Inspection on 15/06/06 for Waterfield Supported Homes Ltd

This inspection was carried out on 15th June 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Waterfield Supported Homes Ltd 28/11/08

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Waterfield Supported Homes Ltd 10 Dowanhill Road Catford London SE6 1HJ Lead Inspector Barbara Ryan Unannounced Inspection 15th June 2006 10:00 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Waterfield Supported Homes Ltd Address 10 Dowanhill Road Catford London SE6 1HJ 020 8697 6969 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) Waterfield Supported Homes Ltd Ms Christiana Obiageli Ezeilo Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Not applicable Brief Description of the Service: Waterfield is a residential service for four adults with mental health problems. It is part of Waterfield Supported Homes Ltd. The home is situated in a Victorian house in a residential area, close to local shops, a post office and GP surgery. The home has a communal sitting room and dining area on the ground floor and well as a kitchen and a utility room, with a shower room and WC leading from this. There is also a conservatory overlooking a mature garden. There is a single bedroom on the ground floor and a further three single bedrooms on the first floor; there is also bathroom, a staff bedroom and a small office. All the residents’ bedrooms are double size rooms. There is space for off street parking at the front of the house. The home offers medium to long-term support for residents who have been assessed as ready to move into a community setting. Staff liaise closely with mental health services, and multidisciplinary teams and use person centred planning to support residents with regard to their mental health needs. The weekly cost of the home ranges from £900 to £1400 per week. Residents are responsible for paying for their own toiletries, for taxis and other fares. The home provides information about their service through the service users guide and statement of purpose. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, that took place on 15th June beginning at 10 am and ending at approximately 4.45. The method of inspection included a tour of the building, inspection of all the residents’ care plans and files, discussion with the manager, a member of staff and a volunteer. There were three residents at home on the morning of the inspection. One resident was spoken to informally and interaction with this resident and staff was observed. There was an exanimation of the management of the medication and other records kept by the home, including staff files. What the service does well: What has improved since the last inspection? Not applicable, as this is a first inspection. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 6 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. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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): 1,2,4,5 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The home has a statement of purpose and service uses guide that contain full information about the home. Residents have their needs fully assessed prior to admission and are given a statement of terms and conditions. EVIDENCE: The home has a Statement of Purpose and Service Users guide that give full information about the home. Each resident is given a copy when they come to visit the home, and staff will go through this with them if they need support with this. Residents’ files showed evidence of a full assessment of the prospective resident’s needs being undertaken. The home has their own basic assessment form; they also gather information from other professionals involved with the person and this gives a full picture of the resident’s needs. Residents are able to visit the home to view it and the manager said that they have worked closely with the agencies involved with new residents and have undertaken phased admissions with residents depending on their needs. Residents can visit, then there will be an arrangement to spend the day, then a day and a night, or several days for a while. This will depend on the resident’s needs. One resident lived three days a week at the home for several weeks and was able to take the time they needed to adjust to their new home. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 9 All residents are given a contract of terms and conditions, and a folder with the statement of purpose, Service User guide as well as their contract. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. Residents benefit from having care plans that reflect their needs. There are comprehensive risk assessments. Residents are supported to take decisions about their lives. EVIDENCE: All residents had care plans. Some of the residents have only been in the home for a few weeks. The manager said that they have an initial care plan for each resident and will, as they get to know residents, review and add to the plan as needed. The care plans had a section to identify needs, aims and objectives, strengths and weaknesses and a section to recorded what the residents will do and what the staff will do. These were full and detailed. Care plans had not been signed; the manager said that at present they are working with residents around this, and will also be working with the multi-disciplinary team on this issue. The staff will then sign the plan at the same time as the residents. All residents have been given copies of their care plan. The manager said that this is something she is taking slowly at present. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 11 Resident’s files had risk assessments on them; the home have their own form and will supplement this as needed with much fuller detail and history supplied by the mental health team. For some residents there was extensive information around risks. There were also actions and crisis plans, that outline warning signs, triggers etc. The home had a section for daily records on residents’ files, these were up to date and the level of recording was good, with information given about residents mood, mental state, their activities whilst the staff member was on shift and were generally very full and detailed. Files contained occupational therapy assessments and records of CPA meetings. The manager said that they aim to review care plans every two months; this will be done with the residents and their key worker. At present there is only one resident with a photo on their file. The manager is in the process of doing this for the other residents. She has spoken to residents and has a taken some. She will be working with residents around the photo that will go on their files as residents are concerned that photos should be good and that they look smart. All the residents at the home manage their own money. One resident needs support to go to the post office to withdraw the money, but will then keep the money themselves. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,15,16,17 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. Residents are being supported around opportunities for personal development, are able to maintain links with family, friends and the local community. The home has also established some boundaries around life at the home. Residents are supported to ensure that their rights and responsibilities are recognised and are able to access a healthy diet of their choice. EVIDENCE: Where possible, the home had tried to ensure that interests and activities that residents had been pursuing prior to their admission to the home have remained as part of their programme, and have worked with residents around their own particular needs. Two residents go to work based projects and have continued to attend these. Another resident who has needs around gaining confidence to go out has had a programme of short trips to the shops and local areas set up for them. The home is supporting residents around maintaining contact with family and friends. The manager said that initially they will ask residents to let them know Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 13 if friends are visiting. This is to ensure that the home is not overwhelmed with visitors to the detriment of other residents and to give staff some opportunities to get to know the residents’ friends and visitors. The home will ask visitors to leave no later than 10pm at night. The home will support residents to visit family and will work with other professionals around residents’ children visit the home if this is needed. All residents have keys to their rooms and the front door. There is a 10 pm curfew for residents to be in by. There is a weekly rota for residents to share housework and cooking. Staff support residents with this. Residents have a weekly meeting to work out a shopping list and one of the residents will go with staff to buy the food. The manager is establishing a monthly house meeting and at the initial ones there have been discussions around the type of package for TV channels that residents would like and this has been purchased. The manager has made links with the local community after some initial concerns had been expressed. The home has a volunteer from the local church working there one day a week at present. The home has referred residents to the activities resource team, who will be working with individual residents to continue exploring what activities and resources are available the community. There had been an initial problem with the kitchen being used very late at night and there had been discussions with residents about the possible need to lock it at night after a certain time. The manager said they had looked at identifying an area where snacks and drinks could be made outside the kitchen at night. However this issue has now been resolved and the kitchen is being left open. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. Residents are supported with personal care as appropriate to their needs and wishes and are having their physical and emotional needs met. The home’s management of medication is generally good, but some issues needed to be addressed to improve their administration. The home will be looking at issues around illness and death with regard to residents’ wishes in due course, but at present are concentrating on supporting residents to settle into the home. EVIDENCE: Most of the residents are able to manage their own personal care, although some residents may need encouragement. Residents’ files showed evidence of contact with other health professionals. The manager said that she has attended tribunal hearing with regard to prospective moves to the home and there was evidence on file of the home’s contact with the multi-disciplinary teams involved with residents. The manager said that they will contact them with regard to any issues that arise around the residents’ mental health, liaise with the CPN, write letters to the consultants and attending meeting as appropriate to the needs of the resident. On the day of the inspection the manager and staff supported a resident in a sensitive manner with regard to attending a clinic, and achieved this despite the resident’s initial distress. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 15 Residents’ files showed evidence of the home supporting residents around issues of weight and checks of blood pressure and sugar level where this was appropriate. Residents are supported to visit the GP as the need arises and the home has made referrals to district nurse services where appropriate. The home has a lockable cupboard in the staff bedroom were medication is kept. This room is kept locked. The management of the medication was looked at. Medication for two residents is managed via a dossett box, that the manager fills once a week. The manger has just started this system and will review how effectively this works. An inspection of the mar chart showed that not all the medication given had been initialled on the mar chart, although on checking back the worker had recorded it in the daily recorded. The home is in the process of assessing residents with regard to whether they will be able to self medicate. At present residents are still being assessed and the manager said that they will be working with residents around this issue for a little longer to ensure that residents will be able to manage their medication themselves. The home should complete forms for any homely remedies and have these signed by the GP. The home has a file that lays out the home’s policy regarding medication. At present the home has not gathered any information around issues of ill health, death and dying. The manager said that this is something that they will be working with but are at present concentrating on residents settling in and getting to know them. This is something they will be perusing in due course. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The home has an appropriate policy with regard to complaints, but there needs to be information about organisations that will act as independent advocates for residents. Staff are aware of issues around the protection of vulnerable adults and some of the staff group have come to the home with training in this area; any staff who have not had training should receive this. EVIDENCE: The home has a complaint form for residents to complete and a complaints procedure. The form and policy is in the service uses guide. The home should give information with regard to how to contact an independent advocate to support the person if they wish or need this. There has been one verbal complaint and this has been investigated and appropriate action has been taken. The home is awaiting the minutes from the CPA where this was also discussed. The home should have a policy with regard to the protection of vulnerable adults. The manager was aware of issues around this and the actions that need to be taken to protect residents from a range of abuse. They are working actively in this area at present. A number of the staff have been on training around the protection of vulnerable adults prior to staring work at the home. All staff should have training on this and the manager will download the Lewisham policy for the home to have a copy of. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 28,30 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The home offers a pleasant and safe living environment, with an attractive garden; the communal spaces are pleasantly furnished, residents’ bedrooms are personalized and suit their needs. The home is clean and hygienic. EVIDENCE: The home is set in a two-storied Victorian family house, in a residential area, near local shops. There is a communal sitting room with a dining area in the front of the house. There is a conservatory at the back which leads on to an attractive garden. The conservatory is the home’s designated smoking area. This was pleasantly furnished, with comfortable seating there is a small TV and a computer in this area. Residents are able to garden if they wish and one resident has undertaken some planting in the boarders. The ground floor has a kitchen and a utility room with a shower room and WC leading from this. The utility room is equipped with a washing machine and dryer. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 18 There is one bedroom on the ground floor and three further bedrooms on the first floor. There is a bathroom and staff bed room on this floor as well as a small office. The home is pleasantly furnished and all the bedrooms have a lockable metal cupboard for residents. Extractor fans have been fitted in the kitchen and the utility room and the ceiling and shelving in the upstairs bedroom have been made good. Of the residents bedrooms seen these were personalised and well furnished The home has a TV with sky programmes in the communal sitting area; there is also a water cooler and a notice board with information for residents. There is a pay phone in the hall. The home has pleasant ornamentation in the communal areas and is clean and hygienic. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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): 32,33,34,35,36, Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The staff team is now complete. There are sufficient staff to meet residents needs and they are qualified and competently trained. The recruitment procedures protect residents. Other training needs are being identified and addressed; formal supervision sessions are to be established. EVIDENCE: The staff team is now complete. The rota was looked at; there is one staff member on duty am and one pm and one sleeping night worker. The manager is present in the home from 9 to 5 on weekdays and the deputy manager works the same hours at weekends. There is an on call system if staff need support at other times. The manager lives locally and is able to come if needed. This is sufficient for the needs of the residents at present. There are 9 staff, including the manager, three of whom are registered nurses. There are 6 support workers, 5 of whom have NVQ level 2 and one of these staff is completing their level 3. The staff member spoken to said they felt very happy with their new post, that the team recruited was working well together and that they were being well Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 20 supported by the manager. They had a good understanding of residents’ needs and the skills needed to work in the area of mental health. The manager is at present negotiating around employing trainers to set up a series of in house training sessions for staff and will be looking at what other training is needed. Staff files contained evidence that they had undertaken a variety of training prior to coming to work. The manager said they will be building on this to maintain and increase the skills in the team. She will also be including in the training negotiations clinical supervision for the nursing staff and herself. At present formal supervision sessions have not been set up, although there has been on going informal supervision of staff as new residents have moved into the home and staff have taken up their posts. The manager said that now she has her staff team completed she will be setting up formal supervision sessions for all staff. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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): 37,39,42 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The home is well run; the manager has established good procedures and practises and is knowledge with regard to needs around mental health. There is a format for residents to express their views and the manager is exploring how best to develop this further with regard to quality assurance. Health and safety procedure are in place to protect residents and staff. EVIDENCE: The manager was able to demonstrate knowledge of residents’ needs and mental health issues. She has experience of managing a staff team and has completed a postgraduate certificate in management; she is also a registered nurse. The manager intends to complete an annul quality assurance survey for stakeholder and is at present exploring the best ways to ensure that residents views are represented in quality assurance monitoring. At present this is done Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 22 around residents meetings and individual discussion with them and their families. The home has good health and safety practises in place; they do a weekly check of all sharp items in the kitchen, test fire alarms once a week and have been advised to have a fires drill every three months. Fridge temperatures were recorded daily and were within safe limits. There were colour coded copping boards in the kitchen. Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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 3 5 3 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 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 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 2 3 3 X 3 X X 3 X Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 24 N/A 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 YA20 Regulation 13(2) Requirement The registered manager must ensure that all mediation is correctly recorded on the mar chart with all medication given initialled by the worker who gave it. The registered manager must ensure that the staff rota includes the duty times for the registered manager and deputy manager. The registered manager must 1. Ensure that freezer temperature are recorded 2. Begin fire drills now all residents and staff are in place in the home. Timescale for action 10/08/06 2 YA32 17(2) Sch 4 10/08/06 3 YA42 13(4) 10/08/06 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 25 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 Refer to Standard YA6 Good Practice Recommendations The registered manager should continue to work with residents around signing their care plans, but if this is not something that can be achieved the care plans should be signed by the person who draw it up and it be recorded that the resident was not happy to sign it. The registered manager should ensure that there is information available with regard to contacting an independent advocate with regard to support in pursuing a complaint. The registered manager should plan for all staff that have not received up to date training around the protection of vulnerable adults to receive this. The registered manager should, now the staff group is complete, set up formal supervision for all staff. 2 YA22 3 4 YA23 YA36 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Waterfield Supported Homes Ltd DS0000065688.V291256.R01.S.doc Version 5.1 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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