Inspection on 10/08/06 for 1 Old Road

This inspection was carried out on 10th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Old Road 09/11/07

1 Old Road 20/06/07

1 Old Road 24/11/05

1 Old Road 11/07/05

1 Old Road 11/11/04

1 Old Road 18/02/04

1 Old Road 02/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Scic - Old Road, 1 1 Old Road Southam Warwickshire CV33 0HD Lead Inspector Deirdre Nash Key Unannounced Inspection 10th August 2006 2.30pm Scic - Old Road, 1 DS0000004307.V307675.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 Scic - Old Road, 1 DS0000004307.V307675.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. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scic - Old Road, 1 Address 1 Old Road Southam Warwickshire CV33 0HD 01789 298709 01789 296724 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) Stratford & District Mencap Ms Rachael Sass Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Ms Sass achieves the registered Managers Award by 1st September 2006. 24th November 2005 Date of last inspection Brief Description of the Service: 1 Old Road is a semi-detached house, which provides accommodation for four adults who have learning disabilities. The ground floor has the communal accommodation, with a lounge that leads into a large open plan dining area and kitchen. There is a small utility room off the kitchen. The ground floor also has one bedroom with its en-suite WC and shower. There are three bedrooms on the first floor in addition to a bathroom and staff sleep in/office. The house has a rear garden and parking for cars at the front. Shops and village amenities are available locally. The property is owned by a Warwickshire housing association and held on lease by the care provider. Fees for 2006/7 are £598.17 per week. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at all of the information that we have received about this home and kept on our records over the past twelve months. The provider organisation has had appropriate contact with us about the home during that time and kept us informed about how residents are. After the last inspection in November last year, we asked them to send us an action plan detailing how they were going to improve the things that we pointed out as being below standard and they did so. We sent the home a questionnaire in May to fill in and bring us up to date with facts and figures about the home. It was properly filled in and sent back to us in good time. We also sent Comment cards to be distributed to relatives to find out their views about the home. None of these were completed and returned to us. The Inspector called on the home without notice late afternoon mid week, met the residents, spoke to staff, spoke to the senior support worker and the manager, looked around the home and looked at records. The care of all three residents currently living at the home was ‘tracked’ in this way in order to see if the home is providing a service that meets the national minimum standards. What the service does well: The manager is registered with us. The home is well managed and staff know the residents well and treat them with respect and kindness. The manager makes sure that individual residents have their needs re assessed by social services to keep up with any changes. The home helps residents get the routine and specialist health care that they need. Residents are involved as much as they are able in the day to day running of the house and staff speak up for them to make sure that they get their entitlements from public services. Residents get out and about and the home works hard to make sure that they have some regular leisure, occupation and entertainment opportunities including an annual holiday. Staff are properly recruited to make sure that they are suitable to look after vulnerable people and they are given the training that they need. The provider organisation has left a vacancy at the home unfilled because it is in the best interests of residents at the moment. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 6 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. Scic - Old Road, 1 DS0000004307.V307675.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 Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 The outcome for this group is good. Due to the changed condition of an existing resident the home is not currently making any new admissions. Service users are not being invited to live in a home that cannot properly welcome a new comer. EVIDENCE: There have been no new admissions since the last inspection. The home currently has only three residents and this is a policy decision for the time being due the changed condition of an existing resident. The provider has decided that it would be unfair on any new person to move them in at the moment. The service has a statement of purpose and service user guide. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 The outcome for this group is good. The home shows a commitment to obtaining up to date assessments of need for residents as their condition changes and including them as far as possible in decisions about life changing care needs. Residents’ are involved in their own care. EVIDENCE: Each care file looked at contained good service user plans based on assessment made by social services in 2003. The manager and staff report that the condition of each of the 3 residents have changed over the past few months. The manager has persuaded social services to re assess the needs of two residents with developing dementia. This is very positive work and new service user plans are being devised on the basis of those assessments. The manager now needs to make sure that the plans address each one of the service aims that the Community Care plan sets out for SCIC to deliver and make clear representations to social services about any aims that they cannot meet so that other arrangements can be made/financed. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 10 There were good written risk assessments in the care files of all 3 residents with evidence of regular review by the manager. Daily personal records made by staff show that residents are involved in decisions about the home such as choosing furniture, décor and food. However one resident told the Inspector that he wants his own home. This was raised at the last inspection when a requirement was made. Discussion with the manager indicated that this person is unlikely to cope with more independent living. This was mentioned but not properly addressed in the recent social services assessment of his needs. Any aspiration expressed by a resident that is being denied even for good reasons must be agreed within a multidisciplinary review that includes the resident and his representative and put on record and subject to further periodic review. The service user plan put together by the home can then reflect what measures have been agreed to compensate for this aspiration. The requirement remains and must now be complied with. At least one member of staff is always in the house so that no one has to go out to day services if they do not wish to. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 The outcome for this group is good. The home supports residents with a range of social, leisure, and educational and occupational opportunities. Residents have opportunities to maintain appropriate and fulfilling lifestyles in and outside the home. EVIDENCE: All 3 residents had been out during the day of the inspection. Staff report that one resident goes to a small day care facility now that seems to suit him better but on the days that he does not want to go or wants to go in later, staff facilitate this. Another resident talked about his new car that staff had helped him to get through the Motability scheme. This is a good example of how the home does promote residents rights. A resident also said that he had been out to a disco on the night before and met up with some old friends there, and he also talked about the voluntary work that he does at the weekend. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 12 Daily records showed that all 3 residents run their daily routines in a way that suits them and staff support them with any variations to this. There was fresh fruit and salad vegetables in the fridge and the manager reports that residents go with staff to the local supermarket to shop for food. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 The outcome for this group is good. The home helps residents to get the routine and specialist health and therapeutic services that they individually need. Residents are well looked after. EVIDENCE: Care files show that all three residents have had contact with health care specialists recently as their well-being has changed in different ways and the home has helped them to do this. The home is commended for its practice in this area. Service user plans seen give staff direction for assisting with personal care and a sensitive approach to personal care was indirectly observed. It was clear from observation that staff strive to help people with deteriorating abilities to keep up their own personal care skills for as long as possible. The care file of one resident contained a document called ‘when I die.’ This shows that the home helps residents who can, to make informed decisions about such arrangements. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 14 Medication records for one resident were looked at and were in general good order and complete. The Manager reports all staff undertaken safe admin of medication training. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The outcome for this group is adequate. Records are not kept as well as they should be and staff do not have a full understanding of the Adult Protection procedures. Individual rights are not sufficiently safeguarded. EVIDENCE: The home has central complaints log that showed no complaints received over the last months. The last complaint recorded was from a resident and this does show that residents feel able to complain. The details of the outcome were sketchy and should be more detailed and include any potential improvements to the service/staff practice. The quality of these records should be improved. An entry had been made in the log that was nothing to do with a complaint. This suggests that the complaint log is not being used as a serious record for recording concerns and improving the service There was no evidence that the two incidents of aggression against one resident by another that were notified to us last November, had been referred through the Protection of Vulnerable Adults (POVA ) procedures. There was evidence that the manager had taken practical action that seems to have been effective, to avoid a recurrence. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 16 Senior staff spoken to were unaware that abuse between residents comes within the POVA procedure. This was raised before with the home in 2004 after a similar incident. The manager must follow the provider organisations procedure that includes the Warwickshire wide multi agency agreement for responding to suspicions or allegations of abuse. Social services are the lead agency and must be informed and decide how to proceed to protect the individual. The home must not see residents as a group that just have to put up with each other’s behaviour. A requirement is made again. The manager reports that the home has achieved the reinstatement, with back pay, of the mobility allowance benefit that was denied to one resident by government agencies. This is good advocacy work on behalf of someone who cannot speak up for himself. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 28, 29, 30 The outcome for this group is adequate. Although the house is homely the layout is not suitable for the residents that have some mobility difficulties and developing dementia. There are insufficient proactive measures being taken to compensate for the handicapping effect that it is likely to have on residents. Residents are not living in a home that is prepared for a period of considerable change in their needs and abilities. EVIDENCE: There is a programme of maintenance and one bedroom was in the process of redecoration. The home was clean and tidy and homely but the changes in health and ability of two residents mean that it is no longer necessarily a safe environment for them. The third resident has been moved to the only ground floor bedroom where there is a bathroom en suite and this has helped her to adapt to her changing needs. The senior support worker toured the house with the Inspector and took a list of things that need attention to make the environment less of a handicap for people with dementia and poor sight. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 18 The list included for example, repairing some loose and uneven slabs in garden, making sure that light bulbs that don’t work especially on the staircase, can be replaced without waiting for two /three days for a handyman, (an immediate requirement was left with the manager over this) and stopping the practice of using energy saving bulbs that take a few seconds to fully illuminate a space. Other measures would also be effective. Thinking about how colours can be used on doors and flooring, especially toilets and bathrooms to help to clearly show the purpose of the room. For a person experiencing confusion this can reduce falls and help him or her to manage their continence and maintain their confidence in moving around the house. This also promotes their psychological well-being. Although there was no evidence that residents are reluctant to move freely about the house, observation supported staff comments that one resident turns off staircase and hallway lights even when he moves around the house during the night. The home is not ‘dementia ready’. This requires a proper plan and there is information about how to achieve it in the professional journals. A requirement is made to make this home safer for residents with deteriorating conditions if the home intends to continue to look after them. The home has taken some specialist advice since one resident was injured in a fall in the kitchen and this is positive but it is reactive. Proactive measures are required to keep residents safe but as independent as possible around the house. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35,36. The outcome for this group is good. Staffing levels are sufficient for the current numbers and needs of residents and staff are properly recruited, inducted, trained and supervised. Residents experience a professional approach to their care. EVIDENCE: Staffing levels have returned to the former level of one member of staff on duty at a time including at night. There are only three residents at present. There is good back up support locally for staff. The manager says that there is some scope for extra staff for events and outings. This is sufficient for residents current needs but will need to be kept under review, including whether ‘waking’ night staff are necessary if the condition of one particular resident does not improve. The personnel file of the last recruit to staff team was looked at. Records were in good order with a checklist audit sheet on the file and the manager reports that the new worker undertook the Learning Disability Award induction programme, as the Provider organisation requires of its staff. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 20 Staff seen interacting with residents were kind and enabling in their approach. There are men as well as women carers on the team; two of the residents are men. Staff have undertaken some training in dementia awareness but those spoken to could not say precisely how this has improved their work. A plan of training in dementia care should to be put together as part of dementia ‘readiness’ of the home. Staff confirm that they have regular 1:1 supervision sessions with their line manager. More than 50 of staff hold an NVQ at Level 2. Scic - Old Road, 1 DS0000004307.V307675.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 42 The outcome for this group is good. The home is well run and the organisation is committed to the well being of residents. Resident’s benefit from a service that is being run in their best interests. EVIDENCE: The manager is now registered with us. She also manages the small domiciliary care branch locally run by the same provider organisation and a project of supported tenancies near by. These share a staff group with the home but there is no indication that the staffing of the home suffers because of this arrangement. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 22 There is a senior support worker in the home. The home is well run and most requirements from the last inspection have been complied with. Recommendations from the Fire Officers inspection last year have been dealt with and records show that electrical, gas and fire safety equipment has had appropriate inspection and maintenance over the last twelve months. Staff confirm that they have undertaken and updated mandatory health and safety training including manual handling. Referred to above the light bulbs in the house are energy saving and slower to fully illuminate than conventional bulbs. The bulb at the head of the stairwell was not working, only the vanity unit light was working in the bedroom of one resident. The front outside light was not working. This is potentially dangerous and confusing for residents with poor vision and dementia. An immediate requirement was made to risk assess and risk manage the poor illumination on the staircase until the bulb could be safely replaced on the following day. One resident was seen turning off the remaining hallway lights as he descended the steep staircase in the dusk, depending heavily on the rails provided on both sides. This behaviour must be risk assessed and the manager must find a way to address this problem before someone falls on the stairs. Toilet cleaning fluid and aerosol air freshener were seen left open on the bathroom windowsill. These could pose a danger to residents with confusion and should be locked away. The toilet seat was loose on it hinges, this is dangerous for residents who’s mobility is deteriorating. These things must be checked regularly and put right. Reference has been made through the report on the need to comprehensively review the homes ‘dementia readiness’. It is a matter of priority that a system for daily checking the light bulbs at least is put in place. Paving slabs in part of the garden are uneven and moving, cement around the inspection cover has broken away. These must all be made safe as all of the residents now have some mobility problems and one in particular has had two serious falls this year in the house. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 23 We have no record of a regulation 26 visit report since February 2006. The manager had them at the home but they must be sent to us regularly so that we can be confident that the provider organisation is properly supporting the home. The manager reports that the provider organisation carries out an annual quality survey. The summary of the findings must be sent to us and made available to any other interested parties. One resident is now age 65years. This resident has been moved to a down stairs bedroom to accommodate changes in mobility. The registered person must apply to the Commission to agree a variation to the registration of the home if this resident wishes to remain there. The home will need to continue to demonstrate that it can meet her needs. Leaving a vacancy unfilled for the time being shows that the provider organisation runs the home in the best interests of service users. Scic - Old Road, 1 DS0000004307.V307675.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 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 3 3 3 3 x x 1 x Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard *RQN Regulation CSA 2000 Requirement The registered person must apply to the CSCI to vary the categories of registration of the home if it wishes to continue to care for someone who has reached 65 years. The home must ensure it acts on valid choices made by residents concerning issues of importance to them and commits to record any choices that are being denied even out of duty of care. The registered person must ensure that any incidents of assault against a resident by another are dealt with through the POVA procedures to protect the rights of individuals. The registered person must ensure that a strategic plan to make the home ‘dementia ready’ is prepared. Guidance can be found in the professional journals. The registered person must devise a strategic plan for developing staff skills, knowledge and understanding of dementia. Timescale for action 01/10/06 2. YA7 12(3) 15/09/06 3. YA23 13 15/08/06 4. YA24 12 01/04/07 5. YA35 12 01/12/06 Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 26 6. YA42 13 7. YA42 13 8. YA42 13 9. YA42 13 The registered person must ensure that the staircase can be safely used after dark. (Immediate) The registered person must ensure that all areas of the house including the staircase are sufficiently illuminated for the abilities of residents at all times. The registered person must ensure that on risk assessment, residents are safe from hazardous cleaning substances. The registered person must ensure that repairs and maintenance are carried out with sufficient speed to protect residents with confusion, poor vision and poor mobility from tripping or falling. 10/08/06 01/09/06 01/09/06 15/09/06 Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 27 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. Refer to Standard YA7 YA22 Good Practice Recommendations It is recommended that all service users have person centred plans that promote their wishes and ensure that they are met. The manager should make sure that records of complaints/concerns are kept in good condition. Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 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 Scic - Old Road, 1 DS0000004307.V307675.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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