Please wait

Inspection on 23/06/08 for Ellesmere

Also see our care home review for Ellesmere for more information

This is the latest available inspection report for this service, carried out on 23rd June 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a comfortable home that is in keeping with other residential properties in the area. Service users are supported to live as independently as possible and to integrate in the local community. Individual needs are assessed; plans and risk assessments have been developed from the assessments. Service users are involved in this process and benefit from the person centred approaches the service has adopted. They are also supported by a well trained staff team, that has remained stable for some time. Service users, said, "This is my home." " I can do what I want to, I just tell the staff where I`m going and let them know when I`ll be back. I have my own front door key." " I meet with my key worker to talk about what I want to do." "I`ve got a job and I enjoy it." Staff said, "Training, supervision and appraisal is up to date." " The service values service users rights and privacy and respects them as individuals."

What has improved since the last inspection?

The manager has identified a number of improvements since the last key visit, these are detailed in the service`s own development/improvement plan which also includes the service objectives for the next 12 months. No requirements were made at the last key inspection site visit.

CARE HOME ADULTS 18-65 Ellesmere 43 High Street Wolstanton Newcastle-under-lyme Staffordshire ST5 0ET Lead Inspector Wendy Jones Key Unannounced Inspection 23 June 2008 14:30 Ellesmere DS0000004937.V370078.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 Ellesmere DS0000004937.V370078.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. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ellesmere Address 43 High Street Wolstanton Newcastle-under-lyme Staffordshire ST5 0ET 01782 620155 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) Choices Housing Association Limited Mrs Jill Millar Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 Maybe LD(E) Date of last inspection 23rd May 2006 Brief Description of the Service: Ellesmere is a residential care home that is registered to provide five places for adults with a learning disability. The home is operated by Choices organisation, a local provider with a number of small homes across North Staffordshire. The home is a mature semi detached house located on the busy High Street of Wolstanton, near to Newcastle-under-Lyme, and within easy access of all local amenities and public transport. The property is well maintained and presents a warm and welcoming atmosphere. The design and layout of the premises promotes normal daily living. The home is tastefully furnished and communal space consists of a pleasant lounge and a large kitchen/ diner. There is one en-suite bedroom situated on the ground floor. The other four bedrooms are on the first floor. These are not en-suite, but each has a washhand basin. The bedrooms are decorated to reflect each service users interests and personality. The bathroom and toilets are in close proximity to the bedrooms and communal areas. Laundry facilities are available within the home, and service users are supported to undertake their own laundry tasks. There is a patio style garden at the rear of the property with a rockery garden that the service users maintain. The home does not have space to provide car parking for visitors or staff. Cars have to be parked in the surrounding side streets. The Service user guide does not contain the fee range for the service, prospective service users or their representatives should contact the provider for this information. Ellesmere DS0000004937.V370078.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 star. This means the people who use this service experience good quality outcomes. This was a key inspection site visit of this service undertaken on 23 June 2008. In total the visit took approximately 05:00 hours. The purpose of this visit was to assess the services performance and to establish if it provides positive outcomes for the people who live there. The visit included checking that any issues arising from the previous inspection visit of 23 May 2006 have been acted upon; looking at information the service provides for prospective residents, their carers and any professionals; looking at information that the service provides to people who use the service to ensure that they understand the terms and conditions under which they have agreed to live at the home and the fees they should pay. Other information checked included assessments and care records, health and medication records; activity and records relating to the menu’s, staff training and recruitment, complaints and compliments, fire safety and health and safety checks. The manager, staff and people who live at the home were spoken to during the site visit and a brief tour of the building was undertaken. Before the visit began, the service provided it’s own assessment of it’s performance, in the form of an Annual Quality Assurance Assessment (AQAA). Surveys were sent out to the people who use the service, relatives, staff and any professional that has involvement in the service. We received 3 staff surveys. The main points are included in this report. No requirements have been made as a result of this visit, recommendations were discussed with the manager and are listed at the end of this report. People who use the service are referred to as service users throughout this report, this term was agreed during the inspection visit. The service provides for 5 service users who have a learning disability, three were involved in the inspection visit on this occasion. We sent out 5 service user, 5 relative, 7 staff, 2 health professional, 2 care manager and 1 GP survey, according to our record 3 staff surveys were returned to us. What the service does well: The service provides a comfortable home that is in keeping with other residential properties in the area. Service users are supported to live as independently as possible and to integrate in the local community. Individual needs are assessed; plans and risk assessments have been developed from the Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 6 assessments. Service users are involved in this process and benefit from the person centred approaches the service has adopted. They are also supported by a well trained staff team, that has remained stable for some time. Service users, said, “This is my home.” “ I can do what I want to, I just tell the staff where I’m going and let them know when I’ll be back. I have my own front door key.” “ I meet with my key worker to talk about what I want to do.” “I’ve got a job and I enjoy it.” Staff said, “Training, supervision and appraisal is up to date.” “ The service values service users rights and privacy and respects them as individuals.” What has improved since the last inspection? 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. Ellesmere DS0000004937.V370078.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 Ellesmere DS0000004937.V370078.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who may use the service can be sure that they will receive the information they need to decide if they want to move into the home and can be sure that their needs will be assessed. EVIDENCE: The service told us, “We have a specific admission criteria which can be found in the Statement of Purpose. We offer graduated introduction to a prospective service user to the home. The Statement of purpose and Tenants handbook is available for prospective service users.” There has not been a new admission to the service since the last key inspection visit. But a check of care records show that assessments of need are thorough and there is evidence that the service has liaised and worked with other relevant professionals. Service users said, “ This is my home.” “ I don’t want to live here, I want to live on my own.” We discussed issues relating to the Mental Capacity Act and recommended that the manager is to refer one service user to the local authority for a mental capacity assessment. A copy of the Statement of Purpose and service user guide is on display in the home, it’s recommended that the range of fees the service charges is included in it. Ellesmere DS0000004937.V370078.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that they will have care plans, based upon their assessed needs and they will be involved in the implementation and review of them. EVIDENCE: We looked at a sample of two care records, relevant information included, a copy of the service user guide, a contract, a licence agreement, a full assessment of need and service users plans. The care plans are based upon the assessment of need and are subject to regular review. Daily records give an account of each individuals preferred routine in the home and the activities both social and occupational they enjoy. Annual reviews of care plans are undertaken with the social worker and interested parties. Risk assessments are in place where a need has been identified and one service user showed that he had been involved in the risk assessment process and understood what it meant to him. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 10 The service told us, “all managers have attended person centred planning training and have commenced introducing these ideas within the work place. We intend to review the PCP documentation, to make it more user friendly and to standardise the agenda and format of service users meetings and ensure that each service user has their own copy of the minutes of each meeting.” We spoke to 3 service users during this visit. 2 are aware that they have care plans and had been involved in reviews and confirmed that they meet regularly with their key worker to discuss matters relating to their care needs. 2 service users are subject to guardianship orders that relate to their place of residency. Ellesmere DS0000004937.V370078.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who us the service can be sure that their rights to live independently are supported by the service. EVIDENCE: A sample of service users weekly activity records, show a range of social, recreational and occupational opportunities are available. One service user goes to work with the organisations “handyman service”, another service user doesn’t get involved in any structured activity preferring to spend his time socialising with family and friends. One other service user is retired and records show that he is involved in older person groups that are in the local community. Some service users can access the community independently and use public transport on their own; others need more staff support to ensure their safety. The service told us that; “ All service users have a front door key and a key to their own room.” This was confirmed by service users and from observation Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 12 during this visit. The records show good risk assessments relating to activities both in and out of the home. Staff stated that most service users had enjoyed a short break away in a holiday cottage earlier this year. Another service user preferred days out and short trips and was being supported to be involved in these by his key worker and the staff team. Service users are supported to maintain relationships with family and friends, risk assessments are in evidence and where there are restrictions there is evidence of discussion and consultation with the individual about this. From discussion with staff it is also evident that where appropriate service users rights to privacy are respected. Dietary information is available in the home with each service user having a record of the food he enjoys, and special dietary requirements are catered for. None of the current service users have any specific cultural dietary needs. Ellesmere DS0000004937.V370078.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their personal and healthcare needs will be met. EVIDENCE: Care records show that service users health care needs have been assessed and where necessary plans have been put in place. The service has used an “OK Health check,” for sometime, this document includes information about every health issue the service user requires support with and how the service can support them with it. Health action plans are then implemented to evidence this. The manager also states that staff will be receiving further information and training about health action plans. Records show that service users attend health care clinics for routine checks and visit their GP. Specialist health professionals are also involved with some service users, these may include consultant, psychiatrist, neurologists, psychology and epilepsy nurse specialist. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 14 Preventative health checks have also been accessed and improvements since the last inspection visit include access to well man checks, also epilepsy training for staff and the purchase of essential monitoring equipment. No health professionals have returned surveys prior to this visit, so we have not been able to ascertain their views of the service. A check of the medication storage facility and the medication records show that medication is appropriately recorded. Where service users have been prescribed PRN medication (as required) protocols have been agreed for this. In one example where the protocol was not explicit, in that it didn’t say what the medication dosage was. This was discussed. The service has a medication reference book the British National Formulary(BNF), but it was dated 2005. It is recommended that the service tries to obtain a more up to date copy. The current storage facility is in need of updating in line with changes in guidance. Relevant advice and information has been given about this. None of the service users self medicate it is recommended that this is kept under review. One service user had medication dispensed by the pharmacist in a separate cassette when he visits his family for a few days. Staff said that they have received medication training that complied with the standards recommended. It is understood that assessments of competence have also been carried out. Ellesmere DS0000004937.V370078.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that the service will listen and look into any complaints that they have. But they must have confidence that the service will take action to respond to every area of concern they identify. EVIDENCE: We have not received a complaint about this service and have not been directly involved in any safeguarding enquiries. The service has a complaints procedure in place in a form that is service user friendly, containing pictures and simple language. The manager confirmed in the AQAA that this document had been given to all relatives and service users. Service users told us that they knew who to complain to if they needed to. Throughout this visit there was evidence that service user felt comfortable enough to express any concerns they may have, to both the manager and the staff team. Information in the AQAA indicates that the service regularly seeks the views of relatives and service users about the quality of the service, by sending out satisfaction questionnaires. And since the last inspection the service has received 4 complaints all have been resolved within 28 days and none have been upheld. During this visit one service user said, “ I don’t want to live here. I’ve told them but they keep saying in the future.” The service user was informed by the manager that an appointment would be arranged for him with a social worker. We discussed with the service user and the manager his rights to an Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 16 assessment and more broadly discussed the recent impact of the Mental Capacity Act. The manager demonstrated an understanding of the main principles of this and service user rights. We would recommend that the service makes sure the service user knows that his views will be listened to and will be acted upon, on every occasion he expresses concern. Staff said that they had received training in relation to recognising and reporting abuse. The manager stated that two incidents have occurred recently where two service users have been victims of abuse in the community. The police are involved in both issues and have supported the service and the individuals. We are satisfied that the service has taken the necessary steps to safeguard service users as mush as possible, risk assessments were in place and have been revised following both incidents. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that the service provides a comfortable homely environment. EVIDENCE: The service is s semi detached property on the main high street in Wolstanton, Stoke-on-Trent. It is close to shops, the doctors and other community facilities and is on a main bus route. The home is in keeping with other properties in the area and is not distinguishable as a care home. The service has five single bedrooms, one is on the ground floor and has ensuit facilities. The others are located on the first floor but don’t have en-suite. Communal space is sufficient for the needs of the service user group. There is a separate lounge and a kitchen/dining room. Bathing and toilet facilities are provided in sufficient numbers to meet their needs. Throughout, the home has been maintained in a good condition and the décor is tasteful and reflects the gender of the service users. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 18 Two service users confirmed that they had keys to their bedroom doors and the front door of the home. Two service users allowed us access to their bedrooms. One service user had mementos of family and other items, relating to his hobbies and interests on display. Another said that he had chosen the things he wanted to go into his room. The service has risk assessments relating to the environment these are reviewed regularly. It is also noted that the service is clean and well maintained throughout. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that the staff tam are well trained and have the skills to meet their needs. EVIDENCE: Staffing levels usually equate to two during the waking day, although this can reduce to one for short periods of time. One waking and one sleep in staff are provided at night. As three of the service users are relatively independent in the community the staffing levels appear to be adequate, but must be kept constant under review to ensure that service users independence is not affected. This is particularly important given the possibility of changing health needs of one service user who may require more supervision and support in the future. The manager told us that no new staff have been employed since the last key inspection, as a consequence recruitment records were not looked at during this visit. Previous inspection visits have indicated that all relevant recruitment checks have been carried out by the home; this was confirmed from the information in the AQAA and from the staff surveys. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 20 All staff have a National Vocational Qualification (NVQ) at level 2, 2 have also achieved level 3, the deputy manager has achieved level 4 and is understood to have completed the Registered Care Managers Award. A member of staff confirmed that training is provided and that all mandatory training has taken place or is planned. This was confirmed from the records available, the information in the AQAA and from staff surveys. The service also ensures that all staff receive training in the management of potential aggression (MAPA) and Learning Disability training (LDQ). Additional training relevant to the specific needs of individual service users has also been provided, for example epilepsy training. Staff confirmed in the surveys and from discussion during this visit that 1:2:1supervision and appraisals are up to date and regular staff meetings take place. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that the service is appropriately managed and their health and safety is assured by good procedures, records and risk assessment. EVIDENCE: The manager is a nurse (RNMH), has a number of years experience in social and health care settings and has completed the Registered Mangers Award(RMA). The deputy manager has also completed this and NVQ level 4. There is evidence that the service continues to develop and improve. Information to support this is provided in the AQAA and the quality assurance and improvement documentation made available to us. This plan has been developed to into 13 service objectives which link directly to the National Minimum Standards (NMS) expected for services for younger adults. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 22 Two service users told us that they had been involved in fire drills and explained where they would go to if the fire alarm rang. Individual service users have risk assessments; the home has an emergency evacuation and contingency plan in the event of a fire. Discussion with fire safety officers has confirmed that they are satisfied with the services fire safety procedures, and staff confirmed that fire safety training is up to date. It was recommended at the last inspection site visit that polices and procedures are regularly updated, information in the AQAA indicates that policies are currently being reviewed. We are kept informed of any accidents or incidents in the home. The service told us in the AQQA that all equipment in the home including electrical and gas appliances have been serviced regularly; this was confirmed from records and observation. The registration and insurance documentation is up to date. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 X 5 X 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 3 26 3 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 2 4 3 3 3 X 3 x Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 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. 6. Refer to Standard YA1 YA20 YA20 YA20 YA22 YA6 Good Practice Recommendations The Service User Guide should contain the range of fees service users can expect to pay The medication storage should be changed to reflect the current standards expected. Up to date information about the purpose and effects of medication should be available in the home. Medication protocols should be explicit to ensure that all staff have accurate information. The service needs to assure service users that their views will be acted upon on every occasion they identify areas of concern. Person centred planning should be fully implemented. Ellesmere DS0000004937.V370078.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Ellesmere DS0000004937.V370078.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!