Inspection on 12/10/06 for 340 Wilson Avenue

This inspection was carried out on 12th October 2006.

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

The inspector found 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

340 Wilson Avenue 02/11/05

340 Wilson Avenue 20/06/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 340 Wilson Avenue 340 Wilson Avenue Rochester Kent ME1 2ST Lead Inspector Jo Griffiths Key Unannounced Inspection 12th October 2006 12:00 340 Wilson Avenue DS0000064405.V306082.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 340 Wilson Avenue DS0000064405.V306082.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. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 340 Wilson Avenue Address 340 Wilson Avenue Rochester Kent ME1 2ST 01622 769100 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) MCCH Society Limited Mrs Susan Jessop Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: 340 Wilson Avenue is managed by MCCH Society Ltd. It is registered to provide care and accommodation for three adults with learning and physical disabilities. However, MCCH to have recently reduced their occupancy to 2 and no longer have a shared bedroom. The home is situated in a quiet residential area close to the town of Rochester. Local shops, a post office, and pubs are within walking distance. Service users accommodation includes two single bedrooms, one of these bedrooms used to be shared. Bedrooms have been adapted to meet individual needs. In addition the building has several adaptations (a lift, grab rails, an assisted bath) and an open plan communal area on the ground floor to enhance accessibility and promote independence. There is a large landscaped garden at the rear of the building. The fee for this service is currently £1260.00 per week. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced. The inspector visited the home between 12.00pm and 4.30pm and spoke with staff and the people who live in the home. The way staff support people was seen during the visit. The Manager was also at the home and gave feedback on things that had been achieved since the last visit. The care plans and other records were seen. 1 comment card was received. In the section of this report called “Details of Inspector findings” the people that live at 340 Wilson Avenue have been referred to as the “service users” of the home. What the service does well: The people at this home appear happy with the care they are receiving. Staff have an excellent understanding of their needs, likes and dislikes. The staff have built good relationships with them and treat them with respect. Visitors and other professional have given their views on the home. Comments included “ The house is extremely homely, all the staff are very supportive.” “ The people living at this home are well cared for” Individuals care plans and risk assessments make sure their needs are being met. Their care is reviewed every 6 months. The staff and Manager are very good at making sure that people’s health needs are met and that they receive the best service possible from their GP. The residents of the home enjoy lots of different activities and get out and about in the local community most days of the week. They enjoy the food and the staff are trained in nutrition to make sure a balanced menu is offered. The staff team are well trained and all of them have achieved their NVQ award. This means that the staff are qualified to support the people in the home to the highest standards. Lots of consideration has been given to making the house as easy as possible for the people living there to get around. There are textured panels on the doors and handrails so that people with visual difficulties can get around independently. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 340 Wilson Avenue DS0000064405.V306082.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 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users needs are assessed and kept under review. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The 2 current service users have been living at 340 Wilson Avenue for many years now. Their needs are well known by staff and are kept under review within their care plan. There has been a new format for assessment recently introduced and this has been completed for both service users. There are no plans to admit any new service users to the home at present as the Manager wishes to reduce the number of registered beds to 2 so that there are no shared bedrooms in the home. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Service users have an individual plan that meets their needs. Service users are supported to make choices. Service users are supported to take risks as part of a fulfilling lifestyle. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users’ care plans have been recently updated. All areas of health, personal, emotional and social need have been addressed. The care plans are detailed and give lots of information about how to support the service user. They are written clearly for staff to follow, although it is advised that out of date information be removed to avoid confusion. The senior carer said that it is planned that the care plans will be typed on a computer. It is advised that each page be dated so that the date of any changes can be clearly seen. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 10 The plans are being further developed with the Keyworkers. The Manager should ensure that the plans are made as individual as possible to the service user. For example, the 2 service users in the home have similar goals and plans set. This may be because they have similar needs and interests, but the Manager must be sure that staff are really thinking about peoples interests and needs when planning goals. The ways that service users make choices have been included within the plans. Staff described how they offer informed choices. Staff have a good understanding of the service users likes and dislikes and gave examples of how they use this knowledge when offering activities and menus. Where service users have not been able to express their views or make decisions the care Manager has been consulted. Decisions made on behalf of the service users have been done within a review meeting with the care Manager and other people that know the service user present. Any decisions have been made in the best interests of the service user. Risk assessments for service users had been updated. These cover activities they may do, the environment they live in and any individual risks. The risk assessments are followed by staff and are reviewed at the 6 monthly review meeting. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Service users enjoy a range of activities at home and within the local community. Service users enjoy a range of leisure activities. Service users are supported to make a maintain relationships. Service users rights are respected within the home. Service users enjoy a balanced diet. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Each service user has a weekly timetable of activities available to them. This is based on what staff know about their interests, hobbies and areas of skill. The timetable is generally followed each week providing service users with a range 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 12 of activities and a fulfilling lifestyle. Service users can choose not to do an activity. The activity programmes are reviewed within the 6 monthly meeting for each service user. The timetable includes lots of community based activities such as going to church, using the library, going to the pub on a Saturday night, meals out and going to the bank or shopping. There are also activities within the house including reflexology, aromatherapy and massage. A service user moved away from the home this year and staff are supporting the service users at Wilson Avenue to keep in touch with him and to visit when they wish to. The service users are also supported to see their sister when they wish to. Staff were seen to respect the rights of the service users. For example, they asked permission of the service users to show the inspector around the home and asked them whether they wished to take part in the activities for the afternoon. Service users do not have a lock on their bedroom door because this would make it hard for them to access their rooms due to visual impairments. Staff knock on door before entering and respect service users privacy. The home does not have a set menu. Service users choose on a daily basis what they would like to eat. Staff offer choices based on what service users like and what will best provide a balanced diet, taking into account their dietary needs. For example, one service user has Osteoporosis so staff have consulted with a specialist and have a list of foods high in calcium that can be included in the persons menu. There are 2 members of staff who have completed nutritional training. They review the record of the menu regularly to make sure it is healthy and balanced. Records and care plans report that both service users enjoy their meals. Supplements are available for one service user should they require them, but these have not been needed recently. There was a fresh fruit bowl on the kitchen side and staff said service users can have snacks when they wish. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Service users personal care needs are met in the way they prefer. Service users health needs are well met. Service users are protected by the homes procedures for administering medication. The overall outcome in this area is excellent. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Service users personal care needs are set out in their individual plan. The way in which they prefer to receive the support is detailed for staff to follow. This is kept under review. Where possible same gender personal care is offered and records show that the support that service users get is meeting their personal needs. There is some equipment available, such as shower chair and bath lift, to help service users with their personal care needs. All personal care takes place in private. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 14 Service users health needs are addressed within the individual plan. The home has an excellent working relationship with the GP. The GP reviews the health and medication of each service user every 6 months. Other health specialists including the district nurse, psychology, dentist, optician and chiropodist are involved. There are also alternative therapies such as aromatherapy, reflexology and massage available if service users wish to use them. The Manager gave examples of how service users health needs are identified and addressed. It was very clear that staff are committed to ensuring that service users receive the best healthcare possible. Staff and the Care Manager will advocate on behalf of the service user where needed. The service users need staff to support them to take their medication. All medication is stored safely within a locked cabinet within the home. Accurate records are kept of all medication given, although where medication is prescribed on the MAR sheet for 8am but given at 9am this must be reviewed with the pharmacy. Only staff that have received training give medication. The Manager also completes an annual assessment of staff competence to make sure they are giving medication following safe procedures. There was one senior staff member who was due an update of the training and assessment. This had been booked for December 2006 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Service users and their representatives know how to make a complaint if they need to. Service users are protected from abuse. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: There have been no complaints received by the home. Service users and their representative know how to make a complaint if they need to. The complaints procedure is displayed in the home. Staff have been trained in safeguarding vulnerable adults. Most staff have also covered this area within their NVQ award. The Manager ensures that recruitment procedures are safe to protect the service users and the home is kept secure to prevent unwanted visitors. There is a policy for safeguarding vulnerable adults in the home. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Service users live in a homely, comfortable and safe home. Service users bedrooms meet their needs and promote their independence. Service users have access to suitable bathroom facilities to meet their needs. Service users have sufficient communal space to meet their needs. Service users have the specialist equipment they need. Service users benefit from a hygienic home. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The home is comfortable and has a homely atmosphere. There is a lounge and separate dining room for use by the service users. Each is furnished adequately and there is a TV, stereo and suitable lighting. There were fresh flowers in the lounge. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 17 The service users rely on staff to help them upstairs, but one person can move around the ground floor independently. Due to service users visual and physical impairments it is important that service users can find their way around the home. Staff demonstrated awareness of the problems that moving furniture can cause visually impaired people. They also described how service users are able to find their way to various places in the home by touch. Rails and tactile clues have been placed around the home to help the service users move around independently. This is excellent practice. An Occupational Therapist has been involved for both service users and the staff have implemented the recommendations made in the recent reports. It has been suggested that service users may enjoy beanbags in their bedrooms to relax in whilst they are having reflexology. The Manager was advised that if this is something the service users would like the staff must make sure that the service users mobility is not limited by being on the beanbag. The Occupational Therapist has also assessed both service users for new comfortable armchairs for the lounge. These are on order. There was a requirement in the last report that the sofa be replaced. This was made because the wooden sides were a risk to a service user who has now moved out. The Manager hopes to replace the sofa eventually when it is worn. Service users bedrooms are decorated to their own tastes. One service user showed me his newly decorated room and was very pleased with it. The Manager should consider comfortable armchairs for the service users so they can relax in their rooms. Their visual impairments and physical disabilities should be taken into account when looking at furniture provision. The kitchen is open plan. This is very beneficial to the service users as they can sit at the dining room table and help with preparation or join in the conversations that go on around cooking time. It also means service users can always be aware when meals times are due as they can smell the cooking. There are 2 bathrooms. One upstairs that has an assisted bath and one downstairs with an assisted shower. There is a lift between floors. All specialist equipment has been recently serviced. There is a separate laundry room and hygienic procedures for managing laundry. The home is kept very clean. The rear garden is spacious and has slopes and ramps to help service users get around. The back gate has started to rot and should be repaired or replaced to ensure security. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 Service users are supported by qualified staff. Service users are supported by sufficient numbers of staff. Service users are supported by trained staff. The overall outcome in this area is excellent. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: Standard 34 has not been assessed as it has been agreed that CSCI will assess this nationally for MCCH. Rotas showed that there are always at least 2 staff on duty during the daytime. This allows all activities to take place. On some days more staff are on duty to help with shopping and other tasks. In the evening there is one staff member who sleeps over. There is a back up on call system. Staff training records were examined. All staff have completed the core training they need to safely support service users. Some updates are required and these have all been booked. Evidence of this was seen. All staff, except one who is leaving, have achieved or are working toward their NVQ award. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 19 This is very positive as service users can be confident that they are supported by qualified staff. As well as formal training the Manager makes use of other professional bodies such as the Occupational Therapist and the Kent Association for the Blind. They provide advice and support to the staff team on caring for service users with specialist needs. 340 Wilson Avenue DS0000064405.V306082.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 36, 42 Service users benefit from living in a well run home. Service users are consulted on their views but quality assurance systems need formalising. Service users’ health and welfare are protected. The overall outcome in this area is good. This judgement has been made from evidence gathered during the inspection, which included a site visit. EVIDENCE: The Manager is working toward the Registered Managers Award and the NVQ 4 in care. A new Senior support worker has been appointed and has applied to do the NVQ 3 in care. The Senior and the Manager supervise the care staff between them and both have been trained to do this. Staff said that they felt well supported in their roles. 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 21 The Manager monitors the quality of the service provided on a daily basis. Team meetings and supervisions are held monthly and the Manager reviews all incidents and daily records. In addition a nominated person from MCCH visits each month to review the service. Reports of these visits are kept in the home. Questionnaires are available for visitors to complete as part of the quality monitoring of the home. Some examples were seen and positive comments noted about the home. These have been included in the summary of this report. Whilst there are a number of methods of quality review being used there is still no policy within the home for quality assurance. The Health and Safety of service users and staff are given high priority in this home. Equipment and facilities in the home have been serviced, but the Manager must ensure a copy of the Gas Safety certificate is kept in the home. The Environmental Health Officer has recently inspected the home and made a recommendation that the safer business pack be introduced. The manager has done this. It was also recommended that the Manager complete the HACCP course, which is a training course in risk and safety management in food premises. Again the manager has arranged this. The fire risk assessment that was required from the last inspection has been completed. 340 Wilson Avenue DS0000064405.V306082.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 3 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 2 25 3 26 2 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 3 X 2 X x 2 X 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 23 Yes 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 YA39 Regulation 24(1) Requirement The registered person shall establish and maintain a system for evaluating the quality of the services provided at the care home. In that, a policy for quality monitoring of the home must be introduced. This is carried forward from the previous inspection 2. YA20 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. In that, where the time for administration of a medicine has changed the MAR sheet must be changed to reflect this. 3. YA42 13(4a) The registered person shall DS0000064405.V306082.R01.S.doc Timescale for action 31/12/06 15/11/06 15/11/06 Page 24 340 Wilson Avenue Version 5.2 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; In that, the Manager must ensure the gas boiler has been serviced and a certificate of safety is obtained. 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 YA6 Good Practice Recommendations It is recommended that out of date information be removed from the care plan. It is also recommended that the Manager ensure the care plans are individual to each service user in terms of the goals set. It is recommended that the garden gate be repaired or replaced. It is recommended that service users be offered comfortable armchairs for their bedrooms. 2. 3. YA24 YA26 340 Wilson Avenue DS0000064405.V306082.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 340 Wilson Avenue DS0000064405.V306082.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. 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