Inspection on 27/09/06 for 27 Graham Avenue

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

27 Graham Avenue 10/05/07

27 Graham Avenue 09/01/06

27 Graham Avenue 18/07/05

27 Graham Avenue 14/12/04

27 Graham Avenue 19/04/04

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

CARE HOME ADULTS 18-65 27 Graham Avenue 27 Graham Avenue Brighton East Sussex BN1 8HA Lead Inspector Nigel Thompson Unannounced Inspection 27th September 2006 09:30 27 Graham Avenue DS0000014126.V305767.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 27 Graham Avenue DS0000014126.V305767.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. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 27 Graham Avenue Address 27 Graham Avenue Brighton East Sussex BN1 8HA 01273 503058 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) Hallcreed Limited Ms Kathleen Penney Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty-five (65) on admission. Service users with a learning disability only to be accommodated. Date of last inspection 9th January 2006 Brief Description of the Service: 27 Graham Avenue is registered to accommodate up to four people with a learning disability; it does not provide nursing care. The home is situated in a pleasant residential area of Brighton close to local shops and pubs. It is convenient for bus services into Brighton and other areas, and Preston Park train station is also nearby. The building is a three-storey semi-detached property with large rooms and has a patio area with a barbecue in the long rear garden. Residents have the use of a large lounge, a kitchen/dining room and a music room. They also have the advantage of the use of a hydrotherapy pool at one of the other properties owned by Hallcreed Ltd. There is ample free parking in the road outside the home. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current range of fees at 27 Graham Avenue, as of 27 September 2006, is £82.40 - £109.00 per day. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours in September 2006. It found that the majority of key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were four service users living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with the Registered Manager. Two service users were also spoken with. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: The comfortable, relaxed and welcoming environment has evolved over several years and reflects the general stability and commitment within the staff team and the open and inclusive management style. Through working closely and consistently with service users, staff have developed a sound understanding of their individual care and support needs. Service users are encouraged and supported to make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. 27 Graham Avenue DS0000014126.V305767.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. 27 Graham Avenue DS0000014126.V305767.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 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. However the ‘Statement of Purpose’ and ‘Service Users’ Guide’ do not provide prospective service users and their relatives with sufficient accurate and up to date information about the home and the services provided. EVIDENCE: The manager confirmed that no-one has been admitted to 27 Graham Avenue since 1993. Also, with no proposed changes, there is very little likelihood of anyone moving into the home in the foreseeable future. However, from examination of relevant documentation, it was evident that certain information made available to prospective service users and their relatives is out of date. The Statement of Purpose and Service User Guide are to be reviewed after it was noted that certain information is out of date, including inaccurate details 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 9 regarding the management structure and care staffing levels and references to the National Care Standards Commission (NCSC – the previous organisation responsible for regulating care services). As discussed with the manager, it is important that details contained in these documents be kept under review, so as to accurately reflect the services provided and the current situation within the home. The manager confirmed that, in line with the organisation’s current admission policy, following a referral to the home, a full pre-admission needs assessment of the prospective service user would be carried out, from head office, by the recently appointed Care Services Manager. 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Individual care plans enable staff to meet service users’ assessed needs in a structured and consistent manner, however they do not always reflect changing support needs. Satisfactory and effective systems for consultation enable service users to make choices and decisions about their day-to-day living. EVIDENCE: The manager confirmed that service users and, where appropriate, a relative or representative have the opportunity to be involved in care plan reviews. In three plans that were examined, it was evident that recent reviews had taken place, however, in each case there was no record of who had been present at the review. Much of the relevant documentation was also undated, including ‘Individual Programme Plans’ and personal risk assessments. There was therefore no documentary evidence of when such information had been updated and 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 11 whether plans accurately reflected the individual’s current or changing needs or circumstances. It was noted in one service user’s care plan that was examined that there was no documentary evidence of a review having been held since October 2005. The ‘front page’ information sheet in each file has clearly been developed and typed out many years ago. Unfortunately, it is evident that the only updated details since then have been added in the form of unprofessional looking crossings out and hand written amendments. 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users maintain contact with family and friends as they wish and benefit from appropriate occupation and leisure activities and from satisfactory menus, that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of service users are identified and recorded in their individual care plan. Service users continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. However the current minimal staffing levels inevitably impact on the social opportunities available for individuals. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 13 Care plans examined showed details of individual social and recreational activities and the level of support required from staff. Activities and facilities accessed, include attending a local day centre, various trips out, swing ball and a variety of other leisure activities. As previously documented, despite the limited and variable communication skills of service users, staff have evidently worked closely and sensitively with individuals to develop effective levels of interaction. The manager confirmed that, where appropriate, service users’ family links are encouraged and supported, however not all service users have regular family contact. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Menus are varied and balanced and are based on service users’ identified likes and preferences. An alternative to the main meal is always available and a copy of the menu is displayed in the kitchen. The manager confirmed that service users are not generally involved in meal preparation. 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users are protected by the home’s medication policies and procedures, however unsatisfactory communication within the home and inadequate recording systems do not always ensure that their physical and emotional needs are met in a structured and consistent manner. EVIDENCE: Although as previously documented, individual care plans enable staff to meet service users’ assessed personal care needs in a structured and consistent manner, the current systems for communication between staff within the home are unsatisfactory. No individual daily records are maintained for service users and the only written ‘communication’ between shifts consists of random notes in the diary. The inadequate and ineffective handovers are all the more significant as it is evident that members of staff often do not see one another from one day to the next. The home is regularly un-staffed during weekdays while service users attend local day centres, although there is an emergency on call system in place. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 15 As an example of poor recording practices within the home, it was noted that there was no record or any documentary evidence of service users having been away on a recent holiday. No records of hospital, doctor’s or dental appointments were made available for inspection. The manager confirmed that no structured service user / staff meetings are held and although the occasional random and informal meeting does take place, no minutes are taken. The home operates a ‘Monitored Dosage System’ (MDS) to ensure the safe control and administration of medication. Regular monitoring of procedures and general guidance and advice is provided by a local pharmacist. All medication is stored securely and was found to have been recorded accurately, in line with the home’s policy and procedure. All staff who are directly involved in administering medicines have received appropriate training. The manager confirmed that, following risk assessments, no service users currently self-administers their own medication 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. The lack of an accessible and up to date complaints procedure does not ensure that service users, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Service users are at potential risk from abuse, through inadequate and outdated policies and procedures. EVIDENCE: It was noted that there is currently no accessible complaints procedure in place, for the benefit of service users’ relatives or other visitors to the home and the manager was unable to provide such a document for inspection. In line with the majority of the home’s policies, the complaints policy is required to be reviewed and updated. For the benefit of service users living in the home, a simple illustrated complaints procedure has been developed, with the use of symbols. The manager confirmed that due to the variable levels of mental capacity among the service users, it is unclear as to the individual awareness or understanding of the process. However she did add that one service user: ‘…..is well able to communicate her dislikes’. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 17 It was noted that no complaints have been received by the home since the previous inspection. The home has inadequate and outdated policies and procedures on adult protection and there was no evidence of a ‘Whistle Blowing’ procedure having been developed. The manager confirmed that staff are made aware of relevant policies and procedures relating to abuse and adult protection through their induction training. However there was no documentary evidence that staff receive the appropriate guidance, as relevant staff training records were not made available for inspection. 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains suitable for it’s stated purpose. Service users benefit from accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: There has evidently been little change in the physical environment of the home since the previous inspection and overall standards remain satisfactory throughout. The well maintained décor and generally good quality furniture and furnishings provide a comfortable and pleasant environment for service users. It was evident that many of the service users’ rooms have been personalised, with pictures, family photographs and other possessions and small items of furniture, to reflect individual taste, choice and interests. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 19 The home also provides service users with adequate and accessible communal areas including a spacious lounge, a good-sized kitchen diner and a ‘music’ room. At the rear of the property is a patio area with a long well maintained garden. The home continues to meet the requirements of the fire service and the environmental health department. The home has sufficient bathrooms/WC facilities for service users. One bedroom has an en-suite bathroom. On the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. There is not always sufficient trained and competent staff on duty to meet the assessed needs of the service users. However, service users are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: Two members of the care staff have NVQ level 2, or above, in care, representing 50 of the staff within the home. However, as there is no training matrix in place and because of the general unsatisfactory standard of training records, it was not evident which specific staff training is currently provided. Of note and clearly a welcome development, are the recently implemented and impressive training folders, now in place in respect of the manager and one member of staff. Evidently, the organisation’s training officer has produced the folders and it is understood that similar files are to be provided for all staff. There are concerns regarding the minimal staffing levels operated within the home and the potential impact this has on the care and support of service 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 21 users, as well as the inevitable affect on their social and recreational opportunities. No current duty rota was made available for inspection. However the manager confirmed that there was often only one member of staff on duty, both mornings and evenings, as well as at weekends. As discussed with the manager, this situation is unsatisfactory and clearly does not always ensure that the assessed needs of service users are being met, or that their best interests being served. The manager did confirm that and the matter is being addressed and additional staff are currently being recruited, through the organisation’s head office. Staff recruitment records, although not held in the home, were made available and inspected at a later date at the head office. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. As previously documented, current communication systems for staff within the home are inadequate. Informal staff meetings are held ‘from time to time’ and are unstructured and no minutes are taken. The current provision of formal staff supervision is also unsatisfactory. The manager confirmed that sessions take place ‘as and when’ and are not always recorded appropriately. 27 Graham Avenue DS0000014126.V305767.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users benefit from the stability and consistency of the manager and are protected by satisfactory health and safety procedures. However their best interests are not safeguarded by ineffective quality monitoring systems, inefficient record keeping and out of date policies and procedures. EVIDENCE: The home’s registered manager has worked for the organisation for thirteen years and has been in her current position for the past seven years. She has considerable relevant experience and continues to undertake appropriate training to update her knowledge and skills. As well as holding the NVQ level 2 in care, she confirmed that she is presently studying for the Registered Manager’s Award (RMA), which she expects to complete by January 2007. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 23 The home continues to use a pictorial satisfaction feedback chart for service users to demonstrate how they are feeling about the service they receive. However there is no evidence of any recent survey having been carried out and, in view of their often limited communication, it is recommended that feedback from service users’ relatives and stakeholders in the community be sought formally from time to time. Files for policies and procedures that were examined were found to be disorganised and poorly maintained. Many policies were also found to be generic and relate to the wider organisation. There was also evidence that policies are not routinely being reviewed and updated, as required. The manager confirmed that the health, safety and welfare of service users and staff remain of paramount importance within the home. She added that training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. However, as previously recorded, inadequate staff training records were not able to support this. All portable electrical appliances are now regularly tested and since the previous inspection, as required, risk assessments have been carried out for all hazardous substances used in the home. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. 27 Graham Avenue DS0000014126.V305767.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 2 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 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 3 x 3 X 2 X 2 3 X 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation 6 (a) Requirement It is required that all information made available to prospective service users and their relatives, including the Statement of Purpose and Service User Guide, be accurate and up to date. It is required that service users care plans, including risk assessmnets, be kept under regular review and updated to reflect changing needs and circumstances. It is required that an accessible complaints procedure is developed and that a record is maintained of all complaints received, including details of any investigation, action taken and the outcome. It is required that service users be protected from potential abuse by appropriate staff training and relevant and up to date policies and procedures. It is required that sufficient qualified and competent care staff are on duty at all times to meet the assessed needs of service users. It is required that a duty rota be DS0000014126.V305767.R01.S.doc Timescale for action 31/12/06 2. YA6 15 (2) (b) 31/12/06 3. YA22 22 (8) 31/12/06 4. YA23 13 (6) 31/12/06 5. YA33 18 (1) (a) 30/11/06 6. YA33 Schedule 30/11/06 Page 26 27 Graham Avenue Version 5.2 4 (7) 7. YA35 18 ( c ) 1 8. YA36 18 (2) 9. YA39 24 (1) (3) in place of persons working in the home. It is required that staff receive training appropriate for the work they perform and that training is recorded. It is required that all care staff receive formal supervision at least six times a year and that it be appropriately recorded. It is required that quality monitoring systems be improved by seeking the views of service users’ relatives and other stakeholders. 31/12/06 31/12/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA19 YA33 YA41 Good Practice Recommendations It is recommended that communication systems be improved to ensure that the emotional and health care needs of service users are met. It is recommended that regular structured staff meetings take place and are recorded and actioned. It is recommended that all policies and procedures be regularly reviewed and updated and that the current disorganised system of filing be improved. 27 Graham Avenue DS0000014126.V305767.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 27 Graham Avenue DS0000014126.V305767.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. 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