Inspection on 03/03/09 for Carlton Bridge

This is the latest available inspection report for this service, carried out on 3rd March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Bridge 30/04/07

Carlton Bridge 11/12/06

Carlton Bridge 01/06/06

Carlton Bridge 19/12/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOME ADULTS 18-65 Carlton Bridge 42 Woodfield Road London W9 2BE Lead Inspector Sheila Lycholit Unannounced Inspection 3rd March 2009 10:20 Carlton Bridge DS0000065284.V374375.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 Carlton Bridge DS0000065284.V374375.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. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Bridge Address 42 Woodfield Road London W9 2BE 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) 020 7286 4032 F/P 020 7286 4032 The Westminster Society Paul Allan Rushton Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 7th April 2008 Date of last inspection Brief Description of the Service: Carlton Bridge is a residential care home for eight people with a learning disability. There are currently eight people with significant support needs living in the home. Stadium Housing Trust owns the property, Westminster Society, a voluntary organisation, provides the care and staff and Paddington Churches Housing Association are responsible for the property management. The home is located near the Harrow Road, close to shops and other community facilities. Transport links are very good with both tube and buses near by. Carlton Bridge is a modern, terraced four-storey property. The service users’ rooms are arranged over the first, third and fourth floor. Sitting/dining rooms and kitchens are situated on the ground and second floors. There is a spacious lift to all floors and the home is accessible to wheelchair users. The weekly fee for the service is approximately £2, 000. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. The unannounced inspection took place on Tuesday 3rd March 2009 from 10.20am until 4.30pm. At the start of the inspection the Assistant Manager, who was having a session with her NVQ Assessor, was on duty with 3 support staff. The Manager came on duty in the early afternoon for a late shift. The Manager had completed an Annual Quality Assurance Assessment in detail before the inspection. The Manager and Assistant Manager made themselves available throughout the visit. Four service users were at home at the start of the visit, 3 were at day services and 1 was at home with his parent, returning later in the day. In addition to the Manager and Assistant Manager, one member of staff was spoken with in private and all service users at home were introduced. What the service does well: What has improved since the last inspection? Since the last inspection, the Manager has been registered with the Commission and steps have been taken to create a more consistent staff team. A senior staff team has been established with one permanent Assistant Manager who transferred with the new service users and a temporary Assistant Manager on secondment. Although some medication errors have occurred the incidence has decreased as a result of staff training and regular auditing. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 6 There is a higher priority given to fire safety, with regular testing of alarms and monthly fire drills. Personal evacuation plans, which are well thought out, have been compiled for each person. What they could do better: 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. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 7 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 Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 8 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): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clearly written and up to date Service User’s Guide is available, which must be issued to all service users. The transition of 4 service users to the home in 2008 was well managed. EVIDENCE: Three service users’ individual files were looked at, together with the transition records of 1 other service user. One file contained a copy of an up to date Service User’s Guide and contract. The Guide was comprehensive and clearly written, though the information on current staffing needed to be included. The Manager confirmed that the Guide and Contract had not been issued to all service users. Since the last inspection 4 new people have moved to 42 Woodfield Road, who were previously living at another service, which has closed. Records and discussion with the Manager show that the transition was carefully planned with the involvement of service users, their families and advocates. Colleagues from the multi professional team advised on supporting people through the move, contributing to the individual transition plans. Records show that each visit to the house was monitored and steps taken to resolve any problems. The needs of each person were re-assessed before the move. Three of the people who moved into the house were seen during the inspection visit. They appeared at home and to have a good relationship with the staff on duty. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 9 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): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and support guidelines are well written and show the involvement of the service user. Comprehensive risk assessments are available. EVIDENCE: Support guidelines and care plans for three service users were looked at. The support guidelines are written in the first person and show that staff who have drawn up the guidance know the service user well and are aware of how they wish to be supported. Care plans have been made more accessible with the use of photos and are of a good standard, covering all major areas of the person’s support, communication, activities and contact with families and friends. PCPs were also seen on file, though these, as the Manager confirms, are at an early stage of development. Discussion with the Manager and Assistant Manager indicate that staff at 42 Woodfield Road have had difficulty in arranging regular reviews for service users with their Care Manager. Staff must ensure that the care plan is reviewed at least every 6 months or more Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 10 frequently if the person’s needs change, regardless of whether or not the Care Manager is available. One service user whose needs and support provided have changed considerably in the past few months had not had a review since August 2008, leaving his care plan out of date. Monthly summaries could be used to review the care plan, checking that it reflects the person’s current needs and the care and support provided. Staff are using multi media, in particular photos, to make documents more accessible but would benefit from further training and specialist support. An additional computer terminal for the use of staff and service users would allow service users to make a greater contribution to meetings and reviews and would support their communication more generally. Risk assessments were seen on each of the 3 files looked at. These were comprehensive and up to date. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at 42 Woodfield Road receive good support to take part in a range of activities. Good relationships have been established with families and friends. Some steps have been taken to encourage healthy eating but further action is needed. EVIDENCE: Activity plans were seen on service users’ files and displayed on the staff notice board. Five service users attend local day services, one attends college and three have individual activities arranged by staff at the house. The Manager confirmed that regular visits are made to the cinema, live music events and to local restaurants and pubs. Photos on file show service users taking part in a range of community activities. Individual holidays have been arranged for some residents, with staff support, including a recent trip by one person to Tenerife. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 12 Discussion with staff and records show that good relationships are maintained with families and friends. One service user spends 3 nights at his parent’s home each week. Service users are supported to keep in contact with families further afield by phone. Families regularly attend reviews and meetings. The cultural and religious needs of service users are identified and steps taken to ensure that they are met. One person receives communion each Sunday from a Sister who visits him. The Manager said that staff are trying to arrange for him to attend Mass regularly at the local Catholic church. Service users attend cultural festivals and events reflecting their background. Staff ensure that one service user who is Muslim eats only Halal meat and that she receives personal care from female staff. Each of the sitting rooms has an adjacent, pleasant dining area. Menus, which are displayed in each of the kitchens, are drawn up with the involvement of service users. It has been identified, in the preventative health care action discussed under standard 19, that a number of service users need to eat more healthily and to avoid any further weight gain. There was a good supply of fresh fruit and vegetables in the kitchens but menus also rely on pre-prepared and processed food. On one day there was chips on the menu twice, on one occasion accompanied by chicken nuggets. Menus also included a pub meal on one evening followed by a takeaway the next. More visual images of meals, including illustrated cookery books and recipes from magazines might encourage service users to choose a wider range of foods. One service user, whose low weight was being monitored at the last inspection, has been supported to maintain his weight. While his weight is regularly checked, on the advice of the Dietician food and fluid charts are no longer completed. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff work closely with health care colleagues to ensure that service users’ health care needs are met. A high priority is given to preventative health care. Steps have been taken to improve the handling of medication, although errors continue to occur. EVIDENCE: Support guidelines were seen on each of the three service users’ files looked at. These described in detail how each person wishes to be assisted. The advice of members of the multi professional Learning Disability Team, including the Psychologist, Speech and Language Therapist and Physiotherapist are sought as necessary to support service users’ physical and emotional well being. Discussion with the Manager and records show that service users’ health care is given a high priority. Health action plans are completed in detail. All service users have an annual medical check-up with their GP. One person was attending his check-up on the day of the inspection. Records show that service users who are anxious about medical procedures, such as blood tests, are Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 14 supported by staff, who have had some success in encouraging agreement to recommended procedures. The Manager confirms in the AQAA that training has been provided to staff to increase their understanding of health care needs, including attending Healthlinks sessions. The Assistant Manager has completed the Health Facilitator training. Service users who moved to the house last year have retained their former GPs to ensure continuity of health care. Records show that prompt action is taken to contact GPs when there are any concerns. At the time of the inspection, the District Nurse was visiting one service user daily following his discharge from hospital. Steps have been taken to improve the handling of medication, including staff training and regular audits. The Boots measured dosage system is used. Current MAR sheets were looked at and were up to date. Some errors have continued to occur in particular, regarding missed doses of medication, which had led to weekly audits being implemented. Medication incidents are examined at Team Meetings to try to prevent a reoccurrence. The Manager undertook to check the storage of one prescription with the Pharmacist. It is recommended that a photo of each person is added to the medication packs in the slot provided. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 15 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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has an established complaints procedure in an accessible format. Staff take steps to protect service users from abuse or neglect. EVIDENCE: There is an accessible complaints procedure, which was seen on file, though staff must ensure that copies are also displayed in the home. The Manager explained that a copy is normally placed on the ground floor notice board. One complaint has been received since the last inspection from a service user, which was addressed by the service. All complaints are logged on line and are monitored by senior managers. The Manager is trying to encourage service users to express lower level complaints and concerns, for example in house meetings and in key working sessions. No safeguarding adults referrals have been made since the last inspection. Staff receive training in safeguarding as part of their induction to the service. The local multi agency policy and procedure is available. A system for protecting service users from financial abuse is in place, with regular checks of balances held. All cash is stored securely. Records of service users’ finances were not checked at this inspection but were in good order at the previous visit. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 16 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): 24 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The building, while not ideal, provides a pleasant environment for service users. EVIDENCE: The building is well located close to shops, services and public transport. The accommodation is over 4 floors, which are served by a spacious lift, suitable for wheel-chair use. There is very limited outdoor space, with a small, paved area. The house is generally well-maintained and decorated. Sitting/dining rooms are attractively furnished, though lights would benefit from lampshades. There are two bathrooms with assisted baths and a shower room. During the visit, one service user was spoken with in her room, which was attractively decorated and contained a range of personal possessions. Records showed that she had been able to choose the décor herself before moving to 42 Woodfield Road last year. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 17 There are two laundry areas with a semi-commercial washing machine and drier fitted into cupboards. A duvet was drying over a radiator as staff said that it would not fit into the drier. The building, which is cleaned by support staff, was clean and tidy at this unannounced visit Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 18 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): 32, 34, 35 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Steps have been taken to create a more consistent staff team. Staffing levels are sufficiently high to allow service users to be supported in a range of individual activities. EVIDENCE: Although the use of temporary staff is currently high, progress towards establishing a stable staff team has been made. Most of the vacant shifts are covered by staff from the organisation’s care bank who know the service users. Two new support staff have been appointed and the position of staff on longterm sick leave is being resolved. Rotas provide sufficient staff to allow service users to be support in individual activities and outings. The majority of support staff have achieved or are enrolled on NVQ2 and have access to the Society’s in-house training programme. No staff are currently enrolled on NVQ3. Recruitment is undertaken by the Manager and the Society’s HR team, who carryout all pre-appointment checks. The Manager confirms that he is informed of the result of CRB checks before staff start at the service. Some service users have received training to take part in selection interviews. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 19 In discussion a member of the care bank who had been working at the service for 4 months confirmed that she received good support from senior staff, including being invited to attend team meetings. She had received induction at the Society’s head office and had also received an introduction to the service at 42 Woodfield Road. Staff generally receive good support from senior staff through handovers, staff meetings and supervision. Records of staff supervision, which is undertaken by the Manager and Assistant Manager, indicate that although a system is in place, the frequency of sessions is fewer than the required 6 times a year. Records showed that the Manager himself had received only 3 supervision sessions with his line Manager over the previous 12 months. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 20 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): 37, 39, 41, 42 and 43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Manager has encouraged the development of a person centred service, where the views of service users are sought and valued. Record keeping is of a good standard. The health and safety of service users and staff is given a high priority. Visits on behalf of the provider must take place at least monthly, with a report made available. EVIDENCE: Since the last inspection, the Manager has been registered with the Commission. Both the Manager and Assistant Manager are enrolled on NVQ4 the Leadership and Manager Award – the Assessor was visiting on the morning of the inspection. The Manager has encouraged an emphasis on developing a person centred service that gives a higher priority to service users individual needs and wishes. The senior staff team has been strengthened by the transfer Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 21 of an Assistant Manager who moved with the 4 new service users and the secondment of another Assistant Manager. Service users’ views are sought through house meetings and through satisfaction surveys and interviews, which are undertaken independently of staff at the service. Recording is of a good standard. Attention to fire safety has been improved since the last inspection, with weekly checks of the alarm and monthly fire drills. Detailed emergency fire evacuation plans have been drawn up for each service user. Records show that the fire detection system is service 4 times a year. The Manager confirmed that portable electrical equipment had been tested the previous week. Staff carryout regular tests of hot water temperatures, fridge and freezer temperatures and other checks, as part of the cleaning schedule. As noted elsewhere in this report the building was generally very clean and tidy. Staff must ensure, in line with the cleaning schedule, that the laundry cupboards are kept clear. One of the ovens also needed cleaning on the morning of the inspection and contained a pie. Accidents and incidents are carefully recorded, using body charts where necessary. It is recommended that reports contain reference to the relevant risk assessment and whether it needs to be revised. A number of monitoring systems are in place providing the Westminster Society with management information via the IT system. A recent comprehensive audit took place, which was available in the office. A visit on behalf of the provider was made in the early hours of the morning in February to check the welfare of service users. The Manager had received a detailed report of the visit. However there were no other reports available since August 2008, although the visitor’s book indicated that some other regulation 26 visits had taken place. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 2 Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 30/04/09 1 YA1 5 2 YA6 15 3 YA22 22 4 5 YA36 YA43 18 26 Each service user should be provided with an up to date copy of the Service User’s Guide and have a copy of the contract. Care plans must be reviewed at least 6 monthly and more frequently if the person’s needs change. The complaints procedure must be displayed in the house and all service users should receive a copy. Staff, including the Manager, should receive supervision on at least 6 occasions a year. Visits on behalf of the provider must take place at least monthly, with reports made available to the Manager. 31/03/09 31/03/09 30/04/09 30/04/09 Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 24 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 2 3 4 5 Refer to Standard YA6 YA6 YA20 OP24 YA42 Good Practice Recommendations Additional IT equipment and training for staff in multi media would benefit service users’ communication. Daily notes and monthly summaries should refer to goals and objectives agreed at review and PCP meetings, to ensure that support to service users is focussed. Photos of service users should be inserted into the front of the measured dosage packs, in the space provided. Ceiling lights in the sitting/dining areas would benefit from the addition of lampshades. Accident and incident reports should refer to relevant risk assessments. Staff must ensure that laundry cupboards are kept clear and that ovens are checked after use. Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Carlton Bridge DS0000065284.V374375.R01.S.doc Version 5.2 Page 26 - 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. 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