Care Home: Parliament Street (23)

What the care home does well The owner has many years experience providing care, and is able to pass on her knowledge to staff and other family members. The owner is able to give confidence to new and existing residents by encouraging them to join in conversation and activities in and outside the home, positively developing personalities. Residents are encouraged not to have any secrets, but the owner makes sure confidences are kept. Residents are given a choice in everything they do, so that they are in control of their own lifestyle. As one resident stated in a survey `I am happy. I like it here`. What has improved since the last inspection? New windows and doors have been fitted throughout the exterior of the home. Decoration is ongoing and rooms are gradually being refreshed. The owner continues to improve records for each individual, making sure they are up to date and informative, giving a good picture of the person and the care and support they need. What the care home could do better: Risk assessments need to hold more detail on what the task is that staff need to carry out in order to minimise the assessed risk. For example `help with medication` needs to explain what form that help takes. Now that the owner needs to employ staff to help in the running of the home, she needs to make sure they are trained to the right standard. Staff need to attend accredited training courses to be sure resident`s needs are met by appropriately trained staff. For example, staff need to attend accredited training in medication awareness so they have a basic knowledge of how medication is used, and how to recognise any problems. Staff should also have up to date and refresher training in abuse awareness, or Safeguarding, to ensure residents are protected by their knowledge. If the home is to administer a resident`s medication, the resident should sign to confirm they have agreed to this. Staff should have recorded one to one supervision sessions with the owner, as evidence that the standard of their work is monitored, support and guidance is offered, and training needs are identified. Key inspection report Care homes for adults (18-65 years) Name: Address: Parliament Street (23) 23 Parliament Street Morecambe Lancashire LA3 1RQ     The quality rating for this care home is:   two star good 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: Jennifer Hughes     Date: 1 5 0 1 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 Adults (18-65 years) Page 2 of 27 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 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 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Parliament Street (23) 23 Parliament Street Morecambe Lancashire LA3 1RQ 01524414353 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Mollie Green care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home This home is a large, 3-storey terraced domestic house, which is in a road of similar properties running adjacent to the promenade in Morecambe. There is a small yard at the back, and seats to the front of the house, where people can sit in the better weather. The owner of the home provides non-personal care, emotional support, and guidance in this family environment, for younger adults with a mental health problem. It is a family home, with one family member recruited as staff, and other family members helping when needed. The three bedrooms are on the first floor, with a shower room next to them. The front lounge, dining room, and basement lounge give plenty of communal space. There is easy parking for cars on the road outside the Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 Brief description of the care home home, and local shops and the seafront are a short walk away. Information about the service the home provides is available in a Welcome Pack, which provides an easy to read brochure, which tries to cover everything a resident needs to know about daily life in the home, and other information leaflets on advocacy services, health advice, and activities in the area. CSCI reports are readily available from the owner to anyone who asks to see them. As at January 2009 the fee is £350 a week. Residents receive varying benefit payments, which they use for whatever they wish. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced site visit to the home, in that the owner was not aware that it was to take place. The site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The length of the visit was three hours. Before the visit took place, the owner was asked to complete a detailed self assessment. This gave us information about how the home is managed. In addition, we wrote to staff and residents and asked them to take part in a written survey about their opinions of the service provided. During the site visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The owner and two residents in the home at time of the visit were spoken to. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and Care Homes for Adults (18-65 years) Page 6 of 27 bathrooms. Everyone was friendly and cooperative during the visit. Care Homes for Adults (18-65 years) Page 7 of 27 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 Adults (18-65 years) Page 8 of 27 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 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, 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 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. A service is provided tailored to the individuals needs. Evidence: Individual assessments are provided by the social worker, and were available on the files of the people in the home. Residents visit the home with their social worker before deciding whether they would like to stay there. Information about the home and what services it provides is given to the resident, along with plenty of local information about activities, facilities and advocacy services. It also lets people know how to make a complaint if they need to. The owner said that she thought it was very important to have a talk with the new resident first, to make sure they would get on with the other residents, and also that they would get what they wanted out of staying there. She said she also includes the other residents in the decision. Care Homes for Adults (18-65 years) Page 10 of 27 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 follow. 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 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. Residents take part in deciding what their personal goals are, and benefit from constant support and encouragement to enable them to make their own decisions and live an independent life. Evidence: The residents files showed the asessments making the basis of care plans, where the aim was to make the residents as independent as possible, with goals for them to attain. Risk assessments are carried out, and we advised that the owner expand on these to clearly show how the assessed risk is to be minimised. For example, one risk assessment stated a resident needed help with medication, but did not explain how that help was to be carried out. The owner said I encourage them to take responsibility for their own lives, in a supportive way. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Both of the residents we spoke to knew about their own files and records. I can look at it anytime, said one. We can do what we want. Im going out for lunch in a bit, said a resident, who also chatted about his friends and his travels. The owner commented on how having goals had encouraged confidence and independence in the residents. The other resident said he felt he could not do as he wanted, as he wished to be able to smoke in the home, which the owner did not allow. During the visit the resident sat outside the home to smoke. The resident commented that he accepted the owners decision on keeping a smoke free home. Care Homes for Adults (18-65 years) Page 12 of 27 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 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. Residents are able to make decisions on what they wish to do in their daily lives, and benefit from the support and guidance of the owner, enabling them to become independent and feel fulfilled. Evidence: The owner was aware of the diverse needs of the residents, and tried to make sure each individual had their own needs met within the small group. One resident had a lie-in on the day of the visit, and then chatted about his plans for the day. He told us about his travels and holiday with a friend, and was clearly confident and independently planning his activities. Another resident preferred to stay around the home, choosing to watch the world go by through the large lounge window, or watch the television, or go for walks when he Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: felt like it. The residents were very relaxed, and happy. They praised the owner and staff, and said they felt safe with any of the owners family or friends who may help at the home when needed. The main meal of the day is home-cooked. Its good food - theres plenty to eat, said a resident. They said they could have a full cooked breakfast if they wanted. We saw that the stew and dumplings for the main meal was cooking on the stove. The owner told us that the residents go food shopping on occasion with her, and pick what they would like, with her guidance. The residents are part of a family, and are treated as such. They are given some responsibilities in the home, from helping with the laundry, to helping to keep their own room clean and tidy. This helps to develop confidence and skills in each person, said the owner. Care Homes for Adults (18-65 years) Page 14 of 27 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 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 owner and staff have a good understanding of the residents support needs, so promoting good health Evidence: The individual records show any choices residents have in what care they would like, and how they would like it given. Weekly notes made for each individual help to monitor their progress, and give a good picture of each persons life at the home. I like a lie-in, said one resident now lying on the couch in the lounge, but Im out in a bit to meet my family, so Ill come back later Records show regular contact with Community Psychiatric Nurses, and the owner confirmed she contacts the Community Mental Health Team with any problems she has. We saw that the GP is contacted as necessary. A structured system for medication is used, with signed records when medication has been given to residents, and waivers signed by the residents when they are given the responsibility of taking the medication themselves, after it has been handed to them by the owner. We advised that residents should sign an agreement if the home take Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: control of administering their medication. The owner consults with the local pharmacist on any issues regarding administering medication. A locked safe holds all the medication securely. Im very conscious about how important it is to get the medication right for residents, said the owner. She has trained the staff member who lives in at the home in safe medication procedures, and we advised that an accredited medication awareness course is accessed for staff. Care Homes for Adults (18-65 years) Page 16 of 27 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 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. Residents are confident their concerns will be listened to and acted upon. The owner and her family have an understanding of Safeguarding issues, which protect residents from abuse. Evidence: There is a complaints procedure in place, and a complaints book to record any complaints in. The owner confirmed that she always discussed the need to be open with the residents, and to tell her if they were not happy with something. We saw the residents easily chatting with the owner, telling her what they did and did not like. Both of the residents we spoke to said that they would tell the owner if they had any problems. Surveys we received also confirmed this, and responses were I am happy, I have not got any complaints, and I like it here. The owner told us that she monitored visitors to the home, and tried to guide residents on risk taking and personal safety. The owner was able to discuss Safeguarding issues, and the procedures to take if she thought any resident was at risk of any sort of abuse. She should ensure staff receive refresher training in Safeguarding awareness and procedures. There has been one Safeguarding issue since our last visit, which the owner reacted to very promptly, following correct procedures, so protecting the welfare of the resident involved. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: There have been no complaints received either by the home or the Commission for Social Care Inspection since the last visit. Care Homes for Adults (18-65 years) Page 18 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, 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 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 clean, comfortable and pleasant place to live for the residents. Evidence: The home is in a residential area, and is of similar type to all the family homes around it. Residents told the inspector about the local cafes and shops they went to. The house is not suitable to anyone with a physical disability, as there are no aids to help and support, so all of the residents need to be mobile, and self-caring, as no personal care is provided. All parts of the house are open to residents, except private rooms at the top of the house, where a permanent staff member lives in. There is a dining room near to the lounge on the ground floor, to encourage residents to eat meals at the table, and a comfortable second lounge area in the basement space next to the kitchen, affording residents more privacy with any visitors. The owner has ongoing plans for decorating and improving the home, and at this visit we saw all of the exterior of the home had been fitted with new windows and doors. Some rooms had been refreshed with paint, and the home generally appeared clean and tidy. The owner now employs some domestic help to assist once a week. The bedrooms we saw were full of personal belongings, such as books, posters, and radios. All residents are responsible for keeping their own room as tidy as possible, Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: with guidance from the owner, and we saw they varied depending on the individual. Most of the laundry for the home is done as a service wash at the local launderette, although there is a washing machine in the home to use if needed. The owner told us that she tries to make the home bright and airy for the residents, and the residents surveys responded that the home is always fresh and clean. Care Homes for Adults (18-65 years) Page 20 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, 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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 a recruitment policy, and procedures, to ensure that only people who are suitable for this type of work are offered an appointment. Some training is given to make sure residents are safe. Evidence: Initially the residents were looked after by the family living in the home. Changes in circumstances have demanded the need for a different staffing structure to the home, and there is now a permanent live-in staff member, who is also one of the family. The owner lives nearby and calls in to monitor every day, discussing events in the home with the staff member. Other family members call in and help as well sometimes this is a family home, said the owner. During the owners absence at any time, for example through holidays, appropriate people are in place to provide the management, support and guidance for the residents. The owner always liaises with the Community Mental Health Team about any of her absences. All of the people involved at any time in the provision of support of the residents have a Criminal Records Bureau (CRB) disclosure. The owner has a recruitment procedure in place to use if she needs to recruit new Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: staff. New applicants would need two satisfactory references, and a CRB disclosure, prior to starting work at the home. There is a plan for induction training for new staff. Two of the staff hold food hygiene certificates, and clear fire awareness instructions are in place. Health and safety information has been passed on in-house. Medication training is also cascaded from the owner. External and accredited courses need to be accessed for care staff, to evidence that they are formally trained with up to date information. This further ensures that the residents are protected by staff who know the best way to look after them. The owner told us that the Community Mental Health Team offer information days for owners, to support them and keep them up to date with legislation and procedures. They also provide information on how to meet the diverse needs of people with mental health needs. She told us that the Community Psychiatric Nurses who visit the home also pass on relevant information which helps to develop the service provision. She said that if specific information is required, she also researches topics on the internet. Care Homes for Adults (18-65 years) Page 22 of 27 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 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. Systems and practices in the home promote and safeguard the health, safety and welfare of the people living there. Evidence: The owner of the home has many years experience of looking after people with mental health problems. The residents said that they always told the owner if they liked or disliked something, and that the owner told them to do that. The owner recorded their comments in a diary, and told us that she dealt with them straight away or as soon as possible. Records showed regular contact with GPs, Community Psychiatric Nurses, and social workers, with any comments they had made on the service. The owner said the residents are instructed on fire safety, and the residents were able to tell us what they would do and where they would go if there was a fire. The owner confirmed that the appliances in the home are maintained as in any domestic home. An accident book is used to record all residents accidents, and any follow-up required. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 20 13 Staff must attend accredited 28/08/2009 training in medication awareness before the end of April So that they have a basic knowledge of how medicines are used and how to recognise any problems, so protecting residents welfare. 2 35 18 Accredited training must be attended by the staff which fulfils the aims of the home. To make sure residents needs are met by appropriately trained staff 28/08/2009 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 9 The risk assessments should be further developed by giving more detailed information on how the assessed risk is to be Care Homes for Adults (18-65 years) 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 minimised 2 20 Residents should sign an agreement if, following a risk assessment, the home takes responsibility for administering their medication Staff should receive up to date and refresher training in Safeguarding awareness and procedures to ensure residents are protected from any sort of abuse. Staff should have recorded one to one supervision meetings with the owner, so as to monitor their work, give support and guidance, and identify training needs. 3 23 4 36 Care Homes for Adults (18-65 years) Page 26 of 27 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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