Care Home: St Maur

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What the care home does well Staff work alongside people, in developing and recording care and assessment needs and peoples progress, right from the start of the service. There is a good system of care planning and assessment focused on individual short and long-term goals for good mental health. The service provides a good standard of personal care and support, which promotes peoples independence and development. This includes the development of skills inside and outside of the home with a range of activities such as attending college or leisure activities. There is a dedicated staff team who have a range of skills, knowledge and experience to provide flexible support to people. There is a regular programme of training for staff and staff have a commitment to keeping themselves up-to-date in a range of topics related to peoples care. There were effective quality assurance tools that included people`s views of how the home and the service was run. What has improved since the last inspection? Since the last inspection there have been major improvements to the environment. This has included complete refurbishment of bathrooms and toilets. Redecoration of communal areas such as the lounge, dining areas and kitchen. Peoples individual rooms have also benefited from additional furniture and some redecoration. What the care home could do better: The service user`s guide and statement of purpose should be fully completed and made available to people planning to come into the service. Care Planning and assessment records could be more fully completed and checked to ensure that they are all dated and signed. Medication administration, storage and recording must be improved. Medication storage was also highlighted at the previous key inspection. All medication must be stored, administered and recorded in line with current guidelines. For example: all medication coming into the home should be accounted for, there should be a record of medication disposal and medication should be recorded when administered or the reasons why medication was not received fully recorded. Complaints and how they were resolved should be recorded. The manager should be registered with us and should have the opportunity and time to fulfill management tasks such as ensuring supervision for all staff is completed, auditing care and assessment records and auditing of medication administration systems. The manager should submit an action plan addressing the requirements and recommendations so that we can see that the service has improved in the areas described. Key inspection report Care homes for adults (18-65 years) Name: Address: St Maur St Maur 8 Knowles Hill Road Newton Abbot Devon TQ12 2PW     The quality rating for this care home is:   one star adequate 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: Andrea East     Date: 1 1 1 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 29 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 29 Information about the care home Name of care home: Address: St Maur St Maur 8 Knowles Hill Road Newton Abbot Devon TQ12 2PW 01626335560 01626363313 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Community Care Trust (South Devon) Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home St. Maur is a detached house in a quiet residential area. It is less than half a mile from Newton Abbot town centre, therefore near to shops and the other usual town facilities. The house is located up a steep drive in a secluded position, and there is a large garden and a small car parking area. There is a lounge, separate dining room (which also has a small office facility sited within it) and a communal lounge. There are six single bedrooms and one double. The home caters for younger adults with a mental health problem, its main aim being to provide a needs-led, person centred care package, based on thorough assessment and care planning which is undertaken with the client. The care and support subsequently provided is a client self management and recovery programme. The home can also provide a small day care service for up to two clients on a daily basis, although this service is not used on a regular basis, but 2 9 1 0 2 0 0 8 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home rather as needed. Care Homes for Adults (18-65 years) Page 5 of 29 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: one star adequate 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: The quality rating for this service is one star. This means that people who use the service experience adequate quality outcomes. The inspection site visit was unannounced and took place over one day. People were spoken with regarding the lifestyle in the home and the care services they received. The manager and staff were spoken with and a tour of the premises was made. A range of documents were examined including care assessment records, medication and staff records, policies and procedures. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The service users guide and statement of purpose should be fully completed and made available to people planning to come into the service. Care Planning and assessment records could be more fully completed and checked to ensure that they are all dated and signed. Medication administration, storage and recording must be improved. Medication storage was also highlighted at the previous key inspection. All medication must be stored, administered and recorded in line with current guidelines. For example: all medication coming into the home should be accounted for, there should be a record of medication disposal and medication should be recorded when administered or the reasons why medication was not received fully recorded. Complaints and how they were resolved should be recorded. The manager should be registered with us and should have the opportunity and time to fulfill management tasks such as ensuring supervision for all staff is completed, auditing care and assessment records and auditing of medication administration systems. The manager should submit an action plan addressing the requirements and Care Homes for Adults (18-65 years) Page 7 of 29 recommendations so that we can see that the service has improved in the areas described. 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 29 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 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not have written information about the service to assist them in making an informed choice about where to live. People move into the service only after a full assessment of their needs is discussed with them. Evidence: The service users guide and statement of purpose was under review. Displayed on a notice board was the items that might be included in the new services is going statement of purpose. The manager said that the staff and the people living in the home are adding to the list, but that they were actively involved in its development. The manager said information was passed to anyone thinking coming into the home, through discussion. People were also welcomed into the home prior to moving in, in informal visits, where staff shared information about the day-to-day life and routines at the service. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: There was a detailed assessment process in place for anyone thinking of coming into the home. This included discussion on input from a range of health professionals, consultants, nutritionists, psychologists and nursing staff. The assessment process included visiting the person in in the community and hospital settings. Care Homes for Adults (18-65 years) Page 11 of 29 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 were supported to make decisions about their lives and taking responsible risks and this was recorded in assessment and care records. Evidence: A file, containing a range of information on each persons, personal and healthcare history, current long and short-term goals, care plans and assessments has been compiled. Three files were examined and found to contain a range of information, that people had been actively involved in compiling with staff. Risk assessments for the person, were not always fully completed so the information about potential risks was in a number of places. Some documents were not dated or consistently signed. Ongoing daily records were more specific and detailed and gave a wealth of information about peoples needs and how they were actively involved in their care. This included the person using the service, writing in care plan and assessment s Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: alongside staff evaluation and summaries. Assessment and care plans had long and short-term goals and were regularly reviewed with input from the person living at home and relevant others, such as relatives and health professionals. The document support to staff and managers description of how people supported to make informed choices, be actively involved in the support and care the service provides and to take planned risks. Care Homes for Adults (18-65 years) Page 13 of 29 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 were supported in finding and keeping appropriate jobs, continuing their education and participating in activities within the service and local community. People were supported to make family links and friendships and in their daily routines in making individual choices as part of their agreed plan of care. People enjoyed varied, balanced meals of their choice and flexible times that suited their individual preferences. Evidence: People said that they continued to take part in activities that suited them in the local community.On the day the site visit people were attending college, out for coffee and attending planned activities linked to their personal goals. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: All activites centred around people choices and long and short term goals in developing or restablishing skills such as budgeting, shopping and interacting with people. The kitchen area and meals times were part of peoples plans, so that people took an active part in planning and choosing their meals, snacks and drinks. Meals and special diets were also part of care and assessment records. Care plan and assessment records also included details on a daily basis of the activities that people were involved in. Care Homes for Adults (18-65 years) Page 15 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received flexible support and care to maximise their independance in meeting thier personal and health care needs. Peopls rights and dignity were respected. Medication administration , recording and storage was poor. Evidence: Care plan and assessment records included detailed information on how people were supported to maintain their personal and health care needs. Peoples care was regularly reviewed and a range of outside healthcare professionals were part of those reviews. People said that staff supported them, at a pace that suited them, to be involved in their personal and health care choices. This support ranged from making sure that people attended appointments to prompting people to make sure they attended planned leisure activities. Staff spoke with, were able to give detailed descriptions of peoples needs including health and personal care needs. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: Medication administration, storage and recording was poor. Medication recording was poor as it was unclear why some people had chosen not to take medication. For example there were crosses to indicate that medication had not been given or received but no reasons for this. Medication records also had several different dates highlighted, so it was difficult to establish the actual date of entry. There was no medication disposal record and there was no consistent record of the medications people arrived with at the home. There was a risk assessment process in place for assessing peoples safety in looking after their own medication (this is known as self-medicating). This record of assessment of possible risks to their self-medicating had not been consistent completed for everyone living at home to look after their own medication. There were boxes of medication stored in one persons room that had not been recorded, so that staff had no way of ensuring that this medication was accounted for. The storage of medication was poor as medication boxes, with a with a range of medication in, including creams were left unsecured in one persons room. Boxes and medications were opened with no date of when opened or who they belong to. Strips of medication were out of boxes with no indication of who they were prescribed for. There was no consistent clinical audit of medication storage and recording. An audit of how people were involved in looking after their own medication was in the process of being implemented. The poor storage of medication was highlighted at the previous inspection. Care Homes for Adults (18-65 years) Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns and complaints were listened to and acted upon and People were protected from abuse, self harm and neglect. Evidence: There was a clear policy on dealing with complaints and concerns, that staff were aware of. Staff were able to describe the procedure for dealing with complaints and concerns and said that any concerns or complaints would be addressed by the manager. People said that they felt able to talk to staff about any concerns or worries and were sure that they would be listened to and action taken to address their concerns. One way in which peoples concerns were expressed were were as part of a routine house meeting. The concerns and issues raised were recorded on a white board up until the next meeting and was then erased. individual concerns linked to peoples care were recorded in care and assessment records. There was no written record of formal complaints or how they were addressed. This meant the manager was unable to look back at areas of concern and ensure that they were not repeated failings that could have been addressed and prevented. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Staff routinely received training updates on the protection of vulnerable adults. There were also a range of policies and procedures available to staff on safeguarding people from harm, particularly related to their mental health. There were also systems in place for the recording of accidents and incidents and the notification of serious incidents to us. Care Homes for Adults (18-65 years) Page 19 of 29 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 lived in a safe, well maintained clean and homely environment. Evidence: The premises appeared to be clean and tidy and had recently benefited from large areas of the home having been redecorated. This included huge improvements to bathroom and toilet areas that had been completely refurbished and refitted with new equipment, bathing facilities and decor. The lounge, dining room and kitchen areas had been improved as they had been redecorated and furniture repaired and or replaced. Peoples individuals rooms had also benefited from some additional fittings and fixtures and furnishings of people choosing. People took responsibility for the cleaning and repair in their individual rooms. So it was up to them to report repairs and supported by staff maintain the cleanliness of their room, as part of their care and support. The manager completed a monthly audit of rooms to look at health and safety issues and any need to replace or repair fixtures and fittings and to consider continued Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: redecoration of rooms. The manager said there was plans to continue with redecoration and refurbishment , as part of the ongoing maintenance of the home. The manager said the risk assessments for the premises were routinely completed formally and informally and were recorded. There were a range of health and safety policies related to the building and health and safety that were available to staff. Staff also complete training in health and safety which also relates to the premises. Care Homes for Adults (18-65 years) Page 21 of 29 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 were supported by an effective and competent staff team, that had been selected through a rigorous recruitment process. Evidence: People said that they felt well supported by staff who were knowledgeable about their needs and were always able to help. Staff training records were in place for staff new to the home and as part of ongoing staff records. Staff received informal and formal supervision. Formal supervision was not always fully recorded for all staff. The manager and the staff spoken with confirmed that they received what they described as mandatory training in key areas such as health and safety, protection of vulnerable adults, first aid and food hygiene. In addition staff completed training in areas of interest and development to maintain the registration as qualified nurses. Training relevant to the field of mental health was also obtained through outside agencies. There were good recruitment procedures in place, which included application forms, seeking references and obtaining police checks. The reference number of police checks Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: were available for inspection, however the actual police check was not available. There was no evidence that staff past history including any criminal history had been explored. It is important that the manager evidence that potential staffs past history is explored to ensure that they are suitable to work with vulnerable people. Care Homes for Adults (18-65 years) Page 23 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a well managed home, that took in to consideration people s views on the review and development of the service. Peoples health safety and welfare was promoted and protected. People Th Evidence: The manager had been employed a the home for over a year and had put in an application to register with us that had been returned. We were unable to verify that the manager has the skills knowledge and experience, or is suitable to work with vulnerable people and to mange the home until the application has been received and processed. The manager said that he had the knowledge skills and experience to manage affectively. The manager is supported by senior managers in a group of homes that the service is linked with. Some of those senior managers have been registered with us. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: The manager works as part of the staff team so that his time is divided between working with staff, working with people living at home and trying to develop good policies and practices. Recent demands on staff time centred around almost one-to-one care for one person in the home resulting in the manager spending large amounts of time on staff and care interventions. This appears to have impacted on the managers ability to complete management tasks such as ensuring formal supervision is fully recorded, ensuring medication is administered, stored and recorded appropriately and care and assessment records are fully completed. There were a number of quality assurance tools in place such as health and safety checks, and a questionnaire that the people living at the home were invited to complete. The questionnaire was also made available to visitors relatives and outside agencies. The findings the questionnaires were then displayed on a noticeboard and there was clear evidence that the find is in the questionnaires had been acted upon. Quality was also monitored at staff meetings and meetings with people who live at the service. There were health and safety policies and procedures in place and the manager was aware of the need to promote safeguarding and good health and safety practices. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 Medication must be stored 14/01/2010 securely, clearly labelled and accounted for This will minimise the risk of medication going missing people having access to medication that is not prescribed 2 20 13 Medication to be disposed off or return to the pharmacy must be fully recorded This will ensure that all medication is accounted for 14/01/2010 3 20 13 Medication recording must be accurate, clearly showing when medication was given and the reasons for medication not being given This will ensure that all staff are fully aware of the medication that people have received. It will also ensure that people receive the 14/01/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 medication they are prescribed and need. 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 1 As planned, a written service users guide and statement of purpose should be completed and made available to anyone thinking about moving into the service. Review all care and assessment documents, so that they are fully completed, dated and signed. Assessments for self medication should be fully completed for everyone choosing to look after their medications A process of clinical audit looking at medication administration storage and recording should be routinely completed to ensure that medication administration is in line with current guidelines. Continue as planned with the ongoing maintenance and repair to the premises furniture and fittings. Staffs formal supervision should be clearly recorded for all staff. Staff personal histories including histories of any criminal convictions should be fully explored and recorded. Police checks should be made available for inspection purposes. The manager should resubmit its application to register with us. The manager should be given the opportunity and time to fully complete management tasks such as supervision records and clinical audits to ensure good medication administration. 2 3 4 6 20 20 5 6 7 30 32 34 8 9 37 37 Care Homes for Adults (18-65 years) Page 28 of 29 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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