Inspection on 27/03/09 for Wycar Leys The House

This is the latest available inspection report for this service, carried out on 27th March 2009.

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.

Other inspections for this house

Wycar Leys The House 25/01/06

Wycar Leys The House 25/08/05

Wycar Leys The House 07/09/04

Wycar Leys The House 02/06/04

Wycar Leys The House 15/03/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Wycar Leys The House Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT Lead Inspector Andrew Bailey Unannounced Inspection 27th March 2009 12:30 Wycar Leys The House DS0000008766.V374556.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 Wycar Leys The House DS0000008766.V374556.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. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wycar Leys The House Address Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT 01623 871752 01623 871753 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) Wycar Leys Limited Gina Jessop Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Wycar Leys Limited is registered to provide accommodation and personal care at Wycar Leys The House, Kirklington Road, Bilsthorpe, Newark, Nottinghamshire, NG22 8TT for a maximum of 8 people whose primary care needs are: Learning disability LD (8). 2nd February 2007 Date of last inspection Brief Description of the Service: The House is a one of four care home units on this site and provides care and accommodation for up to 8 people with a learning disability. The home is situated close to the village of Bilsthorpe. Service users have access to the extensive grounds, which include a sensory garden. The latest inspection report and written information about the home is available from The House and Wycar Leys main reception. Fees are based on the assessed needs of individual service users. The weekly fees for the residents living at The House on the date of this inspection ranged from £1173 to £2400. Wycar Leys The House DS0000008766.V374556.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. The service has told us that the people living at the home prefer to be referred to as service users. This terminology is used within this inspection report. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service. The process considers the homes capacity to meet regulatory requirements and minimum standards of practice. The inspection visit was unannounced and took place over a period of 4 hours. There were six service users living at the home on the day of the inspection. We met some of the service users and we spoke with the registered manager and two of the staff. We looked at information that we have received since the last inspection. The information included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. The service has also told us about things that have happened at the home and these are called Notifications. We have considered the eight Have your say about... surveys that were completed before this visit to the home, and feedback from these surveys has been included in this report. Records were examined during the inspection, including the care records of three of the service users who live at the home. This was part of the process called case-tracking that we use to follow the experiences of individual service users. What the service does well: The service has commenced the introduction of person-centred care planning. This provides an individual focus on the needs of each service user. Records are comprehensive, contain relevant risk assessments, and reflect the needs and wishes of the service users. The person-centred plans provide staff with guidance to help them meet the needs of the service users. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 6 Staff support service users to help them make decisions about their daily routines and lifestyles, with consideration for the individual ability and capacity of each service user. Service users can choose to take part in a range of activities at the home and within the local community. The environment is suitably maintained to provide a safe and homely place to live for the service users. Quality assurance systems are in operation to monitor the achievement of outcomes for the service users. 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. Wycar Leys The House DS0000008766.V374556.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 Wycar Leys The House DS0000008766.V374556.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): NMS 1,2,4 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 receive information to help them decide whether the service can meet their needs, and have the opportunity to visit the home before choosing to live there. EVIDENCE: The service users within The House have all lived there for several years. The most recent admission was in 2003. We examined the information about the admission process that we received from the service in their Annual Quality Assurance Assessment. We also spoke with the manager about how the procedures would work for any prospective service users and we looked at the process that took place when three of the service users had been admitted a few years ago. In the Annual Quality Assurance Assessment (AQAA) that we received before this visit the service told us that the Statement of Purpose and Service User Guide are available to prospective service users and current service users. They stated that two managers undertake a thorough assessment of prospective service users, in addition to receiving the most recent care management assessment from the referring agency. The service told us that Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 9 a transition plan is devised from information provided by the family and Social Worker to ensure a smooth transition into the new environment. This can include short visits and overnight stays. The service stated that staff from the home would go out and meet with the potential service user to get to know them before the admission. We looked at the surveys that we received recently. One of the respondents remembered that they had received a brochure and pictures of the home before admission to The House. We case tracked three of the current service users, which included examination of the written records held about these people. The record files of two of the case-tracked service users had evidence of the homes pre-admission assessments, whilst one of the documents had been archived. The personcentred plans contained a user-friendly personalised Service User Guide. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support needs of service users are recorded in their person-centred plans, and there is guidance for staff to follow to help them support the service users. EVIDENCE: The service told us in their Annual Quality Assurance Assessment (AQAA) that the service users have individual person-centred support plans, which reflect the individual needs of the service user and how those needs are to be met. They told us that plans are reviewed and adjusted on a regular basis to allow for changes in circumstances. The service said that individual risk assessments are in place and are regularly reviewed, and that this allows for individual service users to take potential risks, which have been reduced through assessment, but are part of everyday life. We case-tracked the care and support for three of the service users who live at the home. The process included examining the written records held about Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 11 those service users. The service users had person-centred plans and these provided detailed information about the support needs of the service users. The plans consisted of strengths, support needs and the actions to support the service users. Not all of the individual sheets in the person-centred plans were marked with the name of the service user. The plans are held within named ring binders, but if sheets were to have become separated from the binder then there could have been difficulty in identifying the person to whom they referred. The manager told us that she was hoping to increase the use of symbols within the plans to make them user-friendlier. The manager also told us that the person-centred plans are formally reviewed every six months. There was no evidence that family members/representatives of service users had been involved in the periodic review of care plans, although the additional annual review process does invite the input of family members. The manager said that she hopes to encourage family/representatives to take part in the internal process for the six-monthly review of person-centred plans. There was evidence within the case-tracked care plans of acknowledgement of where people had decreased ability to make decisions for themselves, for example in respect of consent to medication and mental capacity to consent. The manager has identified that more extensive recording of competency may be required in line with the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, for example, in relation to the security arrangements at the home. The manager has attended training on the Mental Capacity Act and Deprivation of Liberty Safeguards. The ‘Have your say…’ surveys that were returned to us indicated that service users have limited capacity to make decisions for themselves, for example, choosing from two choices on offer, and may have difficulty understanding complex information. Risk assessments were documented within the care files of those service users that we case-tracked and of these were generally detailed and individualised. The risk assessments for activities were generic and focused on the activity rather than the service user. The manager told us that the service is in the process of introducing person-centred risk assessments for all activities. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recreational expectations and preferences of service users are met by the activities on offer at the home. EVIDENCE: In the AQAA self-assessment that we received before this visit the service told us that the service users at The House have severe learning disabilities and limited communication abilities and that this restricts the educational opportunities available to them. The service told us that they therefore try to build on existing life skills by encouraging each individual to participate in community activities. The AQAA told us that organised activities such as keep fit have been introduced in the past year and that each service user has an individual activity schedule, which is reviewed regularly. Specific activities are identified for each service user to meet the needs of the person. Due to staffing levels being increased the service told us that this has allowed for increased community access for the service users. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 13 During the inspection the manager told us that an art therapist visits the home weekly and that some of the service users take part in these classes. One of the service users that we case-tracked takes part in the one-to-one art classes and also enjoys horse riding, swimming and keep-fit. We noted that the daily routines of the service users were detailed in the person-centred plans and that service users had an activity schedule setting out the activities that they participated in. Some of the service users visit family members, for example at weekends and the acting manager told us that families and friends are welcome to visit the home. Two of the service users that we case-tracked visit family regularly in the community setting. Staff that we spoke with told us that privacy and dignity forms a part of the training that they receive at the home. During the inspection we noted that staff knocked on bedroom doors before entering, promoting the privacy and dignity of the service users. The manager told us that the catering arrangements were due to change imminently from central kitchens serving the four homes on the site, to individual catering within each unit. Staff that we spoke with confirmed that they had received food hygiene training to prepare them to undertake the unit catering function. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 14 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): NMS 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users living at the home receive individualised personal and healthcare support. The medication systems promote the welfare of the service users. EVIDENCE: The service told us in their Annual Quality Assurance Assessment (AQAA) about the health support available to service users. They said that a local General Practitioner (GP) makes regular visits, including undertaking annual health checks to ensure the health and wellbeing of the service users. The General Practitioner and a Consultant Psychiatrist also hold joint clinics at the home to review and assess each individual on a regular basis. The AQAA told us that each service user has regular check-ups with the dentist, optician and chiropodist and that these visits are recorded in their person-centred plans. The written records that we looked at as part of case-tracking acknowledged the individual abilities of the service user and identified any support needed from staff to assist the service user to meet their needs, for example, personal hygiene needs. We were able to confirm from the person-centred plans that Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 15 the case-tracked service users had received regular health checks from visiting health professionals. We examined the medication storage and recording system in respect of the three service users that we case-tracked. The Medication Administration Records (MAR sheets) were suitably recorded for these service users. The manager told us that the community pharmacist had undertaken an inspection of medication systems recently and that there were no outstanding matters to address. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 16 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): NMS 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has appropriate systems for dealing with any concerns and complaints and aims to protect service users from harm. EVIDENCE: The AQAA self-assessment that we received prior to the inspection told us that each service user has a user-friendly copy of the complaints procedure, including pictures of the people that they can complain to. The service told us that service users’ family members also receive a copy of the concerns and complaints procedure so that they are aware of what action they need to take if they wish to raise an issue or complain. The AQAA told us that all staff undertake safeguarding adults training every year to ensure that they are made aware of their personal responsibilities and what course of action they need to take if they see or believe that any form of abuse has occurred. The self-assessment told us that all support staff receive training in breakaway techniques, restraint, diversion and de-escalation. An external training provider facilitates this training and staff receive annual updates. The Commission had been informed recently about an incident that was referred through the safeguarding adults procedures. This incident had resulted in an injury to a service user. The matter had been appropriately referred by the service via the safeguarding adults procedures, and is currently being investigated by the external multi-agency team. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 17 During the inspection, as part of the case-tracking process that follows the experiences of selected service users, we examined the complaints files held at the home. There were two recent entries that related to the case-tracked service users and these were of a minor nature. The manager informed us that all staff receive training in safeguarding adults and staff members that we spoke with confirmed that this training had taken place. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, safe and homely environment for the service users. EVIDENCE: In the self-assessment that we received from the provider before this unannounced inspection the service told us that the home has been specifically adapted to the needs of the service users who reside here. For example, all of the home’s furniture and fittings have been made to ensure that they cannot be easily thrown or broken. The service told us that environmental risk assessments are in place and that these are reviewed regularly. Each service user’s room is individualised and personal effects are encouraged within them. The House has its own domestic staff member to ensure a clean environment is maintained. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 19 Seven of the responses to the ‘Have your say…’ surveys told us that the home is sometimes fresh and clean. One of the surveys indicated that this was ‘Due to another service users behaviours’. The home appeared clean and tidy at the time of our unannounced inspection visit. The manager stated that all staff receive training in infection control and that there are infection control policies and procedures for staff to follow. A member of staff that we spoke with confirmed that infection control training takes place at the home. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training and recruitment practices promote the safety of service users. EVIDENCE: In the AQAA self-assessment that we received before the inspection the service told us that they have a robust recruitment process and that staff receive a thorough introduction when employment commences. This includes a supernumerary period for their first few shifts to allow staff to get to know the service users as well as getting to know the policies and procedures. The service told us that staff training is continuously updated and reviewed and if any additional training is required the home seeks out a training provider to deliver it. National Vocational Qualification (NVQ) training is provided for the staff to undertake once they have completed their induction training. We examined a sample of the staff recruitment files and we found that satisfactory checks had been carried out before staff had commenced employment at the home. This included Criminal Records Bureau clearance checks and receipt of two written references. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 21 The manager confirmed to us that the induction training meets Skills for Care standards. We spoke with staff during the inspection and they told us that they have good training opportunities, including training on safeguarding adults, fire safety, first-aid and manual handling. One of the staff that we spoke with had received specific training on the subject of autism, which is relevant to the current service users living at the home. Another member of staff that we spoke with had not received this specialist training. This staff member had only recently commenced working at the home but felt that autism training would provide a better insight into this condition and better prepare staff to meet the needs of the service users. We discussed autism training with the manager of the home. The manager is nearing completion of Masters degree in autism and intends to develop a training package for staff on this subject. She told us that there had not been any recent training on autism for the current staff, and that only two of the seventeen staff had received formal autism training. The manager recognised the importance of staff receiving specialist training on this subject. The AQAA self-assessment told us that about plans to introduce autism training to give staff a greater understanding of the service users. The manager also informed us that she is planning dates for staff to receive Makaton training to further enhance communication with service users. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the management systems in operation at the home. EVIDENCE: The AQAA self-assessment told us that the required Regulation 26 provider visits are undertaken and that there is a weekly management report and monthly quality assurance report produced by the unit manager. Information provided in the AQAA dataset indicated that there is appropriate maintenance and checking of equipment and services within the home. A manager registered with the Commission leads the team of staff at The House. She is experienced within the field of learning disability, holds a Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 23 nursing qualification in this specialism, and is nearing completion of a Masters degree in autism. The manager stated in the AQAA that she intends to enrol for a recognised management qualification. Two members of staff that we spoke with during the inspection confirmed that they had received the required health and safety related training to enable them to support and protect the service users living at the home. The manager confirmed to us that she completes a weekly management report and a monthly quality assurance report. We were able to confirm at inspection that the mandatory monthly visits and reports by the registered provider are taking place. These regulatory visits are part of the quality monitoring processes, which act in the interests of people using the service. The manager stated that service user meetings are not held due to the limited understanding of the client group, but that ad-hoc meetings are held with the service users’ relatives to discuss progress and any concerns that may arise. The manager told us that annual satisfaction surveys are conducted with relatives. As part of the service user case-tracking methodology we examined the accident and incident records, where these were applicable, and we found that records contained appropriately detailed information about such events. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 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 X 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 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 Refer to Standard YA6 YA6 YA35 Good Practice Recommendations Individual sheets within the person-centred records should include the name of the service user so that they can be suitably identified if they become separated. There should documentary evidence that efforts have been made to involve the service user and/or their personal representative in the periodic review of care plans. Staff should receive training in autism in line with the identified needs of the current service users living at the home. Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Wycar Leys The House DS0000008766.V374556.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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