raised in our development plans for the home. We provide daily activities for the residents and also provide a range of entertainments in the home, such as visiting musicians, parties, fund raising raffles. We also provide day trips out of the home such as summer boat trips. Planned entertainment is organised by the staff with one senior having an over view for activities within the home. Long term sickness and staff vacancies have had an impact on the capacity of senior staff to undertake this part of their duties in full. However people living at the home do not appear to have missed out as relatives have been very supportive. There are several Church services held within the home every month that are facilitated by various church leaders. Families are always welcome into the home and often called several times a week. Some families visited daily. In discussion with one relative they said that their family member was happy at the home and there was always something to do. A healthy menu is available to people that use the service. Breakfast is served in the dining room or on a tray in their room. The dining room is light airy and is pleasant area to enjoy a meal. A member of the staff team freshly cooks meals each day. There is always a choice of meals with a wide range of alternatives. Drinks are available throughout the day. Residents confirmed that drinks and snacks are available upon request twenty-four hours days. Meals are very excellent, with a choice, portions are good. Lovely meals. Care Homes for Older People Page 15 of 26 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. Practices within the service protect people who use the service and ensure that they are listened to. Evidence: People spoken with said that they felt safe living at Evelyn Wright House. They were clear about who do speak to if they had a concern or felt that they were not being treated appropriately. Carers also said that they would report any concerns and knew that there is a whistle blowing policy in operation at the home. The home has not received any complaints over the past twelve months. One safeguarding referral has been made and fully investigated. A complaints policy and procedure is in operation at the home and the registered manager states that: We follow the NCC Complaints Procedure Do it once, Do it well. We operate an open door policy where service users, relatives and staff feel they are able to bring their concerns to raise any concerns or complaints. These are investigated and responded in a positive manner in line with our policies and procedures. We have a Safeguarding Adults Policy and a Whistle blowing Procedure .Two Senior staff and one senior Night Staff have undertaken training in Deprivation of Liberty Act so as to ensure our service works within the Act and supports the rights of residents. We have two further Senior staff to attend. All staff are aware of the Mental Capacity Act and its guidelines. Care Homes for Older People Page 16 of 26 Evidence: The services recruitment systems ensures that staff working at the home are subject to robust employment checks, that include, employment history, references and criminal record disclosure checks. A copy of the local safeguarding protocols and procedures is held at the home. Care Homes for Older People Page 17 of 26 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 homes environment is well maintained and exceeds expectations of people using the service. Evidence: The front door of Evelyn Wright opens onto the front lounge, a table is located on the left hand side whereby the homes Statement of Purpose, most recent Inspection Report, and Quality Assurance documentation can be found. The table also houses the visitors signing book. In touring the building all areas were seen to be clean, hygienic and maintained to a high standard. Housekeeping staff have a well planned routine and maintains supplies/records of materials in accordance with health and safety regulations. The communal areas were clean and furnished to a good standard with homely touches throughout the home. The communal areas facilitate the company of peers or quite areas where people can sit and enjoy the views into the garden. Hanging Baskets placed around the home to improve the appearance during the summer months which made a talking point for residents. Has been one improvement confirmed by the manager. The gardens surrounding the property are well maintained, with a range of mature plants and shrubs, in addition a patio area has been provided, Care Homes for Older People Page 18 of 26 Evidence: which is surrounded by fencing providing a safe and secure area. The manager within the AQAA supplied information prior to the inspection taking place on the frequency of safety checks and the maintenance and upkeep of the home. On reviewing these at the home all were in order except for the lack of a certificate for landlords gas safety. A recommendation has been made for health and safety records to be maintained and up to date. There is good domestic routine within the home and in the kitchen to ensure that food hygiene practices are maintained. All areas are maintained to a high a standard of cleanliness. A programme of redecoration and refurbishments is ongoing within the home and people using the service confirmed that they are always consulted about changes. Bedrooms contained personal items of furniture and electrical equipment such as TVs, video and DVD players, Radios and CD players, personal paintings and photographs. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are safe as a result of the robust recruitment procedure and feel supported by the dedicated and competent staff team. Evidence: Evelyn Wright House has a thorough recruitment procedure and files seen confirmed that required employment checks, application form, two references, criminal records bureau disclosures and interviews have taken place. One file provided evidence that a Protection of Vulnerable Adults first had been completed but the CRB disclosure number was missing. The acting manager agreed to contact human resources to have this sent. The staff team have a sound knowledge base about the needs of people that use the service. Through observation during the inspection they showed that they had a range of skills to support individuals and were proactive in maintaining everyday living skills. A clerk, cooks and domestic staff all of whom have attained a National Vocational Qualification in their areas of expertise support the Registered Manager and care staff. The provision of ancillary staff enables residents to receive uninterrupted and focused care from care staff. Carers are offered a range of opportunities to train. Of the staff team of twenty seven, twenty three have achieved National Vocational Qualification at level two or above. This is above the required National minimum standards (NMS) of Care Homes for Older People Page 20 of 26 Evidence: 50 of staff being qualified. Carers spoken to have a good knowledge of the needs of people using the service and were committed to providing a good service. They felt supported but had not received some formal regular supervision over the past few months. Long term sickness and vacancies have impacted on this area. This will be addressed by the new manager. Carers have access to a wide range of topics that includes Health and safety, Fire, safety, Food Hygiene, infection control, safeguarding, healthy eating, activities for residents, and dementia awareness. Training records confirm that all staff had completed manual handling training and undertake annual refresher training. Discussions with staff and the viewing of staff records confirmed that all newly recruited staff undertake a detailed induction and foundation training programme within the first six months of employment, the level of training provided is reflective of that which is expected by Skill Council. The programme of induction and foundation training covers five areas of expertise, focusing on the principles of care, the role of the worker within the organisation, maintaining safety at work, communication and recognising and responding to abuse or neglect. Care Homes for Older People Page 21 of 26 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 service is managed in the best interests of people living at the home. Evidence: The registered manager was leaving the home to take up another manager position within the County Council. A new manager was in post and they were due to start the handover the following week. In discussion with the new manager on a follow-up day to look at staff files they confirmed that they had already assessed what areas needed to be addressed at the home to ensure that they were meeting NMS. Records were not available to demonstrate that formal one to one staff supervision takes place on regular basis. Staff did however say that they felt supported on a dayto-day basis. They said that they could take issues to the manager and other senior staff at the home and be listened to. Staff could not confirm the frequency of supervisions. Supervisions have not been routinely recorded. There was evidence in files seen that staff receive annual appraisals to access their performance and development needs. Staff meetings are held on a frequent basis to discuss practice Care Homes for Older People Page 22 of 26 Evidence: issues. The staff rota is developed to ensure that there is a balance between direct work with people using the service and administrative tasks. The home has good financial recording systems. The AQAA confirms that these are audited and recommendation followed. Records for all financial transactions are keep up to date, and improvements are being implemented across all local authority homes to meet the required standards requested by Audit commission. Residents finances are handled in line with NCC policies and procedures, residents are encouraged whenever possible to take charge of their own finances. The majority of residents, due to level of dementia, have a nominal amount held on their behalf by the home. All records and money can be accessed at any time and are audited regularly by the homes business support assistant. All accidents and incidents are recorded and audited. Health and safety procedures are in place with regular fire and health and safety checks being undertaken. The Pre Inspection Questionnaire submitted prior to the CQC site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. One document however could not be found relating to the Gas Landlords certificate. In discussion with the new manager they agreed to ensure that records were better maintained. There is a good quality assurance system in place with the use of surveys and regular meetings with people that use the service. These meeting are fully recorded and available within the home. Care Homes for Older People Page 23 of 26 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 26 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 37 17 The registered Manager 31/03/2010 must ensure that health and safety records are maintained. This is to ensure that people using the service live are safe. 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 36 Records should be maintained to evidence that supervision is an ongoing process and part of a staff members development programme. It is recommended that staff should receive a minimum of six supervisions a year Confidential healthcare records must be kept in a secure cabinet. 2 3 36 37 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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