Inspection on 28/08/07 for 2 Herondale

This inspection was carried out on 28th August 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 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Herondale 03/08/06

2 Herondale 30/11/05

2 Herondale 22/07/05

2 Herondale 21/02/05

2 Herondale 16/08/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 2 Herondale 2 Herondale Basildon Essex SS14 1RR Lead Inspector Mr Trevor Davey Unannounced Inspection 28th August 2007 13:15 2 Herondale DS0000018053.V349552.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 2 Herondale DS0000018053.V349552.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. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Herondale Address 2 Herondale Basildon Essex SS14 1RR 01268 523399 01268 523399 herondale@mcch.org.uk www.mcch.co.uk MCCH Society Ltd 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) Mrs Diane Patricia Watts Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (8) 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd August 2006 Brief Description of the Service: 2 Herondale is registered to provide personal care and accommodation to a maximum of eight adults with a mental disorder. This includes residents’ aged 18 to 65 years as well as older people over 65 years of age. This does not include people who may have dementia or a learning disability. The home is a modern purpose built premises set in a residential area of Basildon. The accommodation is on two floors with eight single bedrooms some of which are on the ground floor. Residents have use of the lounge, separate dining room, quiet/smoking room, laundry and kitchen. There is a shaft lift access between the ground and first floors. The home has a garden to the rear and adequate parking to the front. It is also close to local shops and Basildon town centre can be reached on foot or by public transport. Information about the home is made available to prospective residents in the Statement of Purpose and Service User’s Guide. The current weekly fees are £955. Extra charges are made for hairdressing, chiropody, toiletries, activities and holidays. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection site visit took place over a period of 4.45 hours. The visit mainly focused on the progress the home had made since the last inspection and covered all key standards. The Registered Manager together with other staff and residents were spoken with during the site visit. Their comments and contributions received were helpful in assisting the Inspector to prepare this report. As part of the site visit, a tour of the premises took place and some of the personal care records and other official records within the home were also assessed. The management of the home had conducted their own survey and quality assurance exercise and as part of the inspection process, the Inspector provided survey forms at the home for completion. This is to find out what residents, relatives, staff and other professionals think of the home and the standard of service provided. The information included in the annual quality assurance assessment form (AQAA) which had been submitted to the Commission for Social Care inspection, was also used in compiling the inspection report. This form gives homes the opportunity of recording what they do well, what they could do better, what has improved in the previous twelve months as well as future plans for improving the service. What the service does well: Since the last inspection, the home has developed its quality assessment procedures and all residents have completed survey forms and relatives also had the opportunity of expressing their opinions. The home is good at communicating with residents and keeping relatives in touch with any changes that take place or concerns, which need to be discussed. Positive comments received included, staff are always helpful and welcoming and privacy is respected. Staff are concerned and keep in close touch. Residents are involved in discussions and making decisions regarding their care plans which are personalised to meet their needs and aspirations. Regular reviews take place. Recording of this information is detailed and up to date. In many cases, the home has managed to establish a very good professional 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 6 working relationship with consultant psychiatrists and community practice nurses which has had a positive benefit for the quality of care for residents. The staff team communicate well together and continue to improve practices and procedures where shortfalls have been identified. Staff accompany residents as required for appointments and leisure activities. Some of the residents spoken with confirmed that staff discus with them possible recreational activities and that they feel safe in the home and have confidence in the staff who support them. Residents get on well with local shopkeepers in the community. The home has managed to establish good and friendly relationships in the neighbourhood. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 2 Herondale DS0000018053.V349552.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 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. Potential residents, families and interested parties can be assured of a robust pre-admission assessment process. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A sample check was made of pre-admission assessments which had been carried out recently. This included information from a previous care home and consisted of care plan and background information. Likes and dislikes had been recorded by staff as well as interests, which enabled staff to pursue possible leisure opportunities in the local area. There was information regarding problems, which may need to be resolved, and other details from health care professionals as well as current medication and dietary needs. The community psychiatric nurse and social worker had also been involved. Where there had been queries raised by the home, these had been responded to and further information provided. Timescales were in place for a six-week assessment to take place after admission to establish whether the placement is suitable and to determine whether the home can fully meet the needs identified. There was a mixed response from survey information completed by residents where in some cases, they had been asked whether they wanted to come into the home and others where they were not asked. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 People who use the service experience good quality outcomes in this area. Residents can expect to have a plan of care drawn up by the home that reflects their wishes and details their assessed needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans had been completed which are tailored to the individual to take account of their needs and wishes. Amendments to care plans had been made following discussions with residents who sign indicating their agreement to changes made. Monthly reviews had taken place which were dated and signed by each resident as well as the staff involved. A summary of the monthly evaluation had also been completed. Where necessary, risk assessments had been put in place and regularly reviewed. In some cases, specialist reports had been completed by health care professionals, which included details, discussed and any follow-up action required. Daily and nightly log reports had 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 10 been regularly completed which recorded any care, support and intervention provided by the staff team. Survey information completed by residents confirmed that they are able to make decisions about daily routines and have choice about what they wish to do. Feedback from relatives felt that the home provided the support and care that was expected. Where there were important issues, relatives felt staff were good at keeping in touch to make them aware of any significant changes. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 People who use the service experience good quality outcomes in this area. Residents can expect to be supported in participating and experiencing a variety of social and leisure activities and be provided with a balanced varied diet. This judgement has been made using available evidence including a visit to the service. EVIDENCE: From discussion, observation and records available, there is evidence to show that residents are encouraged to enjoy and take part in leisure and recreation activities which reflect individual interest. Some of the residents spoken with confirmed that staff had talked to them about possible recreation activities which included visiting the local library. Responses from resident surveys confirmed that staff treat them well and listen to what they have to say. Feedback from health care professionals express that staff are committed to promoting social inclusion and integration into the community, recognising the 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 12 personal choice of individuals. Some of the responses from relatives confirmed that the home meets the different diverse needs of residents. A record was available showing the details of activities which residents had been involved with. Some of the residents have formed good relationships and go out together into the local community. Some of the activities enjoyed are bingo, yoga, snooker, bowls and line dancing. Residents are accepted by shopkeepers and local traders and regularly enjoy pub lunches. Neighbours are very friendly and supportive of the service. Arrangements are made to celebrate birthdays by having meals out and four the residents are going to Norfolk on holiday shortly. Photographs were displayed in the home of holidays and various outings which had taken place. Information included in the AQAA form completed by the home, indicates that changes have been made to ensure that equality and diversity are promoted within the service. The staff team have focused on treating each person as an individual rather than slipping into the group approach, recognising their personal beliefs and being involved in decisions about their own lives. Residents are able to be involved with the shopping for food and they discus with staff menus, which are prepared each Sunday for the following week. Residents are encouraged to prepare their own snacks at lunchtime as well as carrying out various domestic tasks in the home. Records of meals provided were available although there were some omissions where entries had not been completed. Some of the residents spoken with confirmed that they enjoyed their meals in the home. A risk assessment had been completed for healthy eating and safety in the kitchen, which staff sign and date when necessary procedures are carried out. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 People who use the service experience good quality outcomes in this area. Residents can expect to receive good health and personal care and support. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Health care records are available which includes specialist reports and intervention by health care professionals. Overall, there has been good and regular support from community psychiatric nurses and comments included in a survey completed by a visiting professional, acknowledged that residents have improved significantly since moving out of the hospital environment and the home has good communication links with other services and agencies. The home does have some concerns where there have been meetings arranged in the past to give staff an opportunity to discuss particular situations with health care professionals which never took place because a therapist was not available. Four of the residents are now over sixty-five years of age and come within the remit of the older Persons team at the Primary Care Trust. Since this change, the community psychiatric nursing support has not been so 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 14 responsive as it is for adults under sixty-five years of age. This issue needs to be addressed by the Registered Provider with the Primary Care Trust to ensure equality is maintained for the provision of health care services to all residents living in the home. In the AQAA form completed by the home, there is concern that it has not always been possible to access specialist support needed for particular residents where psychotherapy treatments need to be made more readily available. Again, this is an issue which needs to be taken up by the Registered Provider who has a responsibility for care, and to ensure appropriate treatment and support is available from the Primary Care Trust to meet the needs of residents. A sample check was made of the medication administration records, which had been completed, and the entries made were correct in accordance with agreed procedures. Records were also available of medication received into the home and discontinued drugs which had been returned to the pharmacist. Protocols for P.R.N. (to be taken as required) medication were in place. Training in medication procedures has been given to staff but errors have occurred where the wrong dosage had been given to a resident which was reported to the Commission under Regulation 37 of the Care Homes Regulations. Further training has been provided and procedures updated to ensure medication is administered safely by all staff. This needs to be regularly monitored and checked to minimise the risk of harm to residents. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. Residents can expect to have their complaints taken seriously and be protected by the homes safeguarding adults from harm procedures. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There is a complaints procedure which is available in the home and residents all have a copy. Relatives also have been made aware by the management of its existence and how this can be used if necessary. Since the last inspection, three complaints had been recorded. Copies of the investigation process were made available for inspection and the home was able to demonstrate that these had been thorough and included appropriate responses which had been sent to the complainants. Responses received from surveys confirmed that residents knew how to make complaints and relatives confirmed that the home had always responded appropriately if concerns had been raised. Since the last inspection, staff have received additional training regarding procedures to be used in ‘safeguarding adults from harm’. Staff have also completed training packages and staff have an awareness of the reporting procedures to be used should this be necessary. Residents spoken with confirmed that they felt safe in the home and were able to approach staff if they had any concerns. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 16 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 & 30 People who use the service experience good quality outcomes in this area. Residents can expect to live in a clean, comfortable and safe environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Since the last inspection, carpets have been renewed throughout the whole house and communal areas have been repainted. New garden furniture has also been purchased. Bedrooms are decorated to the residents’ individual choice and no major maintenance is outstanding. Some of the staff team have recently completed health and safety at work training and information completed on the AQAA form, indicates that records for the control of substances hazardous to health (COSHH) are regularly updated. Risk assessments for a safe working environment had been reviewed and updated in January 2007. Up to date maintenance/servicing certificates for gas, electricity and mechanical bath equipment were also available. Portable 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 17 appliance testing had been carried out. The premises were safe, clean and comfortable for resident and records of cooked food, freezer and fridge temperatures were being maintained. At the time of inspection, the garage was being used as a smoking area for residents, which immediately faces the open road. The Registered provider should look into providing a more suitable and alternative provision within the home for this purpose, which takes into account the dignity, and well-being of all residents. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 18 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): 32,33,34 & 35 People who use the service experience adequate quality outcomes in this area. Residents can expect to be cared for by a team of staff in sufficient numbers who use the service but training needs to be improved. Recruitment policies and practices are in place to ensure residents are properly supported and protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff rotas were available for inspection and reflected the people on duty at the time of inspection. There are usually three staff on duty including the manager. Night cover is provided by two members of staff, one on awake duty and the other who sleeps in on the premises and is available to provide assistance if required. Comments from survey forms received and residents spoken with, confirm that staff listen to residents and treat them well. Other feedback from health care professionals involved with the service state that the service responds to different needs of individuals who are encouraged to make known 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 19 their needs and wishes. Relatives have commented that the home usually supports residents to live the life they choose but some of the staff feel that if they had more time, they could be more involved with residents. Evidence that staff recruitment procedures had been completed by the Registered Provider was in place as well as notification to the home on progress made with new applications. Confirmation had been received regarding recruitment records checked relating to agency staff. At the time of inspection, there were three full-time staff vacancies. A variety of courses had been completed and staff spoken with said these included moving and handling as well as M.R.S.A. training and infection control. The majority of staff have achieved or are near completion of N.V.Q vocational qualifications. Although the home applied for training in understanding mental distress five years ago, no arrangements have been made by the Registered Provider to meet this need. This and other requests for specific training such as strategies for crisis intervention prevention (S.C.I.P.) should be followed through to ensure staff are suitably trained to meet the needs and challenging behaviour of all residents in their care. This issue has been highlighted in previous inspection reports. The home has been able to benefit from other health care professionals who have in the past, spoken to the staff team about schizophrenia and bi polar health conditions. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 20 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 People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness, respect and has effective quality assurance systems in place. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager is currently studying for the N.V.Q.4 Registered Managers Award and has recently successfully completed a management development programme. Survey forms completed by staff confirmed that the manager is willing to discuss problems and will support applications for training and further development. Individual staff supervision takes place on a regular basis and communication within the team is good. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 21 Following the report of the previous inspection, improvements had been made to the quality assurance system and survey forms have been revised to make them more user friendly for residents to complete. All residents had completed questionnaires, which were issued by the home, and the manager had written to individuals thanking them for completing the forms and offering to discuss how any issues of concern can be improved. The manager gave examples of where particular issues had been resolved satisfactorily. Feedback received from relatives and other interested parties had also been taken into account for improving the service. In the next twelve months, the home plans to encourage staff to find creative and imaginative ways of stimulating residents to take a greater part in activities outside of the home. Records of financial transactions relating to residents personal allowances were inspected and these had been properly documented with appropriate signatures of both staff and residents. The home has a health and safety policy and appropriate risk assessments are in place to ensure the home is safe for residents and equipment properly serviced. Policies, procedures and codes of practice are regularly reviewed and updated as required. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 22 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 2 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 23 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 YA17 Regulation Requirement Timescale for action 31/10/07 2. YA35 17(2) The Registered Person shall sched.4(13) maintain records of the food provided for residents in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual residents. 18 The Registered Person shall, 30/11/07 having regard to the size of the care home, the Statement of Purpose and the number and needs of service users, ensure that staff receive training appropriate to the work they are to perform, including mental health awareness. (previous timescale of 01/12/06 not met) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 24 No. 1. Refer to Standard YA19 Good Practice Recommendations The Registered Provider should take steps to ensure health care professionals are available to provide the service & support required, particularly for those residents over sixty-five years of age. Ongoing training & monitoring should take place to ensure staff administer medication safely to residents in accordance with guidance issued by the Royal Pharmaceutical Society. An improved facility should be designated as a ‘smoking area’ which respects the dignity and wellbeing of all residents living in the home. 2. YA20 3. YA24 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection 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 2 Herondale DS0000018053.V349552.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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