Inspection on 24/07/07 for 15 Preston Drove

This inspection was carried out on 24th July 2007.

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

15 Preston Drove 06/10/05

15 Preston Drove 07/04/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 15 Preston Drove 15 Preston Drove Brighton East Sussex BN1 6LA Lead Inspector Merle Blakeley Unannounced Inspection 24th July 2007 09:30 15 Preston Drove DS0000060468.V345781.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 15 Preston Drove DS0000060468.V345781.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. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 15 Preston Drove Address 15 Preston Drove Brighton East Sussex BN1 6LA 01273 555291 01273 265623 Roger.Hewitt@southdowns.nhs.uk www.fosteringinbrightonandhove.org.uk Brighton & Hove City Council 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) Mr Roger Charles Hewitt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The home is registered to support up to five adults who have a learning disability. The home is a detached two-storey building set in the Preston Park area of Brighton. Although the home was not purpose built for people with disabilities adaptation have been made to the home that includes a passenger lift and accessible bathrooms. The home is opposite Preston Park and close to local shops, pubs and sports clubs. The home has its own mini bus with a tail lift that enables people who use wheelchairs to access their local community. Single bedroom accommodation is provided on the ground and first floor. There is one assisted bathroom on the first floor and another assisted one. A walk in shower and toilet is located on the ground floor. Meals are prepared and cooked by staff. The home now employs a cleaner. The home is domestic in scale and consists of a lounge, dining room and a kitchen. A large, rear garden provides a safe and pleasant area for people to spend time in. More detailed information about the services provided at 15 Preston Drove can be found in the home’s Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the Provider. Latest CSCI inspection reports are kept in the homes office. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of eight hours on July 24th 2007. During this visit the inspector was able to observe staff interacting with the four people who live there. The inspector also spoke to all the staff that were on duty that day including the deputy manager who facilitated the inspection. Document reading was carried out and a health and safety check was conducted. A returned Annual Quality Assurance Assessment (AQQA) could not be received prior to this inspection, as it had been incorrectly sent to recipient. What the service does well: What has improved since the last inspection? During the last inspection the home received eight requirements and four recommendations. These have all been met. Care plans are now being reviewed; the carpets have been replaced in the home, recruitment files updated and some maintenance issues completed. There have been a lot of very positive improvements made to the home in particular the staff team. The home had previously been short staffed and a lot of agency staff were being used and morale amongst the staff team was quite low, however the home now has a more stable staff team of permanent and relief care workers. A new deputy manager has also been recruited. This has lead to the team working in a very positive and proactive manner, which has resulted in people receiving a much more consistent level of care. Staff said that morale had increased and they were all working well together as a team. The environment was rated as poor during the last inspection due to the unpleasant odours emanating from the carpets. The home has been re- 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 6 carpeted and several other areas in the home have been refurbished. The environment is now very pleasant and rooms are modern, bright and airy. The home has also created a new office space and the small conservatory at the back of the house has been opened up for residents to use. Staff are continuing to try to ensure that people have more involvement in the way the home is run. An interactive menu is to be introduced so that people can make their own choices about the meals they prefer to eat. People are now also going out of the home on a much more regular basis and more activities are being offered. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 7 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. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 8 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 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move into the home. EVIDENCE: Records that were viewed showed that people’s needs were being assessed on an ongoing basis. One person is having a review carried out next week. The four residents who currently live in this home are aged between fifty-seven years and seventy-seven years of age. Their health and care needs are continuing to change and currently the home feels it is meeting the needs of the people who live there. 15 Preston Drove DS0000060468.V345781.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): 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 home maintains comprehensive information on each person. The staff support people to make decisions and take risks where possible. EVIDENCE: All four care plans were viewed. Each person has five to six files, which contain information about their support plan, key worker file, a main file, person centred plan and health action plans. A requirement was made during the last inspection for care plans to be regularly reviewed and updated and this appears to be occurring, however staff who were spoken to on the day did state that they had not received any training in writing up care plans. They felt this was important, as there were so many different files to update. It was also noted that staff appear to write up plans, updates and reviews in different types of formats, which is also very confusing. The home needs to consider ‘streamlining’ all the files, so that they are a little more manageable and ensuring that staff have clear guidelines on how plans, updates etc should be written up. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 11 As none of the residents can verbally communicate staff were asked as to how people make decisions and choices in their daily lives. Staff described in detail how each person made their feelings known by various other methods of communicating such as facial expressions, body language etc. Staff said they felt they would always be able to recognise and acknowledge when someone was not happy or wanted to make other choices. All four residents have a ‘restrictive practices’ file and these were also discussed with staff who stated that restrictions are only set up to ensure that people are not unduly put at risk. Some examples of restrictions placed on people include access to the communal kitchen, making hot drinks and being out in the community. Risk Assessments had been carried out and these are taken to staff meetings and discussed on a regular basis. 15 Preston Drove DS0000060468.V345781.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): 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. People are provided with the opportunity to go out of the home on a daily basis. People retain contact where possible with their relatives. There was evidence that people’s rights are being respected. Residents are being offered a well-balanced diet. EVIDENCE: The home provides a good level of daily activities for people. An activities plan is devised each week, which indicates what each person will be doing. One person currently attends a day care centre and the others enjoy going out for meals, shopping and outings. A holiday to the Isle of Wight has been organised for residents this year. Staff stated that the level of activities offered has improved a lot and people are now going out and about in the local community on a much more regular basis. Residents are now able to go out with staff everyday if they wish. Some residents continue to receive in-house complimentary therapy sessions and these have been provided for several years. There has been one issue that has sometimes made it difficult to take 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 13 some residents out and that is the communal mini bus. A D1 Licence is required to drive the mini bus and there are four staff who hold this additional licence. Staff said that on occasions it can be difficult to take people out if no one on duty has the D1 Licence. The deputy manager said the home will be looking into other vehicle options for the future, which did not involve obtaining an additional licence. The majority of residents do not have ongoing contact with their families and the home is providing an advocacy service for one person at present. The home is looking to provide advocates for a further two people. Staff prepare all the meals for the residents and a four-week menu is devised. Staff said they are going to introduce an ‘interactive menu’ with pictures so that people can be much more involved with the organisation of the menu and choose the meals that they want each week. On the day of this inspection people were being taken out for lunch, as the home was experiencing problems with vermin in the kitchen. Environmental Health are involved and were supporting the home to deal with this problem. Staff had removed all foodstuffs from cupboards and all drawers and cupboards were being cleaned. One particular cupboard where dry foodstuffs were stored had an unpleasant smell emanating from it. It will be recommended that the home try to eliminate the odour from this cupboard. 15 Preston Drove DS0000060468.V345781.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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal support in the manner they prefer. People’s healthcare needs are being met. Staff must be vigilant when administering liquid medication. EVIDENCE: Each person has his or her preferred routine regarding personal care. Staff who were spoken to stated that all personal care was given in private and in the way people prefer. Support plans indicate how each person’s personal care should be given. Staff were seen to treat people with respect and dignity whilst managing their personal care needs. Records viewed showed that people have good access to a number of healthcare professionals such as local doctors, district nurses, physiotherapists, occupational therapists, psychologists, behavioural support and speech and language therapists. One person who is no longer able to swallow is now on a PEG feed and staff are supported by a specialist nurse who comes into the home to train staff and discuss any issues with the Percutaneous Endoscopic Gastrostomy (PEG). The deputy manager stated that the home was hoping to 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 15 receive some specialist type chairs for the two people who were permanently in wheelchairs. All medication records were checked. One person is being administered liquid medication and the records for this did not tally up. The amount that was supposed to be remaining in the bottle and the amount written up in the monitoring sheet were quite different. The deputy manager did state that some staff were experiencing difficulties when administering this liquid medication; it was difficult to dispense and there were no markings on the bottle to assist with seeing how much liquid was actually remaining. Staff have received medication training, however it will be recommended that the home seek the professional advice of a trained pharmacist to assist staff with administering and recording of this particular drug. It was reported that one staff member had been temporarily suspended for incorrectly administering medicines. The deputy manager has now taken over the responsibility for medications in the home. She has produced new policies and procedures. The home’s policy is that two members of staff sign the record sheet when medications are administered to ensure that no errors are made. 15 Preston Drove DS0000060468.V345781.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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes complaints procedure needs to be displayed in the home. All staff have received training in the protection of vulnerable adults. People’s finances were checked and found to be correct. EVIDENCE: Brighton & Hove City Council have produced a complaints policy and procedure, however it was not displayed anywhere in the home. This document is required to be publicly displayed. The four people who live in the home would need to rely on staff to raise concerns or complaints on their behalf. This would be a situation where the use of an advocate would be extremely important. The homes complaints log was viewed and no complaints had been made to the home or to the CSCI. Records indicated that all staff have received training in the Protection of Vulnerable Adults. The home has not received any adult protection alerts. All four people’s finances were checked. In the past there have been errors found in the way that staff use resident’s monies to fund their meals whilst they are out with them. This has been highlighted in the last two reports. A senior care worker said that he was now responsible for overseeing all resident’s finances and receipts were now double-checked. When the inspector checked the receipts one was found from six months ago, which clearly indicated that a staff member had had his meal paid for by the resident. The senior staff member stated that all staff were quite clear that when people 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 17 were taken out for a meal staff paid for their own meal from the homes petty cash float. The home will be required to ensure that staff have very clear guidelines about how meals are paid for when residents are taken out. 15 Preston Drove DS0000060468.V345781.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): 24, 25 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive improvements have been made to the home. The home was found to be clean and tidy on the day. EVIDENCE: The environment of the home received a rating of poor during the last inspection. Unpleasant odours were found throughout the home, which emanated from the carpets. A requirement was made for the carpets to be replaced. This has been done and the home no longer has any offensive odours. Most areas of the home were found to be bright and welcoming and some people’s bedrooms had also been improved. Staff said they had been very proactive in improving all areas of the home. The lounge has been redecorated with a new carpet and modern furnishings. A small conservatory at the back of the home has been opened up for residents to use. Staff are trying to introduce more sensory items to people’s bedrooms to make them more individualised. The only area that requires some additional work is the kitchen/dining area. This area does need some redecoration and a new table as 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 19 the current one is badly marked. The bathroom on the first floor also needs to be made a little more homely, as it has a very clinical appearance. The home has also benefited from creating a new office space. The manager and staff now have a larger and better-equipped office. Previously the office was located in a small staff sleep-in room. A cleaner is employed by the home for four hours a day from Monday to Friday. The home was found to be very clean and tidy throughout. 15 Preston Drove DS0000060468.V345781.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): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home now has a proactive and dedicated staff team. Some recruitment files are missing proof of identity documents. Staff receive a good level of training. EVIDENCE: In the past the home has experienced a high turnover of staff and staff shortages, however since the last inspection the staff team now appears to have stabilised since new staff members have been recruited. The home was also using a lot of agency staff but this has reduced greatly and agency staff are now only used in emergencies. The deputy manager stated that residents now receive consistent care from a dedicated staff team, which also include regular relief staff. In talking with staff it was apparent that there is a good ‘team spirit’ and they all felt very strongly about providing residents with the best possible care. It was also noted that staff morale had greatly improved as well. This has been a very positive step forward by the home, which in turn benefits the overall care that residents receive. There are four staff members on duty in the morning and three in the afternoon. One waking and one sleep-in staff member are employed. There are 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 21 a number of staff that hold NVQ qualifications. The deputy manager is due to commence the NVQ Level 4 Award in January 2008. Several staff are currently studying for NVQ Level 3 qualification. A number of staff recruitment files were viewed. The vast majority contain all the required information, however some did not have proof of identity documents. The home will need to ensure that each staff member has the correct documents included in their files. Records revealed that staff have been able to attend a good level of training, which has included courses on food hygiene, manual handling, medication, swallowing for people with learning disabilities, first aid, fire training, and the Protection of Vulnerable Adults training. Staff that were on duty were spoken to during the day and their feedback was very positive towards the home. They all felt that there had been some very positive improvements made at 15 Preston Drove and that the current staff team were working well together and providing a much more proactive and focused approach to their work. Several also felt that the atmosphere in the home was much friendlier and more relaxed. 15 Preston Drove DS0000060468.V345781.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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by an experienced and qualified manager. EVIDENCE: The current registered manager has been in post for 10 years and he has obtained the Registered Managers Award (RMA). The manager was not present during this inspection as he was away on annual leave. Staff were asked about the management of the home and overall staff said they felt that it was being well run. The majority of staff did feel that they were generally well supported by the manager but some said that there had been occasions when they felt the manager had not been very supportive. The transition from the South Down NHS Trust (who previously managed the home) to Brighton & Hove City Council who now manage the home is virtually 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 23 complete. The NHS Trust still remains responsible for the maintenance of the home. The home has a Quality Assurance Programme, which includes the Team Plan and this covers staffing, finances, health and safety, service users, performance monitoring checks, fire, staff records and restrictive practices. A Brighton & Hove Care Standards Officer carries out Regulation 26 visits monthly. As the people who live in the home do not have the capacity to provide feedback and most of them do not have any relatives; the home now seeks feedback about the service from visiting professionals who come into the service on a fairly regular basis. A health and safety check was carried out during the inspection. Since the last inspection there have been a lot of positive improvements made to the home. A fire risk assessment has been carried out and weekly fire zone checks are now being carried out. Hot water temperatures are checked weekly. Quarterly management health and safety checks are carried out to ensure the safety of both residents and staff. The home is working with Environmental Health to eradicate a vermin problem in the kitchen, which to date has not posed any health issues for the staff or the people who live there. Staff have worked hard to ensure that all areas within the kitchen have remained clean and hygienic. This problem is seen as very short-term and should now have been resolved. 15 Preston Drove DS0000060468.V345781.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 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 2 X 3 X 3 X X 3 X 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement Timescale for action 24/08/07 2. YA23 13(6) 3. YA34 Schedule 2 That the home seeks professional advice regarding the recording and administration of liquid medication. Staff must receive strict 24/08/07 guidelines on how staff meals are to be paid for when they are out with service users. To ensure that all staff files 24/09/07 contain proof of identity documents. 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 YA30 YA24 Good Practice Recommendations The home needs to consider streamlining the information on each resident and ensure that all staff are providing reviews, updates etc in the same format. That the home must try to eliminate the unpleasant odour coming from the dry goods cupboard in the kitchen. To redecorate the kitchen/dining room and provide a new dining table. DS0000060468.V345781.R01.S.doc Version 5.2 Page 26 15 Preston Drove 4. YA24 To make the first floor bathroom more homely. 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 15 Preston Drove DS0000060468.V345781.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!