Inspection on 27/08/08 for 23 Cecil Road

This inspection was carried out on 27th August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

23 Cecil Road 11/12/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 07/11/2008.

CARE HOME ADULTS 18-65 23 Cecil Road Dronfield South Yorkshire S18 2GW Lead Inspector Janet Morrow Unannounced Inspection 27th August 2008 03:00 23 Cecil Road DS0000067816.V370633.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 23 Cecil Road DS0000067816.V370633.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. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 23 Cecil Road Address Dronfield South Yorkshire S18 2GW 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) 01246 291673 01246 291901 Voyage.com Milbury Care Services Ltd Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 6 11th December 2006 Date of last inspection Brief Description of the Service: The home is a converted building situated in the village of Dronfield, which is on the boundary of Derbyshire and South Yorkshire. It consists of a lounge, dining room, kitchen, activity rooms and office on the ground floor, with bedrooms and bathrooms on the 1st and 2nd floors. The home does not have a lift facility. The fees for the home are not set at a minimum or maximum, but each individual service user has a contract with specific costs to meet their assessed needs. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection visit took place over one day for a total of 4.75 hours and concentrated on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last inspection. One concern had been raised with the Commission for Social Care Inspection since the last inspection visit in December 2006, which related to meeting the needs of one individual. This was discussed during the inspection visit. The manager was present throughout the inspection visit. One member of staff was spoken with and three people currently accommodated in the home were also spoken with. One visiting professional and one relative were spoken with by telephone after the inspection visit. Seven surveys were returned to the Commission for Social Care Inspection prior to the inspection visit; four from people living at the home and three from relatives. Care records, a sample of policies and procedures and staff information were examined. A tour of the building took place. Written information in the form of an annual quality assurance assessment was provided by the home prior to the inspection visit and this informed the inspection process. What the service does well: Individual written needs assessments were in place before people were admitted to the Home so that their diverse needs were identified and planned for. There were also up to date plans of care. The environment was comfortable and well maintained. There were a range of age appropriate activities for people living in the home and independence and decision-making was well managed. Three people living at the home said they ‘liked it’. One relatives’ survey stated that the home had the potential to ‘do well’. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 23 Cecil Road DS0000067816.V370633.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 23 Cecil Road DS0000067816.V370633.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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was sufficient admission information available to establish whether or not the home was able to meet individuals’ needs. EVIDENCE: One person’s care file was examined. There was information available from the assessment and care management system and the home had also completed its own documentation. An individual care plan was in place based on an initial assessment of the person’s needs. There were risk assessments in place that took into account individual needs and indicated risks that people chose to take and how they were managed safely. The written information supplied by the home also stated that ‘pre-admission holistic assessments’ were undertaken prior to anyone being admitted to the home. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 9 The person living at the home confirmed in discussion that they had been able to visit and look round the home prior to deciding whether to live there. Two relatives’ surveys responded that they ‘always’ received enough information to make decisions and one responded that they ‘usually’ did. All four surveys from people living at the home responded that they were asked if they wanted to move into the home and that they received enough information to make a decision about moving in. 23 Cecil Road DS0000067816.V370633.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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some aspects of risk management were not comprehensive enough to ensure peoples’ safety. EVIDENCE: One person’s care records were examined and showed that a comprehensive care plan was in place, with a specific one covering decision-making. There were also other key areas covered such as managing finances, behaviour, mobility, social, mental and physical interventions. The care plan was in sufficient detail to instruct staff how to encourage and maintain independence and it was up to date and reviewed at regular intervals. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 11 The written information supplied by the home stated that care plans were drawn up with the person concerned, their family and/or advocate. Signatures were seen on care records that confirmed this. Discussion with staff and observation during the inspection showed how some people made decisions and choices and had relatively high degrees of independence in certain situations, including the use of public transport and in personal finance. However, it was also observed that one person living at the home was using staff keys to locked store cupboards and holding the telephone to the home’s external phone system and it was unclear whether there was a risk assessment or competence assessment to support the safety of this. The care file examined also showed that the person concerned had significant mental health needs and that mental health professionals were involved in reviewing the care provided. Although the person concerned appeared to be having their needs met, there was the potential for care to be compromised, as staff were not trained to deal with mental health needs. There were no risk assessments in place on the file that dealt specifically with how to combat mental health deterioration. The concern raised recently with the Commission highlighted an inability to deal with specialist needs and resulted in action being taken by the Local Authority. The report relating to this incident indicated that the person concerned was not fully involved in the home and that staff had difficulty in dealing with certain aspects of behaviour. This record also indicated insufficient recording on care files to establish that the home had taken appropriate action when difficulties arose. Discussion with people living in the home showed that they were able to make decisions and choices about their daily routines and spent their free time in activities of their own choosing. All four surveys received from people living at the home responded that they were ‘always’ able to make decisions about what to do during the day, evenings and at weekends. 23 Cecil Road DS0000067816.V370633.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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided activities and services that were age-appropriate and valued by people, which promoted their independence. EVIDENCE: Activity plans for each person were available and showed a range of activities on offer. In discussion, one person stated that they went to college and another had a job for two days per week. All three people at the home had their own interests including football, music and films. There was also a small activity area and separate sensory area available for use in the home. The garden area was spacious and enclosed and one person took particular interest in caring for the home’s pet rabbit. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 13 One relatives’ survey responded that the home ‘always’ supported people to live the life they chose, one responded that it ‘usually’ did and one commented that it was not always possible ‘to participate in outdoor activities due to staff shortages and/or availability of qualified drivers’. Visiting hours were open and families were able to visit when they wished. The written information supplied by the home stated that they designed menus to suit individual needs and people had the option of eating alone or with others. This was verified on the inspection visit as one person went out with a relative and two went out for tea to a local pub. There was a choice available for the person who opted to stay in for tea. People were also involved within the kitchen and helped to cook and to prepare the meals. Three people spoken with stated that they liked the meals at the home and one stated that they ‘liked cooking’. Food stocks in the kitchen were at a good level and had a range of fresh and frozen food. 23 Cecil Road DS0000067816.V370633.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 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Inconsistencies in care practices and medication procedures did not ensure health and personal care needs were always met. EVIDENCE: The home had flexible routines based on peoples’ assessed needs, stated preferences and activities being undertaken. Staff had good knowledge of peoples’ individual preferences and interests and people spoken with said they ‘liked the staff’ and found them ‘helpful’. During the inspection visit, it was observed that privacy and dignity was maintained by people having the keys to their own rooms and the written information supplied by the home stated that people knew the key pad code to the front door. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 15 People living at the home had the opportunity to access the primary care facilities, which included General Practitioner (GP), optician and dental services. These visits were recorded in the care file examined. The care file examined showed that there was also information available from external professionals and that reviews of care took place that covered a wide range of needs and involved relevant health professionals. The recent concern brought to the attention of the Commission for Social Care Inspection was discussed with the manager. This had identified that individual needs had not been met. Issues were raised about support for people following hospital admissions and their integration into the daily life of the home. As a consequence, the home had been required to draft an action plan for the Local Authority to address the issues raised. A visiting professional spoken with by telephone stated that there were occasions when the person they were involved with had not received the guidance and occupation they needed and this had caused some behavioural difficulties. Medicines were being kept securely in a locked cupboard. One person’s medication administration record (MAR) chart was examined and showed some discrepancies, as follows: • Two medicines were signed as given on one date but were still in the dispensing pack • One medicine was not signed as given on the chart and there was no code used to explain why it was not given. There were no controlled medicines on the premises. The home did not have a copy of the Royal Pharmaceutical Society Guidelines on administration of medicines in care settings. There were no homely remedies in use, with the exception of Strepsil throat lozenges. Staff administering medication had received training in this and also had their competence to do so assessed. This was confirmed by documentation on staff files. 23 Cecil Road DS0000067816.V370633.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 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints were not addressed properly, which meant that peoples’ concerns were not always listened to and acted on. EVIDENCE: The written information supplied by the home stated that there was a clear complaints procedure and that there was detailed documentation recording all complaints and the action taken. A format for recording complaints was in place but when this was examined, although the complaints were recorded, there was no record of what had occurred to address the complaint and whether the complainant was satisfied with the outcome. The recent concern brought to the attention of the Commission for Social Care Inspection stated that the relative was not satisfied with the way the home had responded to the issues raised. A relative’s survey also stated ‘a complaint was made in 2007 and a formal reply to this was never received’. All three relatives’ surveys stated that they knew how to make a complaint and three of the four surveys from people living at the home stated that they knew. One person responded that they ‘sometimes’ knew how to make a complaint. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 17 The financial record of one person’s personal allowance was examined. The cash held corresponded correctly with the record and was stored securely. Two people were signing the record to verify the transactions. Receipts for purchases were available. The home had a policy on safeguarding adults and also had up to date information from the Local Authority on reporting procedures. The written information supplied by the home stated that knowledge of this policy was included in the induction process. The member of staff spoken with was aware of the responsibility to report any suspicions of abuse and confirmed that safeguarding training was undertaken in the form of an electronic course (elearning). 23 Cecil Road DS0000067816.V370633.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided safe and comfortable accommodation for people to live in. EVIDENCE: The home was clean, well decorated and odour free. One relatives’ survey commented that the home was ‘warm and comfortable’. All four surveys from people living in the home responded that the home was ‘always’ fresh and clean. There was one lounge and one dining room plus a small activity area and a sensory space for people to utilise. The recent concern raised with the Commission for Social Care Inspection commented that there were insufficient comfortable seats for six people and staff in the lounge. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 19 Three bedrooms were seen and were furnished according to individual needs and were personalised. Those people able to do so had the key to their rooms. One bedroom door was damaged and the paint on the front door was peeling off. The laundry facilities were domestic in nature and satisfactory. 23 Cecil Road DS0000067816.V370633.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, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Training and recruitment practices were thorough, which ensured that staff had the skills to care for people. EVIDENCE: The staff rota for the week of the inspection visit 25th – 31st August 2008 was examined. This showed that three staff were on duty in the mornings and afternoons and there was one waking and one sleep in staff at night. The manager was supernumerary. Both the manager and staff member spoken with felt there were enough staff available to provide the care required and confirmed that agency staff were used to cover any absences. However, there had been a number of changes in staff and manager over the past eighteen months. One relatives’ survey commented that ‘the constant turnover of staff is the main cause for concern and the emotional impact of staff movements may be having a negative impact’. The written information 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 21 supplied by the home also stated that one of the barriers to improvement was ‘unexpected staff absences’. Staffing issues were discussed with the manager and she stated that there had been occasions when activities had been affected by lack of staff but that this had improved and staff stability was ‘better now’. Two relatives’ surveys responded that staff ‘sometimes’ had the right skills and experience to look after people properly. Staff training information examined in the home showed that mandatory health and safety training was undertaken as well as other training in relation to the needs of the people living at the home. On the day of the inspection visit, training was taking place in report writing and communication. Other courses included non-contact intervention, positive behavioural change, autism and epilepsy; all had occurred since July 2007. However, there had been no training in mental health needs, despite this being a key area for some people at the home. Staff spoken with described the access to training as ‘good’. The written information supplied by the home stated that one of the improvements made was the appointment of a regional training manager to support designated individuals responsible for the training needs of the service. Staff spoken with confirmed that National Vocational Qualification (NVQ) training took place. Three staff records were examined. These showed that a thorough recruitment process was operated with the information required by Schedule 2 of the Care Homes Regulations 2001 being in place, including evidence of Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) First checks, identity information and two written references. 23 Cecil Road DS0000067816.V370633.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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The appointment of a new manager had increased stability in the home and ensured that it was run in peoples’ best interests. EVIDENCE: There had been a number of management changes over the past eighteen months that had resulted in a period of instability for the home. A new qualified and experienced manager was in place who had achieved the Registered Managers Award, but had yet to register with the Commission for Social Care Inspection. 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 23 Discussion with the manager demonstrated that quality assurance processes were in place with monthly audits being undertaken by the operational manager of the company and six monthly visits by the quality manager. There was also an annual service review that included questionnaires for relatives. Meetings with staff and people living in the home also took place. Mandatory health and safety training took place in key areas such as food hygiene, first aid and fire safety. Staff training information seen confirmed that this had occurred since May 2007. The written information supplied by the home showed that fire equipment had been checked in November 2007, gas safety in April 2008 and portable electrical appliances in June 2008. A valid insurance certificate and registration certificate were on display. 23 Cecil Road DS0000067816.V370633.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 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 2 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 2 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 2 2 X 2 X 3 X X 3 X 23 Cecil Road DS0000067816.V370633.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 YA9 Regulation 13 (4) (c) Requirement Care records must have up to date risk assessments to show how key areas, such as risks associated with mental health needs, are being managed. This is to ensure peoples’ safety and well-being. There must be clear guidelines in place that show staff how to deal with emotional and specialist health care needs to ensure that people receive the support they need. Timescale for action 01/11/08 2. YA19 12 (1) (a) & (b) 01/11/08 3. YA20 13 (2) Medication administration record 01/11/08 (MAR) charts must be completed accurately to minimise the risk of errors and ensure peoples’ safety. Complaints received at the home must be fully investigated and the complainant informed of the outcome to ensure concerns are listened to and acted on. Staffing issues must be reviewed and contingency plans put in place to cover unexpected staff DS0000067816.V370633.R01.S.doc 4. YA22 22 (3) 01/11/08 5. YA33 18 (1) (a) 01/11/08 23 Cecil Road Version 5.2 Page 26 absences and to stabilise the staff group to ensure consistency of care. 6. YA37 9 (1) & (2) The manager must make an application to become registered with the Commission for Social Care Inspection to demonstrate managerial competence. 01/01/09 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 YA20 Good Practice Recommendations The home should obtain a copy of the Royal Pharmaceutical Society Guidelines on administration of medicines in care settings. There should be sufficient seating in the lounge for all people and staff. The identified bedroom door should be repaired and the front door repainted. Staff should receive training in mental health to improve their knowledge and skills in this area. 2. 3. 4. YA24 YA24 YA35 23 Cecil Road DS0000067816.V370633.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 23 Cecil Road DS0000067816.V370633.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!