Inspection on 07/08/07 for 32 South Street

This inspection was carried out on 7th August 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

32 South Street 29/08/06

32 South Street 05/12/05

32 South Street 07/06/05

32 South Street 29/11/04

32 South Street 24/05/04

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

CARE HOME ADULTS 18-65 32 South Street Sheringham Norfolk NR26 8LL Lead Inspector Debra Allen Unannounced Inspection 7th August 2007 09:15 32 South Street DS0000027522.V348146.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 32 South Street DS0000027522.V348146.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. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 32 South Street Address Sheringham Norfolk NR26 8LL 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) 01263 824040 01263 824040 info@prime-life.co.uk info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Position Vacant Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19) of places 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Nineteen (19) Service Users with a mental disorder excluding learning disability or dementia, three of whom are over the age of 65 years, may be accommodated. All new admissions must be between the ages of 18 and 65 years. Date of last inspection 29th August 2006 Brief Description of the Service: 32 South Street accommodates 19 service users with a mental disorder. The accommodation provides 19 single rooms, some with en suite facilities on three floors. The top floor consists of a three bedroom flat with its own sitting room and bathroom and a bed sitting room with bathroom. This accommodation is used by those service users who are more independent. The remaining service users live together sharing the communal accommodation. There is a service users’ kitchen for them to make drinks and a variety of lounges including a smoking lounge and a games room. There is also a very attractive garden. The Home is registered to accommodate those who are under 65 years of age and new admissions will meet this criteria. Because of the previous registration there are some service users who are older than that and the Home is required to monitor their needs carefully to ensure they are catered for. The Home is in a quiet street in a residential area near to the town centre of Sheringham within reach of the beach and the towns facilities. The fees are currently £315 per week, which is the basic rate and does not include any additional one-to-one staff support. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of six and a half hours, during which time a number of service users and staff were spoken with. Discussions also took place with the acting manager and the director, who was also present during part of the inspection. A tour of the premises was also undertaken and care plans, staff files and records required for regulation were examined. The home was found to be clean and tidy and provides service users with a comfortable and homely environment. Pre-inspection information was limited as the Annual Quality Assurance Assessment (AQAA) had not been returned prior to the inspection. This also meant that no service user or relatives’ surveys were received. Four requirements and eight recommendations have been made as a result of this inspection. What the service does well: Service users are encouraged and supported to live their lives as independently as possible and generally come and go and do as they please within an agreed risk framework. On the day of inspection some people were observed going out and there was a very cheerful air about the home. Service users are encouraged to undertake various courses and one person in particular was seen to have attended courses and gain certificates for fire awareness and food hygiene. The service provides support and encouragement to help enable service users retain family links, friendships and personal relationships. One service user has a dog, which some of the other service users appear to enjoy the company of. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: It would be beneficial to keep a copy of service users’ contracts or a signed checklist on file for easy reference and confirmation of receipt by each service user. Of the risk assessments and action plans looked at, it was evident that people are encouraged and supported to take risks and live their lives as independently as possible, but more evidence of service user involvement is required. Although house meetings take place regularly, the notes from these meetings were not seen on the day of inspection. However, the acting manager has confirmed that some of them have needed to be hand-written, due to the current lack of computer facilities and will be filed appropriately from now on. Service users should be consulted and encouraged to do their washing or take it to the laundry room, on a regular basis. The medication policy is due for review and update and the medication administration records (MAR) should be signed as soon as medication is taken to reduce the risk of errors. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 7 Some of the bathrooms and toilets were found to be lacking in items such as sufficient toilet paper and hand-washing facilities. These areas need to be checked regularly to ensure that adequate facilities are always available. Although the smoking lounge was generally clean and tidy, the ashtrays were very full and there was a considerable amount of litter on the tables. Staff need to make regular checks on this room to ensure safe disposal of the ashtray contents and ensure that there is no fire hazard. All risks need to be identified with regard to people smoking within the home and appropriate action plans put in place. There is still room for improvement with regard to a more formal process for obtaining feedback and views from service users, families and other professionals who have involvement with the service. It is envisaged that this will improve following the appointment of a permanent manager. 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. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 Quality in this outcome area is good. Prospective service users have their individual aspirations and needs assessed and the opportunity to visit the home before moving in. Each service user completed an application for residence and is given an individual written contract, together with the service user’s guide and statement of purpose. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection, four care plans were looked at and each contained detailed information confirming that a full assessment had been carried out prior to each person moving into or staying at South Street. Two people spoken with confirmed that they had visited the home before they had moved in and one person said that they had chosen to move to South Street rather than move into another home they had visited, Each person was noted to have been given a contract, together with a copy of the Statement of Purpose and Service User Guide. A copy of the ‘Application for Residency’ was also seen to be kept in service users’ files. A recommendation has been made for a copy of the contract, or a signed checklist, to also be kept on file for easy reference and confirmation of receipt. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is adequate. The changing needs and risk assessments for service users are generally shown in individual care plans, although these will benefit from the continuing improvements. Regular ‘house’ meetings take place but notes of these meetings need to be recorded appropriately. Service users’ information is secure and confidentiality is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were looked at in detail and although they contained detailed information confirming that a full assessment had been carried out prior to each person moving into or staying at South Street, information regarding changing needs, personal goals and risk assessments was somewhat limited. However, it was observed that significant improvements to the care plans are currently in progress by the acting manager and staff team. If these 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 11 improvements continue for all service users’ care plans and show more evidence of service user involvement, the quality rating in this outcome are will almost certainly be raised to ‘good’ at the next inspection. Of the risk assessments and action plans looked at, it was evident that people are encouraged and supported to take risks and live their lives as independently as possible but, again, more evidence of service user involvement is required. Some of the risk assessments looked at, were based around smoking, drinking, managing own finances, personal healthcare/hygiene, medication and going out/socialising. Overall, the information that was seen in the care plans did match up with things that the service users spoke about during the inspection, which confirmed that their needs were being individually considered and addressed. The staff and some service users that were spoken with confirmed that house meetings take place regularly and the acting manager told of a recent situation where service users had got together and called their own meeting to discuss a particular issue. The notes from these meetings were not seen on the day of inspection, but the acting manager confirmed that some of them had needed to be hand-written, due to the current lack of computer facilities, and will be filed appropriately from now on. Until recently, progress notes for service users were completed at the end of every two to three day shift block. However, the acting manager has now implemented the completion of daily progress notes in order that both staff and service users can benefit from a more continuous and consistent support approach. All personal information, relating to service users, was seen to be stored securely in the office, therefore ensuring confidentiality. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users are able to take part in age, peer and culturally appropriate activities, they are part of the local community and are supported to 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 and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with service users on the day of inspection confirmed that they were encouraged and supported to live their lives as independently as possible and generally come and go and do as they please, within an agreed risk framework. On the day of inspection some people were observed going out shopping together and there was a very cheerful air about the home. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 13 Service users were noted to be encouraged to undertake various courses and one person in particular was seen to have attended courses and gain certificates for fire awareness and food hygiene. The daily routines aimed to be as flexible as possible and it appeared that most people were quite content to stay within the home. Those spoken with said they liked their rooms and were able to have them how they wanted and have their privacy without interference from staff. The keyworking system was noted to work well, especially with regard to helping some people to gain confidence although there have been a number of changes in this regard due to a rather high staff turnover recently. There was evidence from speaking with service users and staff as well as information contained within the care plans, that support and encouragement is given to help enable service users retain family links, friendships and personal relationships. Contact was noted to be in various forms such as telephone, letter or visits. There were no noted restrictions on visitors to the home and one service user was seen to have a dog, which some of the other service users appeared to enjoy the company of. Discussions held with the acting manager and staff confirmed that they had a good understanding of peoples’ rights and the need for them to make their own decisions in respect of daily living, except where limitations have been agreed through care planning. The staff alternate with regard to preparing the meals and it was observed that fresh produce is ordered from local sources in order to provide a healthy and balanced diet for service users. During a tour of the premises in the morning, service users were observed being asked by staff for their choice of evening meal. Lunchtime was noted to be a very informal and quite sociable occasion for those who chose to eat in the dining room and the service users spoken with throughout the day said that the meals were usually good. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users receive personal support in the way they prefer and require and their physical and emotional health needs are met. Service users are protected by the home’s policies and procedures for dealing with medication and are supported to self-medicate where possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the service users were noted to handle their own personal care and hygiene, although a few require some prompting or encouragement from staff. Those service users spoken with said that any personal support they received happened in a private and dignified manner. An action plan was noted in one person’s care plan, which stated that they chose to have a small ‘daily task list’ as a reminder and to help them become more independent. These included areas such as personal hygiene, changing clothes and putting dirty laundry into the basket. However, following a number of observations, a recommendation has been made that service users are consulted and encouraged to do their washing on 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 15 a regular basis as in some cases dirty washing baskets were seen to be full and included more than one set of used bed linen. Risk assessments were seen to be in place for those service users who are selfmedicating and one person’s care plan contained a risk assessment and action plan to show how they were being supported towards being able to look after and administer their own medication. The service recently underwent a full Pharmacy inspection and the report from this showed that service users are protected by the home’s policies and procedures for dealing with medication. However, some of the recommendations were that the medication policy is due for review and update and the medication administration records, (MAR), should be signed as soon as medication is taken to reduce the risk of errors. These particular recommendations have been carried over as part of this inspection 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self harm as much as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been one formal complaint since the last inspection and evidence was seen to confirm the complaints procedure was followed, although the matter has not yet been fully resolved. The service users that were spoken with said they knew what to do and who to speak to if they had any problems or wanted to make a complaint. Evidence was seen in care plans, by way of risk assessments and action plans, that showed how service users are helped to be protected from abuse, neglect and self harm as much as is possible. Staff spoken with on the day had a clear understanding of adult abuse and protection and have been trained in this area. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 & 30 Quality in this outcome area is adequate. 32 South Street provides a homely, comfortable and generally safe environment for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was carried out and a number of areas were noted to have benefited from redecoration and new carpets and all of the areas seen on the day were clean, hygienic and free from offensive odours. The bathrooms and toilets were found to be clean, although it was noted that some of these areas were lacking in items such as sufficient toilet paper and hand-washing facilities. A requirement has been made for these areas to be checked regularly and ensure that adequate facilities are always available. The smoking lounge has been moved to one communal room, which is separate from other areas of the house and therefore no longer infringes on non-smokers’ space or rights. Although the room itself was clean and tidy, the ashtrays were very full and there was a considerable amount of litter on the 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 18 tables. A requirement has been made for staff to make regular checks on this room to ensure safe disposal of the ashtray contents and ensure that there is no fire hazard. Within a risk-assessed framework, it is recommended that those service users who do smoke should be encouraged and supported to take some responsibility for this area, such as emptying the ashtrays into a designated metal bin on a regular basis. A Requirement has been made to ensure all risks are identified with regard to people smoking within the home and appropriate action plans put in place. A recommendation has also been made to encourage all service users, where appropriate, to attend one of the fire safety courses. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. Service users are supported by competent and qualified staff who are appropriately trained and they are protected by the home’s recruitment policies and practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff training records were looked at and evidence was seen of courses attended such as Safe Handling of Medication, Drug Abuse, NAPPI, Fire Safety, Food Hygiene, First Aid Appointed Person, Moving & Handling and COSHH. The personnel files that were looked at contained all the relevant records such as References, Application Forms and confirmation of contracts, identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 20 The service has recently experienced a high turnover of staff, including the service manager, which has caused some unrest among the remaining staff and service users. However, the service users spoken with confirmed that everything was a lot better now and much more settled. They also said they liked the staff and the acting manager who were there. It was evident during the inspection that the remaining staff team have worked hard to maintain as much stability for the service users as possible. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40 & 42 Quality in this outcome area is adequate. The service is currently being well run by the acting manager and senior staff. Service users are confident that 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, procedures and record keeping. The health, safety and welfare of service users are generally promoted and protected. This judgement has been made using available evidence including a visit to this service. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 22 EVIDENCE: It has been confirmed, since the inspection that a new, permanent manager has now been appointed for 32 South Street. This person already has some years of experience with the Prime Life organisation. It is envisaged that this will help the service to fully regain stability and consistency with regard to how it is run. However, in the meantime, the staff and service users spoken with during the inspection did say they have felt very supported by the acting manager and senior staff. Staff and management meet with the service users on a regular basis for ‘house meetings’, which are also used as part of an ongoing quality assurance process. However, there is still room for improvement with regard to a more formal process for obtaining feedback and views from service users, families and other professionals who have involvement with the service. A recommendation has been made to this effect, but it is envisaged that this will improve following the appointment of a permanent manager. Health and safety is generally promoted well at 32 South Street and the records looked at were seen to be up to date, including the organisations policies and procedures. Cleaning materials/hazardous chemicals were seen to be stored appropriately and staff training in areas relating to health and safety was seen to be up to date. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 2 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 2 25 X 26 X 27 2 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 2 2 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 2 3 X 2 X 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA27 Regulation 23 Requirement Timescale for action 07/08/07 2. YA39 24 3. YA42 13 4. YA42 13 The bathrooms and toilets must be checked regularly to ensure Adequate toilet paper and hand washing facilities are always available. A more formal process must be 30/09/07 established and maintained, for obtaining feedback and views from service users, families and other professionals who have involvement with the service. The smoking lounge must be 07/08/07 checked regularly to ensure the safe disposal of the ashtray contents and ensure that there is no fire hazard. All risks are identified with 30/09/07 regard to people smoking within the home and appropriate action plans put in place. 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 25 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 YA9 Good Practice Recommendations It is recommended that service users’ involvement in risk assessments is recorded and regularly reviewed to ensure their ongoing relevance. It is recommended to keep a copy of service users’ contracts, or a signed checklist, on file for easy reference and confirmation of receipt by each service user. It is recommended that notes from house meetings are recorded and filed appropriately. It is recommended that service users are consulted and encouraged to do their washing, or take it to the laundry room, on a regular basis. It is recommended that the medication policy is reviewed and updated. and the medication administration records (MAR) should be signed as soon as medication is taken to reduce the risk of errors. It is recommended that the medication administration records (MAR) should be signed as soon as medication is taken to reduce the risk of errors. Within a risk-assessed framework, it is recommended that those service users who do smoke should be encouraged and supported to take some responsibility for this area, such as emptying the ashtrays into a designated metal bin on a regular basis. It is recommended that all service users, where appropriate, are encouraged to attend one of the fire safety courses. 2. YA5 3. 4. YA8 YA16 5. YA20 6. YA20 7. YA42 8. YA42 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 32 South Street DS0000027522.V348146.R01.S.doc Version 5.2 Page 27 - 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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