Inspection on 15/11/05 for 346b Newton Road

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

346b Newton Road 18/07/06

346b Newton Road 21/04/05

346b Newton Road 15/09/04

346b Newton Road 04/05/04

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Dystlegh Grange

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Park Lodge

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

CARE HOME ADULTS 18-65 346b Newton Road 346b Newton Road Lowton Nr Warrington Cheshire WA3 1HF Lead Inspector Julie Conrad Unannounced Inspection 15th November 2005 07:45 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 346b Newton Road Address 346b Newton Road Lowton Nr Warrington Cheshire WA3 1HF 01942 676555 01942 676555 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) Nugent Care Mrs Tomina Teresa Roden Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1), Physical disability (4) of places 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximim of 4 service users to include:up to 4 service users in the category of LD (Learning Disability) up to 4 service users in the category of PD (Physical Disability) The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. One named service user (DC) may be admited in the category of LD(E) Learning Disability over 65 years of age). The Home`s categories of registration must revert back if DC is no longer accommodated at the home. 21st April 2005 Date of last inspection Brief Description of the Service: 346B Newton Road is a care home located on the grounds of Lime House care home on the outskirts of Lowton, and is managed by the Nugent Care Society. The property is a bungalow with four single bedrooms, a lounge, conservatory/dining room, kitchen, bathroom and WC. There is a reasonable level of public transport in the area, however, residents use taxis or wheelchair accessible transport. The home provides twenty-four hour care and accommodation for up to four residents with a learning disability and a physical disability. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of 346b Newton Road, took place on the 15th November 2005 between the hours of 7.45am and 10.30am. The manager and two members of staff were on duty and present throughout the inspection. The core standards were assessed at the last inspection. At this inspection the inspector focused on standards relating to previous requirements and standards not assessed at the last inspection. The inspector spoke with both members of staff and the manager on a one to one basis and as a group. The inspector also spent time talking with all three residents on a one to one basis. The premises were checked and records were inspected. What the service does well: What has improved since the last inspection? The service user guide pack, is informative and well presented and can be accessed in different languages and Braille. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 6 Visitors and staff now access the home via the conservatory door, where there is a table with the visitor’s book and complaints policy and emergency contact numbers. A formal on call system has been introduced. The manager and two senior staff are on the rota. All full time staff are trained in First Aid, having undertaken a four day course. The inspector was told that Wigan Council have agreed to plans to extend the bathroom and fit it with appropriate equipment. 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. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The service user guide, informs prospective residents about the service provided at the home, ensuring they are able to make an informed choice about admission to the home and that their needs and aspirations will be met. EVIDENCE: The service user guide pack is well presented and is available in other formats and different languages and in Braille. There is a pamphlet on 346b, which has a photograph of two residents and two staff on the front cover. The pamphlet describes the service and facilities provided specific to the home. There is general information on Nugent Care entitled ‘changing peoples lives for the better,’ there is information about the history of Nugent Care and its origins. The service user guide and the statement of purpose should include information on the homes confidentiality policy. On page 3 of the statement of purpose, the name National Care Standard Commission needs to be changed to The Commission for Social Care Inspection. The inspector spoke with a resident who said he knew about the confidentiality policy. The manager had explained the confidentiality policy to him. The information provided in the guide and statement of purpose, ensures prospective residents are able to make the right choice about admission to the home. The assessments are very comprehensive and include a brief history of 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 9 each individual resident, their interests and hobbies and their aspirations. Three assessments were seen and were specific to each individual resident. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 10 Residents are consulted in all aspects of home life, ensuring they experience ownership of the home. The confidentiality policy must be made available in written form, to ensure residents and their representatives are fully aware of its content. EVIDENCE: Residents are consulted on an informal day-to-day basis on all aspects of home life, their interests and preferences. A residents meeting takes place every two months. The inspector saw the records of the meeting’s, which are chaired by one of the residents and recorded by a designated member of staff. The resident who chairs the meeting, told the inspector about the meetings and gave examples of what is discussed, ‘changes to the home, trips, holidays, interests and hobbies’. The inspector spoke with another resident about home life, who also appeared to be well informed about changes that are about to take place in the building and trips and plans for Christmas. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 11 The inspector spoke with a resident who said that he understood the homes policy on confidentiality, it had been explained to him by the manager. The inspector checked the service user guide and statement of purpose, there was no reference to the confidentiality policy, a requirement has been made that this must be included in both. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 The manager ensures residents are able to take part in age, peer and culturally appropriate activities. Residents are encouraged to have appropriate relationships, to ensure they live life to the full. EVIDENCE: The manager and inspector discussed the changing needs of the resident group and the change in their interests. The inspector spent time with a resident who had taken breakfast in bed and was watching a video. The resident’s keen interest was evident from the memorabilia in his bedroom. The resident does not wish to go out as often preferring to occupy his time at home. Another older resident goes to day care twice a week and enjoys his time at the home doing jigsaws and knitting. This resident let the inspector see the new jigsaw he had started and told the inspector that he was looking forward to going to Blackpool with two members of staff during early December, staying at the Bond hotel, for a tinsel and turkey weekend. The Bond hotel has been adapted to cater specifically for people with a learning disability and 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 13 a physical disability. The resident said, ‘I like the entertainment’, ‘there is bingo and singers. Last time I stayed there, I bought the singers CD.’ A younger resident is younger and has a good social life. Staff have carried out a risk assessment, which allows the resident to go out alone into Leigh town centre. The resident is very independent and goes into Leigh shopping three times a week, meets friends and relatives for lunch and is involved in the local church and its social club. The resident told the inspector that he too, was going to the Bond hotel with two staff this weekend, he said, ‘Its been refurbished, it’s the first time I have been to the hotel at Christmas.’ The resident met a female friend at the hotel during summer and they have become pen pals. The manager has consulted with the residents about the summer holidays, they all want to go to back to the Bond hotel.. This is being arranged. The home is having a Christmas Eve and New Years Eve party for the residents and family and friends are invited. On Christmas day they will have a traditional Christmas dinner. Staff will put up the Christmas decorations to get everyone in the festive spirit. One resident said, ‘I’m looking forward to Christmas, I always do.’ Two of the residents set up the karaoke machine and make their own entertainment. At Halloween, staff and residents decorated the home with fake cob-webs, pumpkins and at the residents request, the manager made them hot pot. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 21 Personal care is offered in a way that promotes and protects resident’s privacy, dignity and independence. EVIDENCE: The homes assessments and care plans contain a lot of information on each of the residents. The three residents have resided at the home for many years and staff are fully aware of their needs and how each individual prefers to be assisted with personal care. The inspector read three care plans, one of which had not been reviewed on a monthly basis. The inspector spoke with the manager and the key-worker and stressed the need for monthly reviews. As residents began to get out of bed, the inspector observed two staff assisting a resident in his room, they did so in a professional, dignified manner, the resident was able to use an electric shaver himself. The inspector observed and listened to staff attending to a resident The inspector joined him after he had taken breakfast in bed. The resident has no verbal communication, but was cheerful and responsive to the inspector and manager by using facial expressions and body movements. Staff have a good understanding of this residents physical, mental and emotional needs, he can sometimes present with challenging behaviour, staff know how to manage this and are able to calm him down. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 15 The manager or key worker, often talk with residents on a one to one basis, about relationships and other issues that affect their life. The inspector read Nugent Care policy on care during death and dying. Staff recently cared for a resident through illness until almost the end, when he died in hospital The service user guide ‘In the event of death’ states, ‘It is helpful for all concerned if peoples wishes are known, about any particular arrangements they might wish in the event of death. Full support is offered by staff following bereavement.’ Following the death of the resident, staff offered support to other residents, relatives and each other, none of the staff had attended a bereavement course. The inspector has made a recommendation that staff attend a bereavement course. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has a policy and procedure on complaints and the protection of vulnerable adults, which ensures resident’s views are listened to and that they are protected from harm. EVIDENCE: The home has a complaints policy, which is displayed at the entrance of the home and is explained in the service user guide. The manager has also produced an audio-tape explaining the complaints policy, which the residents have listened to. The inspector asked two residents if they knew about the complaints policy, they said they did. One resident said, I would speak to my key worker, who would help me with the paperwork.’ A formal complaint was made recently, which included protection of vulnerable adults, the investigation was carried out by a senior manager at Nugent Care. The outcome of the investigation was sent to the Commission for Social Care Inspection. The complaint was not upheld. All staff receive training in the protection of vulnerable adults, refresher has started and further training for all staff continues next week. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27,30 The home is nicely decorated and furnished, providing a homely environment for the residents. A ramp is required to the conservatory door, to ensure residents can access the home in their wheelchairs safely. EVIDENCE: The home is nicely decorated and furnished. There is a communal lounge, kitchen and a large dining room, which is also used for activities. Each resident has a bedroom, which is nicely decorated and has a TV and music centre and is of a good size. The residents personalise their rooms, one resident shelves are full of different models of buses and coaches. Another resident has signed photographs of soap stars and pictures. This resident has a fire door in his room, which leads out to a small patio area. The resident let the inspector view his patio and his new bird table, on which he feeds the birds and squirrels with chopped apples. There are also ornaments and plants around the patio. The resident talked about the different types of birds that feed from the table and said that ‘three squirrels visit regularly’. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 18 The manager told the inspector that Wigan Council had agreed to fund an extension of the bathroom, which is not big enough or designed to manage wheelchairs and the transferring of residents. A resident said, ‘the bathroom needs changing, you can’t get from the wheelchair to the toilet or bath without being lifted by two staff.’ The new bathroom will have new adaptations and a Parker bath, which will be of benefit to both residents and staff. The main entrance to the home is no longer via the kitchen but through the conservatory. A ramp should be fitted outside the conservatory door as soon as possible, to ensure residents are able to access the home safely. In the meantime, residents are continuing to use the kitchen door. The residents and staff have never accessed the home via the front door. The front of the home has a garden area, which the inspector was told gets ‘water logged’ and thatthe ramp to the front door is crumbling. The inspector has made a recommendation, that the garden have drainage and a new ramp be fitted, to enable residents and staff to utilise the front of the home. The home is clean and tidy and free from odour throughout. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 All staff receive appropriate mandatory training and specialist training, in order to meet the needs of the individual residents at the home. Resident’s benefit from receiving care from well supported and supervised staff. EVIDENCE: All staff receive mandatory training and refresher training takes place on an ongoing basis. Recent refresher training has included; manual handling and risk assessment awareness, food hygiene, stress awareness, health and safety and recording skills. The protection of vulnerable adults training started September 2005 and the remaining staff are to attend this refresher training 24th November 2005, followed by training in care planning and assessment and recording skills. Staff told the inspector that, ‘Nugent Care is very good on training’. At present only two staff have achieved NVQ level 2 in care. One member of staff is waiting to commence NVQ level 3. More staff must undertake this qualification to ensure fifty percent of the staff team are qualified in NVQ level 2. Nugent Care has a policy on recruitment. The inspector saw two staff files, which contain written confirmation that police checks are satisfactory. Other 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 20 required information, including, two satisfactory references, application and employment history etc, are kept at head office for reasons of confidentiality. The inspector checked staff supervision records, supervision is taking place and is being recorded. The manager must ensure at least six formal supervisions are carried out each year. Informal supervision is carried out daily. Staff said they ‘are well-supported’ and found formal supervision to be ‘helpful’. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 43 The manager is supported well by senior staff in providing leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: Since the last inspection, the home has introduced a formal on call system to support the member of staff on night duty. The manager and two senior members of staff are on the ‘on call’ rota. Since the last inspection, the manager has discussed with a senior manager, the possibility of using funding for an additional member of staff on evening duty, from Thursday to Saturday, so residents do not have to go to bed at 9pm. The inspector discussed this with the resident who wishes to stay up later in the evenings, he said, ‘I only want to stay up at weekends, so that would be okay.’ The manager told the inspector, ‘I always ensure I am approachable to both residents and staff’. ‘I keep the atmosphere as homely as possible’. The 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 22 manager was observed as being part of the team, relaxed and approachable, whilst still providing leadership. The manager has started a ‘Leadership’ course, run by Nugent Care for all the managers. The manager attends the course once a month. The course duration is eighteen months and is mandatory. Two senior members of staff are to commence the course very soon. The manager has achieved NVQ level 4 in care and management and said, ‘I found it helped me in my work as a manager as I put a lot of work into it’. The manager started the Registered Managers Award and then stopped due to personal demands. The manager should recommence the Registered Managers Award as soon as possible. Residents are aware of the management structure and staff accountability. One resident said, ‘if I have any concerns or issues I can discuss them with my key worker or the manager.’ Residents were observed as being at ease with staff and the manager. The manager has worked at the home for thirteen years, initially as a senior carer and for the past four years as manager. Sometimes residents prefer to speak to a male member of staff about personal issues. A requirement was made at the last inspection, requesting the manager should send out satisfaction questionnaires to residents and their families. Following discussions with the manager, who pointed out that only one family visit, who give feedback verbally and that there are only three residents. The inspector has suggested that instead of using questionnaires, an annual meeting is held with residents and any family members, where issues relating to satisfaction with care and the service in general can be discussed formally and recorded. An ongoing requirement has been made at this inspection. The manager must ensure the policy regarding residents finances is included in the service user guide and the statement of purpose. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 x 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 2 x x 3 LIFESTYLES Standard No Score 11 x 12 2 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 346b Newton Road Score 2 x X 3 Standard No 37 38 39 40 41 42 43 Score x 3 3 x x x 3 DS0000005752.V266375.R01.S.doc Version 5.0 Page 24 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 YA1 Regulation 4 and 5 Requirement The manager must adapt the statement of purpose and the service user guide to include information on the homes confidentiality policy. The name NCSC should be changed to CSCI, on page 3 of the statement of purpose. An additional member of staff should be on duty during the evenings, so residents do not have to go to bed at 9pm. More staff should be undertaking NVQ level 2. Care plans must be reviewed monthly. A ramp should be installed at the conservatory door. The manager must recommence the Registered Managers Award. The manager should introduce an annual meeting for residents and any family members, to discuss satisfaction issues relating to care and the service provided in general. These meetings should be recorded. The manager must ensure that the policy relating to residents finances is included in the DS0000005752.V266375.R01.S.doc Timescale for action 31/01/06 2. YA12 18 31/12/05 3. 5 6 7 8 YA32 YA18 YA24 YA38 YA39 18 15 23 10 24 31/01/06 30/11/05 31/12/05 31/01/06 31/03/06 9 YA40 13 31/12/05 346b Newton Road Version 5.0 Page 25 10 YA1 5 service user guide and statement of purpose. The service user guide and 31/01/06 statement of purpose should include information on the homes confidentiality policy. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA18 Good Practice Recommendations The ramp to the front of the home should be replaced and the garden area have drainage, so it can be used by residents.. Staff would benefit from attending a bereavement course. 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 346b Newton Road DS0000005752.V266375.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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