Inspection on 01/09/05 for 3 Salmon Street

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

3 Salmon Street 11/11/08

3 Salmon Street 23/01/07

3 Salmon Street 08/02/06

3 Salmon Street 16/03/05

3 Salmon Street 01/06/04

3 Salmon Street 05/02/04

Similar services:

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

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

CARE HOME ADULTS 18-65 Brian Ward House 3 Salmon Street Kingsbury London NW9 8PP Lead Inspector Bernard Burrell Unannounced 01 September 2005, 10:00am 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 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 Stationary 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. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brian Ward House Address 3 Salmon Street Kingsbury London NW9 8PP 020 8200 6718 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Walsingham Nicola Doran CRH PC Care Home only 5 Category(ies) of LD Learning Disability registration, with number of places Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection 16 March 2005 Brief Description of the Service: Brian Ward House is one of 40 care homes operated by Walsingham since 1986 to provide accommodation and care support to adults with learning disabilities. The home is located in Northwest London close to Wembley with easy access to a range of public transport services, shopping, leisure and community facilities and services. The home is also close to a range of health and social care facilities and services. The home is detached property with single room accommodation for 5 residents. One bedroom has ensuite facilities. At the time of this inspection, there were only two residents living at the home. There is also a staff sleeping room for night duty cover. The home provides 24 staffing with input from the registered manager, acting deputy manager, one support and one domestic worker. The residents are supported to live as valued members of the local community and assisted by staff to develop their life skills and abilities within the home and community. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day and was assisted with input from the manager, staff and residents. The inspector examined assessment and care planning records and case files, health & safety policies and procedure documents and files. The inspector also toured the building and interviewed the manager. At the time of this inspection only two residents were living at the home. However there was plan for 3 additional residents to move in imminently. The home is managed well and residents live in an environment that was homely, safe and adequately equipped to meet their needs. Residents reported satisfaction with the care and support they received from staff. What the service does well: What has improved since the last inspection? The home has made improvement to administrative, policy and procedure documentation to help ensure they are more accessible to residents staff and some in formats that reflect the communication ability of residents. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 6 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. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 1,2,4 The assessment of new resident is comprehensive and included input from a range of people associated with each resident, including the residents themselves. This has helped to ensure that decision to live at the home is well planned. EVIDENCE: The home has a service user’s guide that is written in a style and format that meets the needs of residents with limited verbal and communication skills and ability. The guide is kept under regular review and updating. The manager explained that no resident is accepted to live at the home until after they have the opportunity to visit, meet other residents and staff and get an orientation of the environment, including the facilities. The evidence seen on case records plus discussion with the manager also indicated that each resident is given the opportunity to choose the room they prefer. The choices are respected and honoured but subject to the physical ability or limitation of each resident. The initial assessment process is comprehensive and involved contributions from each resident, their relatives/NOK, social workers and other stakeholders. Contributory assessments are also made by agencies making referrals on behalf of new residents. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 9 When a resident moves into the home, the manager reported that staff carry out daily observation and monitoring of each resident to help understand and capture individual preferences, behaviour, health and social care needs. The information gathered is then transformed into a person centered care plan that is reflective of each residents care needs. This according to the manager has enabled staff and residents to get to know each other well, plus ensure that the most appropriate and relevant care support is offered to each resident. Each resident also receives a copy of the service users guide, statement of purpose and a service contract that is designed in style and format that reflects their learning and communication ability. The inspector spoke to one of the two residents living at the home a the time of this inspection about her views of living there. She stated she liked it very much and that staff were good to her and very supportive. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 6,7,9. The residents care needs are adequately assessed and kept under regular reviews. Care plans are person centred and reflected the individuality of each resident. The residents are supported to exercise some level of autonomy, independence and personal preferences. EVIDENCE: The information examined by the inspector, plus discussions with the manager and staff indicated that the residents are assisted to become aware of important information about their lives, including living and private spaces, leisure care needs, services and facilities in the community and the people in their lives. The care plans for each resident also had comprehensive individual assessments covering the abilities of each resident in areas such as communication, personal safety, mobility, eating and drinking, physical health and wellbeing, personal hygiene and communications programmes through the Brent Learning Disability Partnership. Good effort is made by the manager and staff to capture and understand the things that residents have done in earlier life and the skills and interest they have. The information in each care plans indicated residents are supported Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 11 and encouraged by staff to participate in making decisions about their lives insofar as they are able to do so. These included cultural/ethnic, leisure and social facilities and services available in the local community. There was evidence indicating that the relatives, social workers, residents and other stakeholders contribute to periodic reassessment and care planning for each resident. The home provides different methods of communication tools to help residents communicate their feelings, views, emotions and moods. These included pictorial references, large prints and other objects to aid communication and understanding. The inspector observed staff interaction with residents and was satisfied they had good knowledge of the user’s verbal and non-verbal skills and abilities. Staff support the residents to take part in activities within the home, including learning to respect individual space, keeping their rooms orderly and recognising potential risks. There were also recorded examples of risk assessments carried out by staff for each resident to help minimise potential risks and ensuring personal safety plus develop independence and skills. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,17 13,14,15,16,17 The residents enjoy varied social and cultural activities in the home and the local community. They are valued and respected by staff as individuals and enjoy healthy choices in meals and nutrition, plus access to health and social care support and services. EVIDENCE: Each resident had a weekly activity plan designed to meet their personal preferences and assessed care needs. The inspector’s observation indicated that staff value and respect each resident as individuals. The inspector observed good appropriate interaction between staff and residents. The information recorded on case files for residents plus observation made by the inspector, indicated that staff work to create a stimulating home environment plus provision of supporting services. Good effort was being made to create flexible and individually tailored lifestyle for each resident. The inspector’s observation indicated that staff and the manager work with residents to build on their positive individual and collective abilities, including Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 13 experiences and knowledge, rather than merely trying to manage negative features such as challenging behaviour and incapacity. There was documented information about leisure activities, including holiday travel plans, beauty and self-image sessions, music and community outings. In addition, there were recorded evidence of resident’s participation and attendance at the Willesden resources Centre, group relaxation, dance and music appreciation and attendance at football matches. The staff and manger also carry out Whole Life Reviews every six months with plans to have more regular reviews with day care workers and residents. The home had a large garden that was partially maintained and used by residents. However, sections of the garden needed clearance, including cutting of overhanging branches. Access to the garden was also possible for residents who are wheel chair users. The service provides useful information about daily meal choices and provisions. The menu was posted in the dining room and kitchen with pictorial examples of the food and drink that residents can choose from. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 18,19,20,21 The residents are supported by staff to develop their personal choices and preferences in daily living. The physical and emotional health care needs of each resident is adequately assessed, monitored, reviewed and looked after by staff who have the appropriate training and skills. EVIDENCE: The inspection findings indicated the health and nutritional care needs of the residents are adequately assessed and person centered with good access to a range of health and social care services. There was evidence of assessments and care plans covering how each resident prefer personal care to be given, including dressing, controlling body temperature, weight monitoring and managing physical problems such as epilepsy seizure. There was also evidence of support from epilepsy nursing assessment and the primary care trust (PCT) team. In addition each resident had a personal safety, mobility and communication assessment. There was also evidence of nutritional assessment relating to the support individual residents’ needed to help with eating, the types of food plus the meal times preference. The recordings examined also showed that information is restricted to only those who have the permission to access or need to know. There was Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 15 evidence to verify that the plans are regularly updated with input from each user or their relatives/NOK, social and key workers. There were also communication symbols to help illustrate and communicate the information more easily to residents. There were good examples of the administration of medication with detail individual medical and health care assessments. The health care procedures had clear guidelines on how staff are expected to administer medication, dispose of used materials, storage and reordering of medicines plus discontinued medication. Staff are also required to check the medication stock every 4 weeks. Medication issues for residents are discussed at work shift handover meetings. There was evidence of medication training undertaken by staff plus a staff signature verification sheet. There was also signature verification that staff have read and understood the policy and procedures dealing with health care and medication. In addition, there were guidelines for acquiring emergency prescriptions and evidence that staff have been supporting residents to make and attend medical and health care appointments, including out of hours visits by doctors. There were relevant and up to date recordings on each resident’s health care profile, including known allergies, current medication, dosage, side effects and appointments. The home also has guidelines and information in the service users’ guide and contracts about arrangements for funerals. The information has been written with appropriate symbols for different faiths and religion and in easy to understand pictorial format. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 22,23. The resident’s views and wishes are appropriately considered and responded to by the staff. The provider’s employment policy and procedures help to ensure that the protection of resident’s welfare and safety is promoted. EVIDENCE: The inspector was satisfied the home has relevant complaints policy and procedural guidelines in place with appropriate summary information in the service user’s guide. The Complaints guide is written in style and format that meets the communication needs and ability of people with learning disabilities. It also has photographs of people who complaints can be made to. There was no record of complaints recorded at the home or sent to the CSCI since the last inspection. One resident told the inspector she was happy living at the home and had no complaints. The residents benefit from the support of the Brent Learning Disability Partnership and other local community resources. The inspector observation plus discussions with the manager indicated staff encourage freedom of expression, thought and belief among the residents, Staff also help to facilitate participation in chosen activities. The residents are adequately protected by the home’s rigours employment policy and procedures. In addition, the home is managed well and staff are supervised and accountable for their daily interactions with residents. There is also additional monitoring from the Brent Learning Disability partnership, social workers/care managers and relatives. There were appropriate systems and mechanism for monitoring the home’s performance in safeguarding the rights of residents. However, the provider will Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 17 need to ensure effort is made to provide independent financial appointees where possible or necessary- to mange the finance of those residents whose money is currently managed by the registered provider. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 standard(s) 24,25,28,30 The home was satisfactorily maintained. It was clean and hygienic throughout. However, the bathrooms and other communal areas needed decorating and better maintenance of the garden. The home also needs a programme of general maintenance and upkeep. EVIDENCE: The inspector was satisfied most areas of the home were well maintained and bedrooms were decorated to a good standard with adequate furnishing and facilities, including washbasins. There was adequate natural light in each room, good heating system, communal bathrooms, ventilation and storage space. The ground level of the home is accessible to wheel chair users. There were examples of good health and safety hygiene practices being followed in the kitchen and dining areas, including safe and appropriate storage of food items and substance hazardous to health. Closer attention must be paid to checking and recording fridge temperatures each day. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 19 The policy and procedures relating to health and safety in the home were updated and staff signatures verified they have read and understood the policies. Areas of potential risks have been safeguarded with clear instructions to staff how to ensure compliance and monitoring is carried out daily. There was also recorded information of up to date inspection and testing of electrical appliances, equipment and work tools. Work is needed to upgrade and decorate the bathrooms and facilities, including the ones in the upstairs area of the home. Work is also needed to ensure the garden area is better maintained and overhanging trees branches are cut back to minimise the risk of fallen branches. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35 The procedures for recruitment of staff are thorough and offer adequate safety and protection to residents. The staff work as a unified, skilled and effective team. More effort is needed to ensure the home is adequately staffed at all times. EVIDENCE: At the time of this inspection, one care staff was on duty caring for 2 residents. The manager and one other staff arrived within an hour later. The inspector discussed the staffing cover with the manager who gave the following information. A total of 7.5 staff should be employed to adequately cover the services at the home. This includes two waking night staff. At the time of this inspection the following staff were employed, the manager, deputy manager (seconded to another home until October 2005), the acting deputy, two part time care workers and two full time care workers. The manager informed the inspector that the home had 4 outstanding vacancies for care workers. There was also two new staff waiting to start work subject to satisfactory CRB and reference clearance. The inspection findings indicated the manager is well experienced with the right management skills and abilities to manage the home satisfactorily. She has also developed beneficial working relationship with staff and residents. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 21 All current staff at the time of this inspection had contracts of employment with terms and conditions and clear job descriptions. The staffing records showed that regular supervision takes place every six weeks in addition to the six weeks induction programme for all new staff. Each staff also had records of their personal and professional development plan, including evidence of training undertaken or currently in progress. Information in the staff communication book indicated reliable system of written communication and sharing of infrmation among the team. The staff on duty also reported they work well as a team in the best interest of the residents. Staff were also aware of the diversity issues and individual needs of each resident and make good efforts to promote the best values and ethos of communal living at the home. The provider will need to ensure that the home is adequately staffed at all times and there is a reliable pool of staff that can be called on to assist with continuity of care and support to residents. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,40,42. The home is managed well by the current manager, deputy manager and staff with good support from the provider. This approach has worked to the benefit of residents and has helped to protect and promote their welfare, rights and wellbeing. EVIDENCE: The evidence examined by the inspector showed that each resident has copy of the Walsingham 5 year development plan written in April 2005 in a communication style and format that caters to the needs of people with learning disabilities. The inspector was satisfied that the home is managed well and in the best interest and safety of the residents. The inspection findings indicated the residents enjoy progressive choices in a caring environment with appropriate physical, emotional, social and cultural stimulation and interests. There were effective management tools and systems that help to monitor safety and standards of care provided within the home, for example- policies Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 23 and procedure documents were up to date, orderly, well maintained and accessible to staff. There were up to date records of electrical, gas, fire safety, portable appliance test and servicing. There was also a range of risk assessment guidelines, including an index of risks for the current year carried out in January 2005 with reviews planned for January 2006. There was also good system and programme of regular staff supervision and training to help enhance staff’s professionalism. The inspector was satisfied that the welfare and safety of residents are further safeguarded by the provider’s compliance of ensuring staff employed to work at the home are suitably qualified to do so. Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 4 x 3 4 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 4 4 Standard No 31 32 33 34 35 36 Score 4 4 2 3 3 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brian Ward House Score 4 3 4 4 Standard No 37 38 39 40 41 42 43 Score 4 4 x 3 4 2 4 G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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 23 Regulation 10, 12, 13, 37 Requirement The registered provider must ensure that effort is made to provide independent financial appointees or relatives/next of kin to help manage the finances of residents whose money is currently managed by the provider. The provider must ensure that all areas of the garden is better maintained and overhanging tree barnches are cut back to maximise safety to residents, staff and visitors, The provider must ensure that work is carried out to upgrade and decorate bathrooms and other areas of the home. The provider must ensure that the home has an adequate compliment of care support staff available to provide continuity of care and support to residents at all times. The manager must esnure that closer attention is paid to recording daily fridge temperatures and monitoring of cooked foods stored in the fridge. Timescale for action 30 November 2005 2. 24 16, 23 30 September 2005 3. 30 16, 23 30 October 2005 30 November 2005 4. 33 18, Schedule 4.6,4.7 5. 42 13.16, 17,23 30 October 2005 Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 26 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 Good Practice Recommendations Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 4th Floor, Aspect Gate 166 College Road Harrow, Middlesex HA1 1BH 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 Brian Ward House G62-G11 S54415 Brian Ward House V247002 010905 Stage 4.doc Version 1.40 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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