Inspection on 20/02/07 for 39 Beresford Gardens

This inspection was carried out on 20th February 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

39 Beresford Gardens 03/01/06

39 Beresford Gardens 23/08/05

39 Beresford Gardens 17/02/05

39 Beresford Gardens 20/09/04

39 Beresford Gardens 22/01/04

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

CARE HOME ADULTS 18-65 39 Beresford Gardens Cliftonville Margate Kent CT9 3AG Lead Inspector Christine Grafton Key Unannounced Inspection 20th February 2007 10:00 39 Beresford Gardens DS0000023300.V306287.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 39 Beresford Gardens DS0000023300.V306287.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. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 39 Beresford Gardens Address Cliftonville Margate Kent CT9 3AG 01843 221332 01843 221332 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) The Avenues Trust Limited Karen Jean Sedgwick Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: 39 Beresford Gardens is a spacious detached property situated in a residential area, within walking distance of the seafront, local shops and other amenities, including public transport. The home has four bedrooms, one of which is on the ground floor and accessible to wheelchair users. There is a small front garden and a rear garden, with lawn, garden seating and a swing. The home provides residential care in a homely environment for adults with varying degrees of learning disability and has facilities to adequately accommodate one adult with physical disabilities. The level of care and support given is very individual and based upon a full assessment of needs. The fees for each service user are set during the assessment process and are determined according to the needs of the service user, the level of support needed and the staffing numbers required. Information provided by the manager in January 2007 indicates that the fees for the home are £2,792.50 per week. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains the findings of the home’s key inspection and takes account of information obtained from various sources since the last inspection of 3rd January 2006, including a visit to the home. An unannounced visit took place on 20th February 2007 between 10.00 hours and 15.30 hours. The registered manager was on annual leave and the visit was conducted with the assistance of a support worker, who was the senior person on duty. When the inspection commenced, there was two staff on duty, as no cover could be found at short notice for the third staff member, who had been due on duty that morning. A third staff member came on duty early at 13.00 hours and a fourth came on duty at 14.30 hours. The visit included talking to staff and service users and observing the interactions between them. An accompanied tour of the building was carried out and various records were checked. At the time of this visit there were two service users living in this home and the care of both of them was case tracked. The pre-inspection questionnaire was sent out late on this occasion and therefore no surveys were sent out prior to the site visit. The manager had completed the pre-inspection questionnaire in a very short timescale and this was appreciated. The last two inspections have indicated good standards at this home. This inspection has focussed on the key standards, looking at the well-being, safety and quality of life for people living in this home. This has been assessed by spending time with the service users in the lounge, observational information, and discussion with the person in charge and staff, together with the records examined at the time of visit. The findings of this inspection indicate that 39 Beresford Gardens provides very good outcomes for the service users living there. What the service does well: Service users are encouraged to make choices and to live independent lifestyles with support from well-trained staff. The staff team use individually tailored communication methods to support service users to express themselves and to make sure their needs are understood. Service users have opportunities to take part in a wide variety of activities, with appropriate support and safeguards in place to deal with any risks identified. Both service users were at home during most of the morning of the visit and were fully included in the inspection process, with sensitive support from staff. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 6 During the afternoon, a staff member accompanied one service user to a day service provision, whilst the other spent one to one time with their key worker. Each service user benefits from having their own personalised care plan and they are involved in making decisions about the things that are important to them. Service users healthcare needs are fully met. Staff have the skills and confidence to support service users effectively. They were observed working with service users in a calm, relaxed way, responding to their needs with empathy. The inspector is grateful to the support worker in charge of the shift for their assistance with this inspection. 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. 39 Beresford Gardens DS0000023300.V306287.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 39 Beresford Gardens DS0000023300.V306287.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&3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from having a full assessment of their needs prior to admission and they can be confident that their needs will be met by the home. EVIDENCE: From the case tracking it was seen that each service user had a comprehensive needs assessment carried out prior to their admission and these have been ongoing. Initial assessments had been undertaken with multi agency participation, including care managers and other health care professionals, such as an occupational therapist. Person centred care plans include full needs assessments and risk assessments. The focus is on what is important to each service user, what they want to achieve and then detailed support plans are drawn up for each identified need. Service users’ wishes are recorded and short and long-term goals developed to support them. Care plans identify the support service users need in everyday living and include information recorded in simple formats for them to understand, such as: photos, pictures, simple references, who is important, communication and reasons why they might display behaviours and what to do when this happens. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 9 It was seen that the high standards evident at the last two inspections in relation to standard two, service users’ needs assessments, have been maintained. Assessments clearly focus on positive outcomes for service users and one of the ways that this is achieved is by having well trained staff that provide one to one support. Service users’ needs are well met at this home and it was observed that service users are at ease with staff. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their own individual ‘person centred’ care plans that ensure their needs are met. Service users are enabled to make their own decisions and are supported to take reasonable risks, allowing them to enjoy independent lives. EVIDENCE: Each service user has been fully involved in developing a ‘person centred’ plan. The individual plans have identified each service user’s needs and show the support strategies tailored to help them achieve their wishes in respect of certain aspects of their lives. The plans describe the best approach to be adopted and the most effective responses to make. Each plan has a holistic profile that gives a good insight into the person’s background, their past and current abilities and how to build upon their strengths. The plans are regularly reviewed on an ongoing basis. Formal reviews take place every six months to which relatives and representatives from the placing authorities are invited. The home encourages this participation, but it was 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 11 stated that placing authority representatives do not always attend. The home provides them with a copy of the review report. Staff were observed encouraging service users to make decisions, for example, arrangements had been made for one service user to go out on a planned activity in the afternoon, but they were still given the opportunity to go out for a short walk in the morning as well. The service user then declined this choice. The second service user was supported in their choice to go out during the morning. Service users are supported with the management of their finances. An exemplary system is in place to safeguard their best interests in this respect. Records of expenditure were seen indicating a service users’ choice to spend their money how they wished with staff support. Key workers use symbol and audio formats to explain policies and procedures and they support service users to participate in decisions about the running of the home. The support worker who assisted with this visit had a clear understanding of the personal limitations of each service user. Service users are supported to take reasonable risks to allow them to undertake the activities of their choice. A risk assessment is in place for each identified risk and there are clear stepby-step intervention guidelines for staff. All risk assessments are kept under review. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having opportunities for personal development and to experience a variety of stimulating activities. Service users are supported to maintain contacts with families and friends. Service users enjoy a balanced and healthy diet. EVIDENCE: Staff were observed supporting service users with their daily living skill tasks such as laundering clothes. Records indicated involvement with other tasks such as: posting letters and collecting items for recycling. Service users are supported to access local shops, banks, cafes and pubs. Evidence of other activities include: swimming, bowling, horse riding and other group activities arranged by the organisation’s day services at various local venues. The home has a small sensory room, which is well equipped with various resources and the support worker stated that one service user regularly uses it. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 13 Activities are decided individually and are clearly set out in the ‘person centred’ plans. Appropriate staffing levels are in place to provide the necessary support. Arrangements are currently being made for a service user’s holiday with two staff members for support. From discussion with a support worker and records seen it is apparent that both service users have contact with family members. Key workers write quarterly newsletters to families giving them an update on activities undertaken and any important developments. Picture cards are used for service users to choose what they would like to eat and menus are planned weekly with service users’ involvement. Records indicate that service users enjoy a balanced diet. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is provided in a sensitive manner that maintains service users’ privacy and dignity. Service users benefit from good health care support and they are protected by the home’s procedures for managing their medication. EVIDENCE: From the records seen, observations and discussion with staff, it was clear that personal care and support is provided in a manner that promotes dignity, privacy and independence. The care plan files contain details of the individual health care needs of each service user. Records indicated that any health problems are quickly addressed. Service users have access to appropriate healthcare professionals and visits recorded include: the general practitioner, optician, dentist, chiropodist, dietician, occupational therapist, psychologist, and community learning disabilities nurse. The home uses a monitored dosage medication system. Medication is stored securely and records are well maintained and up to date. Good procedures are in place for the management of medications prescribed for use when required. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 15 Staff receive medication training before they are allowed to administer medicines and they have annual assessments of their competence. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are listened to and protected by good staff practices and the home’s policies and procedures on abuse. EVIDENCE: There is a complaints procedure in place that is simplified in a pictorial and symbol format, plus on tape for service users. A support worker explained that staff are aware of each service user’s behaviours and would recognise any behaviours that might suggest problems or difficulties being experienced by them. Staff then act as advocates for the service user and would raise a complaint on their behalf, or contact a family member. Staff receive training on abuse awareness as part of their induction. Where service users require support regarding their behaviour, clear guidance is contained in the service user plan. Any incidents are recorded, monitored and appropriately followed up. The support worker indicated their awareness of the home’s whistle blowing policy and procedure but stated that they had never needed to use it. The home has an excellent system for the handling and recording of service users’ finances that includes staff carrying out a daily check of service users’ personal monies. Staff double check all balances at shift changeovers. Individual zipped containers are used to hold each service user’s purse. When the seal is opened at any time, a new seal number is allocated and two signatures are recorded. Receipts are kept for all expenditures. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst services users are provided with a spacious, safe and relatively homely environment, some parts of the home are in need of attention to bring them up to a better standard. EVIDENCE: The home was seen to be generally clean and comfortable for service users. Communal areas are spacious and consist of a lounge and dining room on the ground floor with a sensory room on the first floor. There is one large ground floor bedroom that is appropriate to accommodate a wheelchair user and there is an adjacent, specially adapted bathroom. Service users’ bedrooms are individual to suit their needs and have been decorated to their choice. There are two vacant bedrooms on the first floor and a second bathroom. Radiators have been guarded for safety. Some areas would benefit from ongoing maintenance, such as repairs to cracks in the internal walls and the scratched and marked skirting boards in the hallway and ground floor doorways that are in need of painting. The support 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 18 worker stated that the cracks are being monitored, as there is a suspicion of possible subsidence. The affected walls will need to be repaired, re-plastered and wallpaper renewed. It was stated that the home has a maintenance programme and procedures are in place to carry out regular audits of the premises and identify any repairs needed. One service user’s bedroom had been redecorated and the oven replaced recently. At the last inspection, it was stated that the repairs and replastering work would be completed within a period of weeks. As it is a year since the last inspection, it is disappointing that the problem has not yet been resolved. The home’s maintenance programme needs to ensure that these areas are upgraded to provide a more home-like environment. Whilst appropriate procedures for the maintenance of infection control are in place, it was discussed that pedal bins should be provided for the safe handling and disposal of clinical waste. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ quality of life is enhanced by the numbers and skill mix of staff on duty at all times to meet their needs. Service users benefit from the well-trained, enthusiastic and supportive staff team at this home. Service users are protected by the home’s recruitment procedures and practices and the thorough induction programme. EVIDENCE: Rotas seen indicated that staff numbers are appropriate to the needs of the service users. Rotas are planned to take account of service users’ individual activities. The home was adequately staffed at the time of the visit and it was clear that every effort had been made to provide cover for absence. Staff were actively engaging with the service users. The Trust has a robust recruitment procedure that includes carrying out all the required checks prior to staff commencing work. Confidential staff files were not seen on this occasion, as only the manager has access to them. However 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 20 general staff files were seen to contain basic details, induction records, development plans, training needs and details of courses attended. The recruitment process has been verified in a subsequent telephone conversation with the manager and also based upon the home’s past good performance in this respect. New staff undertake the Avenues Trust induction programme, which consists of a range of mandatory training components that comply with the Learning Disability Award Framework. This includes an initial six-week induction period followed by ongoing foundation training that continues over a six-month period. Staff training needs are identified at their regular formal supervision meetings and annual appraisals. They are encouraged to attend training courses. Staff spoken to at this visit confirmed that they feel supported by the manager and the staff team. The staff-training matrix indicates that staff have completed a wide variety of training courses to enable them to effectively support service users. This year’s training programme indicates where refresher courses are planned. Information in the pre-inspection questionnaire indicates that four staff have achieved their National Vocational Qualification (NVQ) level 2 or above and a further three staff are currently working towards their NVQ. 39 Beresford Gardens DS0000023300.V306287.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from the effective management practices in place at this home. Service users health, safety and welfare are promoted and protected. EVIDENCE: The manager was not on duty at the time of this visit, but everything necessary for the smooth running of the home was in place and clearly evidenced. Systems have been established to ensure that staff know what to do to protect service users’ safety. There are clear policies and procedures in place, with appropriate risk assessments and safety checks completed within the home. The fire safety logbook indicated that regular safety checks are completed, fire drills held and staff fire instruction completed. Weekly water temperature checks and 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 22 monthly health and safety checks are completed. Staff are trained in safe working practices including: health and safety, first aid, basic food hygiene, infection control and moving and handling. The manager carries out regular quality audits and completes an accident and incident analysis. A copy of the Avenues Business Plan 2006 – 2009 was seen. This includes an easy read version and an executive summary. The home has its own development plan, which ensures that the manager and providers address issues and plan for the future. Quality assurance monitoring takes account of service user opinions and wishes which are then considered in current and future plans. A service manager visits the home unannounced every month and carries out a monitoring visit that measures the home’s performance against the National Minimum Standards for Care Homes for Adults. Copies of these reports have been sent to the commission and indicate that the level of care being given and the quality of the environment is being assessed and that the service is performing well. Record keeping in this home was seen to be of a high standard. Staff have an overlap between shifts so that proper handover sessions take place. Monthly staff meetings are held and detailed minutes are recorded. All of this helps to ensure that everyone involved in the running of this home is kept informed about current issues affecting the service users and the home. 39 Beresford Gardens DS0000023300.V306287.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 4 3 4 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 x 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 4 4 4 3 3 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation Requirement Timescale for action 30/04/07 23(2)(b)(d) The premises to be kept in a good state of repair externally and internally… and …reasonably decorated. Repairs to cracks in the internal walls, re-plastering and decorating to be completed. Scratched and marked skirting boards to be painted. 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 YA30 Good Practice Recommendations That pedal bins are provided for the safe handling and disposal of clinical waste. 39 Beresford Gardens DS0000023300.V306287.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 39 Beresford Gardens DS0000023300.V306287.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. 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