Inspection on 05/02/08 for 26 St Barnabas Road

This inspection was carried out on 5th February 2008.

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

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

26 St Barnabas Road 26/01/09

26 St Barnabas Road 21/03/07

26 St Barnabas Road 21/02/06

26 St Barnabas Road 20/09/05

26 St Barnabas Road 02/02/05

26 St Barnabas Road 22/06/04

26 St Barnabas Road 24/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 26 St Barnabas Road Emmer Green Reading Berkshire RG4 8RA Lead Inspector Sally Newman Key Unannounced Inspection 5th February 2008 09:50 26 St Barnabas Road DS0000011047.V357741.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 26 St Barnabas Road DS0000011047.V357741.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. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 26 St Barnabas Road Address Emmer Green Reading Berkshire RG4 8RA 0118 946 1775 0118 946 1775 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) www.milburycare.com Milbury Care Services Ltd ** Post Vacant *** Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. Service users not to be admitted over 65 years of age. Date of last inspection 21st March 2007 Brief Description of the Service: 26 St. Barnabas Road is part of Milbury Care Services Ltd. and registered to provide support and care for six adults with learning disabilities, between 18 and 65 years of age. The home has 5 permanent residents and one respite placement, which is used by a single service user. The home is situated in a suburb of Reading. It consists of six bedrooms, lounge/dining room, kitchen, shower room and bathroom. The aims and objectives of the home are to provide a secure and comfortable home; encourage and support residents to make decisions and choices in their lives; support and assist service users to make and maintain satisfying relationships; assist service users to develop their skills; and enable service users to engage in valued day time occupation and use the community facilities. The fees range from £1012.32 to £1086.80 per week. 26 St Barnabas Road DS0000011047.V357741.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 was an unannounced inspection that was conducted over the course of 3 days and included a visit to the service of 4 hours duration. Time was spent with the manager, the deputy manager and of the 3 staff on duty 2 were seen in private. 3 service users were seen and briefly spoken to and the relative of one service user was spoken to in private. A random selection of paperwork relating to the care provided was seen and a tour of the premises was conducted with the assistance of the manager. Overall the outcomes for service users remains good but the supporting documentation falls short of the standard expected with little evidence of any concerted effort to improve matters since the last inspection. It is not considered that the situation adversely affects outcomes for service users at this time but inaccurate and out of date recording has the potential to place service users at risk of not receiving the care they need. The frequency of staff supervision and meetings falls far short of the required standard. There was evidence that this lack of formal communication was having an adverse effect on staff morale and teamwork. The manager has failed to apply for registration despite having been in post for 18 months. There was evidence that this complacency has permeated the service and the staff team leading to the deficits evident during the course of the inspection. The provider has a range of polices and procedures relating to equality and diversity. From the evidence seen the inspector considers that this service would be able to provide a service that meets the needs of individuals of various religious, racial or cultural needs. No complaints have been received about this service by the Commission since the last inspection. What the service does well: 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 6 Provides good opportunities for service users to partake in a range of activities in the community. A stable core of staff provides consistent care to service users. The health care needs of service users are well met. Opportunities and support for daily living are good. Communication about service users between staff is good. What has improved since the last inspection? What they could do better: Make robust representation to secure general maintenance services and specifically in relation to the downstairs bathroom and replacement of the sink in the downstairs bedroom. Improve the frequency and quality of staff supervision, appraisal and staff meetings. Ensure care plans and risk assessments are reviewed and updated regularly. Develop and implement service user satisfaction questionnaires. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 7 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. 26 St Barnabas Road DS0000011047.V357741.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 26 St Barnabas Road DS0000011047.V357741.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. Prospective users’ individual aspirations and needs would be assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has not had a new service user move into the home in many years. There are policies and procedures for the assessment of prospective service users that includes overnight stays and individually tailored programmes for moving into the home. Evidence seen from documentation and from discussion with the manager confirms that an appropriate assessment of a prospective service users needs would be undertaken prior to a place being offered. 26 St Barnabas Road DS0000011047.V357741.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 poor. Service users’ assessed and changing needs are not reflected in their individual plan. Service users are assisted to make decisions for themselves. Service users are supported to take risks as part of an independent lifestyle but reviews of risks are not always conducted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence was obtained from discussion with the manager and staff and from perusal of a range of records including two care plans. Staff demonstrated a good understanding of the needs of the current service users and each spoken to in private gave a clear account of their key worker responsibilities. However, of the two service user files seen one recorded the last review having taken place in November 2006. The manager confirmed that another review had been conducted in November 2007 but the paperwork for this was missing. It was also evident that no effort had been undertaken to arrange an annual 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 11 review for another service user, which was now almost 3 months overdue. The manager confirmed that similar deficits were likely to be found in other service user files. It was acknowledged that the service was in the process of transferring all service user information to a person centred planning model, however crucial information must be maintained and safeguarded. It was apparent through discussion with the manager and staff and from observations between staff and service users that there is a commitment to encourage and support service users to make decisions for themselves. This area of practice would be enhanced by accurate recording in daily records and would provide clear evidence of the services’ enabling strategies. Evidence from the manager and from information provided by the service prior to the visit confirmed that regular house meetings are held where service users are encouraged to provide their views on the running of the home. Staff spoken to demonstrated a sound understanding of service users needs in relation to individual risks. The organisation has a policy and procedure in relation to risk taking with formats for recording information. From one service user file it did not appear that any review of risk assessments had been undertaken since June 2006. Although currently all staff are familiar with service users, 3 new staff will be commencing employment in April and could potentially rely upon this outdated information on which to base their interventions with individual service users. The manager must take responsibility for ensuring that all key workers conduct appropriately regular reviews of all aspects of care planning and that records reflecting the outcome of these reviews are available and up to date. 26 St Barnabas Road DS0000011047.V357741.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, 14, 15 & 16 Quality in this outcome area is good. Service users take part in a range of activities in the community including leisure pursuits. Service users’ rights and responsibilities are recognised in their daily lives. Service uses are offered a healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence was provided from discussion with the manager and staff, discussion with a visiting relative and from supporting documentation and observations conducted throughout the course of the visit. In addition, information was provided by the service prior to the visit. There were 3 service users out of the home during the course of the visit at various arranged activities. Care plans seen contained activity sheets, which provided information about the range of activities each service user attended. In addition to regular arranged activities the service provides unplanned trips 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 13 where possible such as pub and restaurant visits and trips to swimming or cinemas. It was not possible to obtain the views of the 2 service users in the home or the service user who visited during the course of the inspection due to communication difficulties. However, it was apparent that these service users were pursuing interests that were particular to them such as reading a newspaper and going into the garden. All staff spoken to considered that one of the strengths of the home was the range of opportunities provided for service users to attend activities, maintain a community presence and to visit relatives. In addition, all service users are supported to enjoy a holiday of their choice with appropriate support. One service user not present in the home during the inspection was booked to go on holiday to Disneyland Paris. The inspector was informed that this holiday had been the choice of the specific service user. 26 St Barnabas Road DS0000011047.V357741.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. Service users receive personal support in the way they prefer and their physical and emotional health needs are met. The arrangements for medication are robust and protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence was provided from discussion with the manager, staff and a visiting relative. In addition, associated documentation was seen and information provided by the service prior to the visit was used in the evaluation of these outcomes. It was clear from discussions that staff had a sound grasp of the service users’ needs in relation to health, personal care and emotional wellbeing. There is a core of established staff that are familiar with the service users and know them well. Health care appointments are documented and any changes in wellbeing are acted upon without delay. A visiting relative confirmed that staff are 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 15 competent and caring and her confidence in the homes ability to meet her daughters complex health care needs was growing. There are comprehensive policies and procedures in place in relation to medication. Only staff trained in the administration of medication are entrusted with the task of handling service users medication and completing the associated paperwork. A pharmacy check had been undertaken on the arrangements for medication within the home on 19.12.07 with no significant issues being identified. 26 St Barnabas Road DS0000011047.V357741.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. Service users views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are comprehensive policies and procedures in place providing guidance in handling complaints. They include the stages and timescales for the process and provide information for service users on how to make a complaint and to whom. Regular meetings are held with service users the purpose of which is to obtain their views about the service and enable any grievances to be aired. There was one complaint recorded since the last inspection. This was from a neighbour and although not yet fully concluded evidence indicated that it had been dealt with appropriately. All staff receive training in the protection of vulnerable adults. Updates are provided regularly by the organisation and the manager confirmed that all staff requiring updates had been booked onto courses. It was evident from discussion with staff that they are fully conversant with the potential for abuse of vulnerable adults and all demonstrated a clear understanding of the steps that needed to be taken should an allegation be made to them or they witnessed an act amounting to abuse or neglect. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. The home provides a homely, comfortable and safe environment for service users. In order to improve the home for service users the communal areas require thorough cleaning and outstanding maintenance issues should be addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was undertaken and the inspector discussed the arrangements for maintenance and renewal with the manager. Since the last inspection some furnishings and carpets have been replaced. It was noted that bedrooms were decorated to individual tastes and personal effects were in evidence in bedrooms. Bedrooms were clean, however, it was seen that skirting boards in communal areas and under cupboard areas in the kitchen had accumulated extensive dust, which had not been cleaned from some time. This observation was accepted by the manager and he undertook to consider 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 18 implementation of a comprehensive cleaning rota. In discussion with staff there was evidence of some feeling that not all staff view cleaning as important as others. This does occasionally give rise to resentments. One staff member felt that her efforts to improve the garden for the benefit of service users was not supported by colleagues leading to apathy and the abandoning of plans. The downstairs shower room smelt of damp and lacks ventilation. This situation was recorded at the last inspection. The manager advised that he had tried to secure maintenance for the shower room but in order to rectify ongoing damp problems it needed complete refurbishment. There existed ongoing problems with the relationship between the care provider and the landlord as to who was responsible for what expenditure. The manager was advised to consult with an Occupational Therapist as to the suitability of the shower room to meet the needs of the current service users. In addition, to obtain Occupational Therapy advice about the replacement of a smaller sink in a downstairs bedroom that causes some difficulty with access for the current wheelchair user. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is adequate. Service users are supported by competent, qualified and appropriately trained staff. Service users are supported and protected by the home’s recruitment policy and practices. Service users would benefit from more effectively supported and supervised staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence was provided from talking with the manager, with staff and a visiting relative. A range of documentation was seen including the staff training record and supervision records. Information provided by the service prior to the visit was used in evaluating the outcomes for service users, in relation to the current staffing arrangements. The organisation has a rolling programme of staff training and all staff are expected to ensure they are up to date with all mandatory training courses. The manager provided evidence of forthcoming training courses and the names of those staff booked to attend. One staff member confirmed a range of training he is due to attend over the coming weeks. It was reported that since 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 20 the appointment of a Regional Training and Development Manager the overall arrangements for staff training have improved and are more organised and easier to access. The home benefits from a core of established staff who know the service users well and are reliable and well motivated. There has been some turn over in staffing since the last inspection with two staff leaving the service. The manager advised that three new care staff members were due to commence employment at the home in April. Over the last year more permanent staff have been recruited resulting in less reliance on agency staff. The organisation has a robust recruitment process, which fully complies with the regulations. Staff confirmed that they had been interviewed for their positions and that appropriate checks had been made including references and confirmation of identity. Information provided by the service prior to the visit confirmed that all staff are provided with copies of the General Social Care Council codes of conduct, a job description and a statement of their terms and conditions. Staff spoken to could not always identify when they had last received formal one to one supervision with their line manager. Supervision records indicated that for one member of staff there were 3 recorded supervisions in the last year, for another there were 3 recorded supervisions in the last 2 years and for another staff member there was no file. The manager indicated that he tried to arrange regular staff meetings but attendance was problematic. Records indicated that there were 4 recorded team meetings in the last 2 years. This level of formal staff supervision and team meetings falls far short of the standard expected and of the organisations own policy and procedures. Generally staff felt that communication about service users was good with shift handovers being described as useful and the use of individual service user diary’s of a good standard. However, the lack of clear direction at times caused resentments among staff particularly in relation to the care of the fabric of the home and its exterior. It was considered that more regular staff meetings would allow for the airing of problems, which would improve the situation and help prevent the build up of resentments and misunderstandings. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. The manager could improve the running of the home to the benefit of service users. Service users views do underpin review and development of the home. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current manager has failed to apply for registration despite being in post for 18 months. Staff would benefit from clearer direction, which would enhance morale and a greater sense of teamwork and shared goals. This firmer and more robust approach should be delivered by the manager and the deputy manager through individual recorded supervision and staff meetings. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 22 Staff described the manager and the deputy manager as approachable and fair. The service seeks the views of service users through meetings and through the formal review process. This information feeds into an annual service review report the latest of which was produced in November 2007 and was available in the home. Regular visits are made to the service by an Operations manager under Regulation 26, however, only the record for May 2007 was available. It will be a requirement that all Regulation 26 reports are available in the home. There are comprehensive health and safety systems in place in the home. Records seen included water temperature and first aid box checks. Vehicle and wheel chair checks, hoist and fire equipment servicing and gas and electrical safety check reports were seen and took place in June 2007. A food safety inspection undertaken by the environmental health department in July 2007 resulted in a four star award being granted. 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score INDIVIDUAL NEES & CHOICES Standard No 6 7 8 9 10 Score 1 3 X X 2 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 3 X 2 X 2 X X 3 X 26 St Barnabas Road DS0000011047.V357741.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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. 2. 3. 4. 5 Standard YA6 YA24 YA37 YA30 YA39 Regulation 17 23 8 16 (2) (j) 26 Requirement Ensure care plans including risk assessments are regularly reviewed and updated. Secure appropriate maintenance to the downstairs shower room. The manager must apply for registration with the Commission for Social Care Inspection. Ensure communal areas are kept clean and hygienic. Ensure all reports made under Reg 26 are available in the home. Timescale for action 29/02/08 31/03/08 31/03/08 29/02/08 29/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA36 Good Practice Recommendations To consult with an Occupational Therapist as to the suitability of the downstairs shower room and the sink in the downstairs bedroom occupied by a wheelchair user. To ensure that staff supervision and staff meetings take place at least to the frequency as required by the standards. DS0000011047.V357741.R01.S.doc Version 5.2 Page 25 26 St Barnabas Road Commission for Social Care Inspection Maidstone 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 26 St Barnabas Road DS0000011047.V357741.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. 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!