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Inspection on 06/12/06 for 30 Vicarage Road

Also see our care home review for 30 Vicarage Road for more information

This inspection was carried out on 6th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a domestic, homely and comfortable living environment for the 6 service users that live there. Staff appear unobtrusive, supporting the service users at their request. Appropriate activities and leisure pursuits are offered that take into account service users interests and hobbies. Family relationships are promoted and encouraged as the service users see them as very important. Staff encourage a healthy nutritious diet that takes into account individual food preferences, and support the service users with preparing meals for everyone and individually as they wish. Service users health is monitored and maintained with support to attend routine and specialist healthcare appointments being provided. Prescribed medication is managed safely by trained staff, on the service users behalf. The home has a satisfactory complaints procedure in place. Service users clearly knew who to talk to should they be unhappy about anything. No complaints have been received by the home or the Commission for Social Care Inspection. A policy on he protection of service users from abuse is also in place in the home. Staff receive training in this area, as part of their induction and via the NVQ II qualification.Although the home employs a very small staff team, service users feel well supported, and receive any assistance they require when they want it. Although comment was made in the comment cards received that that there were not enough staff in the home, staff and service users felt that the staffing levels were satisfactory. The organisation carries out a comprehensive recruitment procedure that ensure that service users are protected and safeguarded. The home has introduced a quality monitoring process that ensures that service users views are at the forefront of service development. Health and safety is maintained appropriately.

What has improved since the last inspection?

Since the last inspection which was on 26 January 2006 the manager and staff have worked to meet the requirements made. The food hazard analysis has been reviewed and updated, all foods were stored and labelled appropriately and a means of auditing the quality of the service provided has been introduced and implemented.

What the care home could do better:

Although service users have comprehensive care plans and risk assessments in place these have not been reviewed for a considerable time, thus rendering the information out of date. Regular reviews of are planning documentation must take place to ensure that service users assessed needs are not compromised by incorrect information being available to staff. Prescribed medication is recorded and administered safely, however improvement must be made to the storage, recording and administration of homely remedies.

CARE HOME ADULTS 18-65 30 Vicarage Road 30 Vicarage Road Rugby Warwickshire CV22 7AJ Lead Inspector Justine Poulton Key Unannounced Inspection 6th December 2006 13:30 30 Vicarage Road DS0000004286.V321335.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 30 Vicarage Road DS0000004286.V321335.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. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 30 Vicarage Road Address 30 Vicarage Road Rugby Warwickshire CV22 7AJ 01788 547781 01788 573410 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) RMH Homes Ms Jane Felicity Bacon Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: 30 Vicarage Road is a large town house in a residential area close to the town centre of Rugby. It provides residential care for six people with learning disabilities and low care needs. There is usually one member of staff on duty with residents. The house is staffed the majority of the time when residents are at home. Day services are not routinely provided at the house but residents can have days at home if they wish. The ground floor consists of two lounges and a large dining/ kitchen area. There are two upper floors, each with a bathroom. The six single bedrooms and one sleep in room for staff are divided between the first and second floors of the house. There is a courtyard at the rear and a range of outhouses; one of which is used for pottery classes by residents from other houses in the scheme, on a regular basis. At the time of the inspection the weekly fee for this service was £650.00. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first key inspection in relation to Inspecting for Better Lives. Identified key standards were looked at, along with a review of the organisations progress towards meeting requirements made at the previous inspection of this service. The pre fieldwork documentation was completed, as well as a site visit to the home, during which time service users, staff, and the manager were spoken with. Three residents were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. Other records, policies and procedures were also examined and the environment was looked at. All of the service users were at home for part of the inspection. The inspector would like to thank the service users, manager and staff for their hospitality and co-operation during the inspection. What the service does well: The service provides a domestic, homely and comfortable living environment for the 6 service users that live there. Staff appear unobtrusive, supporting the service users at their request. Appropriate activities and leisure pursuits are offered that take into account service users interests and hobbies. Family relationships are promoted and encouraged as the service users see them as very important. Staff encourage a healthy nutritious diet that takes into account individual food preferences, and support the service users with preparing meals for everyone and individually as they wish. Service users health is monitored and maintained with support to attend routine and specialist healthcare appointments being provided. Prescribed medication is managed safely by trained staff, on the service users behalf. The home has a satisfactory complaints procedure in place. Service users clearly knew who to talk to should they be unhappy about anything. No complaints have been received by the home or the Commission for Social Care Inspection. A policy on he protection of service users from abuse is also in place in the home. Staff receive training in this area, as part of their induction and via the NVQ II qualification. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 6 Although the home employs a very small staff team, service users feel well supported, and receive any assistance they require when they want it. Although comment was made in the comment cards received that that there were not enough staff in the home, staff and service users felt that the staffing levels were satisfactory. The organisation carries out a comprehensive recruitment procedure that ensure that service users are protected and safeguarded. The home has introduced a quality monitoring process that ensures that service users views are at the forefront of service development. Health and safety is maintained appropriately. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 30 Vicarage Road DS0000004286.V321335.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 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): x EVIDENCE: No new service users have moved into the home since the last inspection therefore this key standard is deemed to be not applicable on this occasion. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. Service users needs are compromised as the information in care planning and risk assessment documentation is out of date due to the lack of reviews. Service users are being supported well when making choices and decisions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two service users care planning documentation was looked at as part of the case tracking process. Although there was a considerable amount of information available regarding their assessed needs it was apparent from the dates available within the files that they required reviewing and updating in areas. It was also noted that some of the language used within the files was very prescriptive for example “residents do not use microwave”, with no explanation as to why. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 10 Risk assessments were in place within the files looked at which followed the order of the individual care plans. Again these contained information that would enable the service uses to take meaningful risks however as with the care plans, they required reviewing. Throughout the inspection service users were making decisions such as what to have for tea, what to watch on the television, whether to sit in the lounge, kitchen or their bedroom, whether to have a drink or whether to change into more comfortable clothes. Service users spoken with said that they were supported with decision making as a matter of course, and were happy that the staff were their for advice should it be needed. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 17 Quality in this outcome area is good. Service users are supported and encouraged to participate in age, peer and culturally appropriate activities. The importance of family links and contacts to the residents is actively promoted by the staff. A wholesome, nutritious diet is encouraged. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that all of the service users attend some form of day service during the week. One of the people chosen for case tracking attends a farm placement for three days per week, and a local day centre for the remaining two. The second person case tracked attends a local day centre for five days each week. As well as formal day services, service users are supported to participate in a variety of activities and leisure pursuits both in house and in the local and wider community. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 12 These include shopping trips, meals out, local pubs and holidays. Service users spoken with were looking forward to a birthday party they had been invited too, and also to Christmas. It was obvious in conversation with service users that relationships with families and friends were important to them. Records seen in one service users daily diary confirmed that regular visits to a family members house were enjoyed. In another it was confirmed that regular contact with the service users mother was maintained. Service users spoke of spending Christmas with their relatives, whilst another was looking forward to a party his family had organised for his birthday. It was apparent from spending time with the service users in their home that the staff on duty respected their rights, and encouraged them to undertake individual responsibilities to ensure the smooth running of the household on a daily basis. The home functions on a domestic basis. As such it was observed and advised that there are no set routines in place other than those imposed by the residents themselves. The home has a kitchen diner, which is domestic in style with appliances in keeping with this. It was well stocked with plenty of fresh fruit and vegetables available. A ‘kitchen folder’ is in place which contains information on kitchen protocols, cooling hot foods, a nutritional policy, water temperature records, fridge and freezer temperature records, records of food core temperatures and a hazard analysis. All foods were stored appropriately, and were covered and dated where necessary. On the day of the inspection service users were assisting with preparing a curry for their evening meal. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. Residents’ personal care needs are compromised by outdated information within their care planning documentation. Residents’ healthcare needs are identified and monitored with routine and specialist appointments being arranged as necessary. Medication is generally managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents support plans provided evidence of information about how best to provide individualised care and support in the form of care plans. These were dated and signed and covered areas such as bathing, and personal care. As recorded earlier in this report however the care plans require reviewing and updating to ensure that the most recent information is available to staff. Information concerning healthcare was available, with records of appointments for routine checks such as dental, chiropody and optical being in place to confirm that they are offered at the recommended intervals. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 14 Evidence to confirm that specialist healthcare input was also received by professional services such as Speech and Language therapists, behavioural therapists and breast screening services was available. None of the residents currently administer their own medication. An organisational policy is in place that includes a section on the administration of homely remedies. Medication is supplied to the home by Boots in a Multi dispensing system (MDS), and is accompanied by medication administration record sheets (MARS). Examination of a sample of administration records and MDS packs provided no cause for concern during the inspection. Medication is stored in a locked drawer in a desk within the second lounge / office. During the inspection a number of opened bottles of Omega 3 1000mg fish oil supplements were found. These were not labelled as belonging to anyone, and there were no records of them having been administered to anyone. A member of staff on duty was able to confirm which service user they belonged to, and advised that the service users mother supplies them. All staff have received training in the administration of medication, except for the newest member of the team who said that she is not administering medication as she has not yet received training. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. The home has a satisfactory complaints system and can evidence that service users views are listened to and acted upon. There are policies and procedures in place for the protection of service users from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure in place. Service users have been given a copy, along with copies of the abuse procedure and Statement of Purpose. A document was available within the two files looked at that the service users had signed to confirm that they had received these procedures. Service users spoken with were clear about what they would do and who they would talk too should they be unhappy with something. No complaints had been received by the home or the Commission for Social Care Inspection. The home has a policy on abuse in place, which service users sign for when they receive a copy. Two staff have received training in this area and the remaining two new staff are covering it as part of their induction programme. It is also a core part of the NVQ II qualification which two staff have achieved. Information provided in the pre inspection questionnaire states that the organisation acts as appointee for three of the service users, with the remaining three having external appointees. Two service users monies were looked at during the inspection. The records, receipts and available cash all balanced. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. Service users live in a domestic, comfortable homely environment that promotes ‘ordinary’ living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large 3 storey house in a residential area of Rugby, close to the town centre. The ground floor consists of two lounges and a large dining/ kitchen area. There are two upper floors, each with a bathroom. The six single bedrooms and one sleep in room for staff are divided between the first and second floors of the house. There is a courtyard at the rear and a range of outhouses; one of which is used for pottery classes by residents from other houses in the scheme, on a regular basis. A walk around the home showed it to be clean, tidy and free from any offensive odours. Although the décor was reasonable the manager said that the home had not been decorated since it opened 10 years ago. Funding had recently been approved, and once the money has been received a complete programme of redecoration for the house would be commencing. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 17 The furniture and soft furnishings were of good quality, and the home presented as a pleasant comfortable place to live. Residents spoken with said that they found the home comfortable, and were pleased with their individual bedrooms which were decorated and personalised to their choice. As the home is domestic in style, the washing machine and tumble dryer are situated in the kitchen. Steps are in place to ensure that the risk of cross infection from carrying dirty washing through a food preparation and cooking area is minimal. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. Service users are supported by a caring and competent staff team. Staff recruitment procedures ensure service users are safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs 4 staff on a part time basis to support the service users when they are at home. These consist of a house leader and 3 support workers. The registered manager is based in another of the organisations homes that she has registration responsibility for. Two of the team have worked for the organisation for a considerable length of time, whilst the remaining two commenced work in July and November 2006 respectively. Of the four relatives / visitors comment cards that were received, two made comment that in their opinion there were not enough staff on duty. The rota provided with the pre inspection questionnaire indicates that the home is staff by one person when service users are at home. Staff spoken with felt that this was satisfactory given the abilities of the service users. Two staff have achieved NVQ II or above. One staff member spoken with said that the induction programme that she is going through is comprehensive, and she is hoping to commence the NVQ II qualification as soon as possible. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 19 The recruitment file of the newest staff member was looked at to confirm that safe recruitment practices are undertaken. All of the documents necessary to demonstrate that service users are protected by the organisations recruitment processes were in place. Each staff member has a training record in place. Staff spoken with said that they had recently undertaken training in food hygiene, health and safety for carers and protection from abuse. Training records confirmed that staff have also undertaken training in the areas of fire safety, moving and handling, communication, and medication administration amongst others over the previous twelve months. Information provided in the pre inspection questionnaire received from the service indicated that training in the areas of dementia, abuse, food hygiene, understanding learning disability and infection control would be undertaken throughout January, February and March 2007. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. A suitably qualified, experienced manager manages the home. Quality monitoring systems in place ensure that service users are at the forefront of service delivery. The health and safety of residents and staff is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager for the home is appropriately qualified and has considerable experience of working with people with learning disabilities. As well as being registered as the Manager for 30 Vicarage Road she is also responsible for another larger home in the organisation. The Manager said that she spends most of her time in the larger service, which is also where her office base is, and visits Vicarage road on average once a week. The day to day management of the home is carried out by the house leader who was not on duty during the inspection. Staff spoken with said that they find the manager approachable and available should they need her. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 21 The atmosphere in the home was relaxed, with service users and staff appearing comfortable with the manager. The organisation has a quality monitoring system in place that is used to gauge the quality of the service provided to service users and as part of the service development process. Service users are asked to complete a quality questionnaire on an annual basis. A report is compiled form the responses received and an action plan drawn up. This ensures that the service users are at the forefront of the services development. A copy of the most recent results and subsequent action plan from this monitoring system was forwarded to the Commission for Social Care Inspection for inspection. The most recent dates for the routine maintenance and health and safety checks were provided in the pre inspection questionnaire received. A small sample of these were looked at during the inspection and confirmed that heath and safety is maintained within the home. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 x 3 x 3 x x 3 x 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 23 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 YA6 YA18 Regulation Requirement Timescale for action 02/02/07 2 YA9 2. YA20 15(2)(b)(c The registered manager must ) (d) keep the service user’s plan under review and where appropriate, after consultation with the service user or a representative, revise the service user’s plan, and notify the service user. 13(4)(c) The registered manager must 02/02/07 ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 13(2) The registered manager must 19/01/07 make arrangements for the recording, handling, safekeeping, safe administration and safe disposal of all medicines received into the care home. This includes homely remedies. 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 30 Vicarage Road DS0000004286.V321335.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 30 Vicarage Road DS0000004286.V321335.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!