Care Home: Pathways North West

What the care home does well What has improved since the last inspection? Risk assessments were in place to enable people using the service to participate in activities that are so far as reasonably practicable, free from avoidable risks. Support staff had undertaken further health and safety training to ensure they were aware of potentially dangerous practice. What the care home could do better: The home did not have a registered manager. Staff supervision should be held at least six times a year. CARE HOME ADULTS 18-65 Pathways North West 175 Blackburn Road Great Harwood Lancashire BB6 7LU Lead Inspector Lynn Mitton Unannounced Inspection 6 December 2007 10:00 th Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pathways North West Address 175 Blackburn Road Great Harwood Lancashire BB6 7LU 01254 829216 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) stephen.dewsbury@btinternet.com Pathways North West Ltd ******Vacant post***** Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is registered for a maximum of 5 service users in the category of MD (Mental Disorder, excluding learning disability or dementia) The service shall employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 12th July 2006 Date of last inspection Brief Description of the Service: Pathways Northwest Limited is registered with the Commission for Social Care Inspection to provide personal care and accommodation to 5 adults with mental health problems. The premises are a spacious end-terraced garden fronted property that is situated in a residential area of Great Harwood. The home is adjacent to the town centre of Great Harwood and is close to local amenities. Accommodation is provided in 5 single bedrooms. Shared space is 2 lounges, both of which are now non-smoking, and dining room/kitchen. There is private garden area to the rear of the home. The home aims to provide structured rehabilitative support that responds to the needs of individuals to help them achieve their maximum potential. There are a range of therapeutic activities i.e. stress management and problem solving available. Fees for the cost of a weeks care at Blackburn Road ranges from £740.00 £1150.00. There was information available to potential users of the service advising them of the home and giving them details about the type of service they could expect. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted on 6th December 2007. The area manager of the home completed a pre inspection questionnaire. The inspector spoke to 3 people living at Blackburn Rd, and to the support staff on duty at the time of the inspection. Throughout the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of people using the service. One user of the service was case tracked, their file examined in detail and two support staff member’s files were also case tracked. Two of the Commissions service users surveys were returned, but no visitors/relatives or health professional’s surveys were returned. Comments and findings of these surveys are referred to throughout this report. The inspector conducted the inspection with the area manager. During the inspection a number of records, policies and procedures were also viewed. What the service does well: One user of the service wrote; “I think everything is going well for me here”. Needs assessments were in place identifying the care needs of people using the service so that support staff would have a clear understanding of how they could support them. Contracts explained what users of the service could expect, how much it cost, and what was expected of them in order for them to live at Blackburn Road. Information on care and health plans meant that service users’ needs were known to support staff and were being met in a consistent way. Policies and practices enabled residents to make decisions about their lives. The risk assessment and management framework supported residents to take responsible risks. The home was run to ensure people had opportunities to enjoy their lifestyle, to fulfil their potential and given opportunities to maintain and increase their independence. They had regular access to the local community, opportunities to maintain family links, their privacy was respected and they were valued as individuals. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 6 Individual dietary needs were catered for and they were encouraged to participate in shopping, planning and preparation of meals. Personal support was offered in accordance with people’s wishes, and in a way that promoted privacy, dignity and independence. People’s health needs were being appropriately recorded and met. Policies and practices for managing and administering medication were in good order. There was a clear complaints procedure and evidence that people using the service views were sought and acted upon. Staff had a good understanding of adult protection issues, ensuring that any allegations would be dealt with appropriately. The standard of décor and furnishings provided a comfortable and homely environment for residents. 70 of support staff had completed their NVQ training and other appropriate training was also being undertaken. Recruitment and selection procedures and policies ensured residents were safe. Residents’ needs were met by welltrained staff. The home was run to ensure good practice was in place with regard to the safety and welfare of residents and staff were safeguarded. A system for obtaining the views of residents was in place. Health and safety procedures were in place and most staff had undertaken health and safety training. What has improved since the last inspection? What they could do better: The home did not have a registered manager. Staff supervision should be held at least six times a year. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA2 & YA5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Needs assessments were in place identifying the care needs of people using the service so that support staff would have a clear understanding of how they could support them. Contracts explained what users of the service could expect, how much it cost, and what was expected of them in order for them to live at Blackburn Road. EVIDENCE: There had been one new admission to the home since the last inspection. The inspector case tracked one person’s file and found that detailed information had been obtained prior to their admission to Blackburn Road. Contracts for people using the service were seen. These had been signed and dated, and fully explained the terms and conditions of their residence at Blackburn Road. There was also information regarding the person’s legal status. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA6, YA7 & YA9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Information on care and health plans meant that service users’ needs were known to support staff and were being met in a consistent way. Policies and practices enabled residents to make decisions about their lives. The risk assessment and management framework supported residents to take responsible risks. EVIDENCE: One care plan was examined. This contained very detailed information about the person, and the level of support needed for staff to ensure continuity of care and also evidenced resident’s input. A date had been planned when this would be reviewed. There was also a care plan completed by the funding authority. The policy of Pathways is to promote responsible risk taking and freedom of choice. The care plan seen contained detailed risk assessments and management strategies. It also contained a safety profile. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 11 Since the previous inspection, household risk assessments had been developed and implemented. The inspector was advised that everyone had a next of kin or advocate. Residents talked to the inspector, and observations were made, demonstrating a number of ways in which they made decisions about their daily lives. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA12, YA13, YA15, YA16, & YA17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was run to ensure people had opportunities to enjoy their lifestyle, to fulfil their potential and given opportunities to maintain and increase their independence. They had regular access to the local community, opportunities to maintain family links, their privacy was respected and they were valued as individuals. Individual dietary needs were catered for and they were encouraged to participate in shopping, planning and preparation of meals. EVIDENCE: One person using the service told the inspector when asked what they liked best about living at Blackburn Road said; “there are more activities, I can go into town when I like and get a can of coke when I like”. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 13 One person using the service told the inspector when asked what they liked best about living at Blackburn Road said; “there are more activities, I can go into town when I like and get a can of coke when I like”. Each person had an individual activity programme, which was encouraged and promoted by staff and the inspector was satisfied that activities were based on meaningful and valued activities, regularly accessing their local community. On the day of the inspection, one person went on a planned visit home, one person went into Accrington shopping, one person went to college and one person spoke to family to plan a birthday visit. One person was at home sewing. The inspector noted that records of residents meetings were in place for every month this year, demonstrating that residents were being consulted about the running of the home. One person worked as a volunteer at a local horse and pony sanctuary; another had expressed a wish to seek further education/employment. One person attended a local college. The staff team endeavoured to ensure people using the service had opportunities to fulfil their potential socially, emotionally, and maintain and increase their independent living skills. The area manager and inspector discussed how the cultural needs of each person were being met. Eid had recently been celebrated and gifts exchanged. Everyone had regular contact with their families. One person went on home leave at the time of the inspection. The inspector was satisfied that families and next of kin were encouraged to be involved in the care planning for each person. Staff supported people to maintain family contacts; this included structured family meetings and trips to Scotland to meet up with family. Peoples preferred name was included on the care plan documents. Residents said that they felt they were listened to and their rights and wishes were respected. Everyone have a key to their own room. One person needs support with personal care; other people needing only prompts. All people using the service open their own mail. One person told the inspector; “we get decent meals. I say at the residents meeting what I’d like on the menu”. Each person was given a weekly budget to buy his or her own food at lunchtime. A record of what each person ate was kept. Residents made their own meals with staff support as required, except tea, which was a communal meal. Meals were discussed at residents meetings. Halal meats were provided for two people. Separate utensils were available for halal meat to avoid cross contamination, and staff had been advised about nutritionally balanced diets for one person on a weight reduction diet and Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 14 another who was diabetic. The diabetic had detailed written dietary advice on their care plan. Fridge/freezer temperatures were being recorded. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA18, YA19 & YA20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support was offered in accordance with people’s wishes, and in a way that promoted privacy, dignity and independence. People’s health needs were being appropriately recorded and met. Policies and practices for managing and administering medication were in good order. EVIDENCE: The inspector observed that residents received personal support in the way they prefer and require, and individual plans identified personal preferences and support needs. One person received 1:1 care support 2 days a week by a care staff who understood their cultural needs and could communicate in their first language. All people using the service had access to specialist workers such as consultant psychiatrists, anger management support groups, abstinence support groups, community psychiatric nurses, and counselling. District Nurses attended regularly to administer one persons medication. There was clear evidence on the care plan case tracked that each person’s mental health and physical health needs were being given due care and attention. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 16 The person case tracked had a “Staying Well Plan” and a health check in place. These were very detailed documents and had been recently reviewed. The inspector noted that a new health care document “Wellness Recover Action Plan (WRAP)” was being introduced but had not yet been fully implemented. There were separate records of visits to consultants, social worker, dentist and GP. The inspector noted that an eye test had not been undertaken for the person case tracked. Policies and practices for managing and administering medication were seen to be in place. There had been one incident of mismanagement of medication since the previous inspection. This had been dealt with in accordance with the policies and procedures for Blackburn Road. The person case tracked had a PRN (as and when required) medication plan in place. Medication was being stored securely and in good order. A medication fridge was in place. No person was taking controlled drugs. Medication administration records were seen and in good order. Patient information leaflets were available. Appropriate records were kept of medication returned to the pharmacy. Risk assessments were in place for one person who checked her own blood sugar levels. Consent forms for staff to administer medication were in place. No one self medicates. There had been a change of supplying pharmacy, and the area manager reported that this system of administration was much preferred to the previous one and appeared to be more robust. All staff completed comprehensive workbooks about the administration of medication. The inspector noted the good practice of a “Caution Card” to notify all staff that a person’s medication had recently changed. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA22 & YA23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There was a clear complaints procedure and evidence that people using the service views were sought and acted upon. Staff had a good understanding of adult protection issues, ensuring that any allegations would be dealt with appropriately. EVIDENCE: Both questionnaires completed by users of the service indicated that they knew who to speak to if they were unhappy, and that they knew how to make a complaint. One person living at Blackburn Road told the inspector that if she had any worries she would talk to the area manager. The Commission had received no complaints, nor had there been any complaints made to Blackburn Road. Policies and practices regarding concerns complaints and protection of vulnerable adults were seen in place, and these included whistle blowing and racial harassment. These policies and procedures had been reviewed in April and June 2007. Staff spoken to by the inspector knew what to do should they have any concerns about a resident’s wellbeing. Prevention of abuse had been undertaken for all staff within recent months. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA24 & YA30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings provided a comfortable and homely environment for residents. EVIDENCE: The home was clean and tidy, and there were no offensive odours. The home was registered with the Commission in January 2006 and had been fully re-furbished prior to this. Since the previous inspection, one lounge (previously a smoking lounge) had been redecorated. This lounge had been split to make an office for staff. All residents’ rooms had been redecorated. A new sofa was on order. The home is now a non-smoking establishment, but a sheltered area outside had been made available for residents who smoke. Laundry facilities were suitable for the needs of the residents. Specialist equipment was not needed for any resident. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 19 A monthly checklist was completed to ensure the standard and safety of the building. People using the service told the inspector that staff do not enter their bedrooms unless they have concerns for their safety and wellbeing, and that they (the residents) were in agreement with this. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA32, YA34, YA35 &YA36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 70 of support staff had completed their NVQ training and other appropriate training was also being undertaken. Recruitment and selection procedures and policies ensured residents were safe. Residents’ needs were met by welltrained staff. EVIDENCE: The inspector was advised that out of the team of 10 support staff, 7 had obtained NVQ2/3 training qualification. 2 staff were undertaking this training. All new support staff completed induction training that linked into the Skills for Care “Common Induction Standards.” specification. The inspector case tracked two staff member’s files. These contained information that demonstrated full checks had been taken to ensure that residents were safeguarded. This included a record of interview. The staffing rota was seen and this showed that Blackburn Road was fully staffed and there were at least 3 members of staff on duty between 9 – 5 pm and 2 staff members between 5 – 10pm and 1 wake and watch person on duty Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 21 between 10pm – 9 am. There were three members of staff on duty (plus the area manager) at the time of the inspection. Each member of staff had a training and development programme. A training matrix was in place, it was advised that this was in need of updating to ensure its accuracy. Staff training was ongoing and relevant to the resident’s living at Blackburn Road. A training and development plan was in place, as was an allocated budget as identified in the business plan. Individual training needs were identified during staff appraisals. The inspector observed residents’ being supported by competent staff. The inspector spoke at length to one member of staff. A staff survey had been undertaken in April 2007 and the overall feedback was very positive. 1:1 supervision notes were seen for one member of staff. One member of staff who started work in October 2007 had not yet received supervision. The inspector advised that best practice would be to hold 1:1’s on a monthly basis during new staff member’s probationary period. The last team meeting had been held in November 2007 and the minutes were seen. There had been 4 team meetings in 2007. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): YA37, YA39 & YA42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home did not have a registered manager. The home was run to ensure good practice was in place with regard to the safety and welfare of residents and staff were safeguarded. A system for obtaining the views of residents was in place. Health and safety procedures were in place and most staff had undertaken health and safety training. EVIDENCE: Blackburn Road was being managed on a day to day basis by the area manager. The inspector was satisfied that there were clear lines of accountability within the home, however advised that a registered manager be recruited as soon as possible. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 23 An annual business, training and development plan for 2007 was in place and seen by the inspector. An internal audit was completed monthly. A staff survey had been conducted in April 2007. A residents survey had taken place in September 2007. The inspector was advised that the results had been collated and were due to be published. The inspector distributed the Commissions surveys to people living at Blackburn Road. All gas and electrical certificates were in place and seen by the inspector. Hot water temperatures were checked and recorded weekly. Fridge and freezer temperatures were checked and recorded daily. Appropriate accident records were being completed. Fire evacuation drills were completed monthly, and fire alarm tests were completed weekly. Staff spoken to knew the fire procedure. A fire and other building risk assessments were seen. The inspector noted that most staff had undertaken health and safety training as outlined in this standard to ensure the safety of the people living at Blackburn Road. Further training was planned for those who had not already completed this. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 4 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 2 X 3 X X 3 X Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA37 Regulation 8(1b) Requirement A registered manager must be recruited for Blackburn Road. Timescale for action 01/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA36 Good Practice Recommendations Staff supervision should be held at least six times a year. Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Pathways North West DS0000066446.V340350.R01.S.doc Version 5.2 Page 27 - 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. 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