Inspection on 05/09/06 for 4 Homeground

This inspection was carried out on 5th September 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 Homeground 03/11/05

4 Homeground 16/06/05

4 Homeground 17/03/05

4 Homeground 16/11/04

4 Homeground 15/03/04

4 Homeground 16/12/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Homeground (4) 4 Home Ground Wootton Bassett Wiltshire SN4 8NB Lead Inspector Pauline Lintern Key Unannounced Inspection 5 September 2006 11:00 th Homeground (4) DS0000028669.V304851.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 Homeground (4) DS0000028669.V304851.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. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homeground (4) Address 4 Home Ground Wootton Bassett Wiltshire SN4 8NB 01793 849495 F/P01793 849495 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) White Horse Care Trust Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: 4 Homeground is run by White Horse Care Trust. It offers accommodation and personal care to three people with learning disabilities. The home itself is a detached house in a residential estate on the outskirts of Wootton Bassett. Each service user has a single room on the first floor. There is a lounge, dining room and a garden to the rear of the property. The bathroom is on the first floor and there is a toilet on each floor.The service users receive personal care and support throughout the day from a permanent staff team. There are two members of staff on duty throughout the day, one in the evening and one sleeping in. The philosophy of care emphasises the importance of an ordinary, domestic type home environment and the involvement of people with a learning disability within the wider community. Each service user is offered a range of daytime and leisure activities. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection took place over five and quarter hours. Surveys were sent out prior to the inspection to service users, relatives, and doctors and care managers. At the start of the inspection only one service user was at the home and two were at the day centre. On their return the inspector was able to meet with them. The inspector met with four staff and the temporary manager Mrs Vivian Wilkes. There has been a permanent manager appointed however they are not yet in position. The inspection involved a tour of the building and examination of various documents and records. These included health and safety records, staff recruitment files, care plans, risk assessments, complaints log and training records. The statement of purpose and the service user’s guide were also available for examination. The fees charged at 4 Homeground are £994.96p to £1091.72p per week. What the service does well: What has improved since the last inspection? Service user’s now have more opportunity to pursue their hobbies and interests in the evening if they wish to do so. All service users’ have received an annual ‘OK’ health check. Mechanisms are now in place to monitor quality assurance and obtain views on the service being provided. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 6 There have been some service user holidays since the last inspection. The home has empowered one service user to manage a small amount of their money, whilst under supervision. 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. Homeground (4) DS0000028669.V304851.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 Homeground (4) DS0000028669.V304851.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): 1 and 2 Prospective service users are able to obtain information on the service in the statement of purpose and the service user guide. There have been no new admissions to this service since the last inspection. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: One service user returned their survey and stated that they could not remember if they had been asked if they wanted to move into this home. There have been no new admissions to the home since the last inspection. Files sampled indicate that each service user had a full assessment to ensure that the home could meet their needs. Contracts between the funding authorities and each service user and the Trust are in place. The Trust has provided a pictorial version for people who may find reading difficult. Terms and conditions are outlined. Service users guides are also in a pictorial format and they provide information about the home, staff and on how to make a complaint if required. The statement of purpose contains current and relevant information. Homeground (4) DS0000028669.V304851.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 and 9 Service users changing needs are assessed and reflected in their care plans. Service users are encouraged to make decisions and choices about their lives. Risks are assessed to enable service users to live an independent lifestyle if possible. Quality in this outcome area is good. This judgement was made from evidence gathered both before and during the visit to this service. EVIDENCE: Two service user’s care plans were examined during the inspection. Each file demonstrated that they have been reviewed regularly and contained current and relevant information for the reader. This includes information relating to communication needs, personal care, spiritual and cultural needs, likes and dislikes and the service user’s understanding of making decisions. One service user’s file states that they are able to make choices however they may need guidance to make an appropriate choice. Another file states that the service user may be able to give consent but may not fully understand major issues. Individual plans identify service users’ wishes and then an action plan demonstrates the progress that has been made towards achieving them. One person had expressed a wish to have the opportunity to have contact with Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 10 animals. There is evidence that the staff have planned to take the service user to farms, zoos and safari and animal parks. One service user is a member of the Christian Fellowship. Others choose not to attend places of worship. It was recommended at the last inspection that one service user be encouraged and supported to take responsibility for some of their finances. The manager confirmed that they now receive a small therapeutic payment from the day centre, which is given directly to the service user and which they manage themselves. The service user informed the inspector that they like to purchase magazines with the money. During the day staff were observed offering choices to service users and encouraging them to make decisions. Risk assessments indicate that they are regularly reviewed and that action is taken to minimise identified risks and hazards. Homeground (4) DS0000028669.V304851.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, 15, 16 and 17 Service users are able to take part in appropriate activities. Service users are able to access the local community. Family contact and friendships are encouraged. Service users are treated with respect and are able too make decisions about their lives. Mealtimes are flexible to suit the needs of the service users. Menus show that meals are varied and healthy. Quality in this outcome area is good. This judgement was made from evidence gathered both before and during the visit to the service. EVIDENCE: Service users access the Upham Road day centre where they participate in various activities such as craft sessions and cooking. Staff report that one service user who likes music enjoys attending the Music Alive. On the day of the inspection one service user was arranging to go to the Trust’s ‘crafty club’ with staff support, which was to be held in another Trust home. The service user explained that they enjoyed meeting their ‘friend’ there. The manager commented that some service users have demonstrated that they do not wish to join in external activities, however the staff continue to Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 12 give them the option to do so if they wish. Staff confirm that if they are planning trips out or activities there is sufficient staff supplied to enable it to take place. There is evidence that service users spend time visiting their families and relatives and friends are welcomed at the home. During the inspection staff were observed talking to service users and not interacting exclusively with each other. When one service user came home after day services staff asked what they were planning to do next, offering them the choice of a cup of tea or remaining in their room for a while. The inspector had the opportunity to talk to the person and to enquire if they were still happy living at 4 Homeground. They confirmed that they were ‘very happy’. The staff appeared to have a good knowledge of the service users likes and dislikes and were aware of situations when they may become unsettled such as having strangers visit the house. The staff took time to reassure service users throughout the inspection. Person centred plans have not yet been developed at the home however after some discussion with the manager it was agreed that they could be part of a project for staff, which would also enable them to address some cultural needs for service users. The manager reported that one new member of staff had a relation who is of the same nationality as two service users so they could advise on the project with regard to cultural diversity. The manager explained that one service user’s family talk to them in their native tongue and cooks Polish food for them. We discussed the home purchasing a Polish recipe book or accessing recipes from the Internet so that their native food can be offered within the home. This was a recommendation set at the last inspection and the timescale will now be extended to enable staff members to put this in place. Care plans indicate that service users are encouraged and supported to take an active part in the running of the home. The service users complete household tasks such as laying the table, clearing away after a meal and preparing their packed luches. Menus were examined and they demonstrated that people’s dietary needs are considered when planning meals. There is a photograph album with photographs of various foods in to enable service users to make choices from. Mealtimes are flexible to suit the needs of the service users. During the inspection the dietician came to meet with the staff team to discuss one service users progress. They were observed commenting to staff ‘well done for helping the service user loose weight and for managing their diet’. There was discussion on how to continue offering healthy choices to service users. Homeground (4) DS0000028669.V304851.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 and 20 Personal support is delivered in a manner that service users prefer. Service users have access to services to ensure that their physical and emotional needs are met. Service users are protected where possible by the Trust’s policies and procedures for dealing with medication. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: Care plans explain how people prefer to have their personal care support delivered. It informs the reader of their likes and dislikes. It was noted that one person prefers to have a bath rather than a shower. There is evidence of specialist input from the community nurse and the diabetic clinic. Each service user has received an annual ‘OK’ health check. One care plan demonstrates that a need had been identified for a service user to improve their fitness levels. A daily walk had been recommended. Records show that staff are supporting them to achieve this goal. One service users care plan explains how they may express it if they are in pain to ensure that the reader will recognise any signs of discomfort for the individual. Preferred methods of taking medicines are recorded, for example one person prefers to take their tablets with milk instead of water. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 14 The home has policies and procedures for staff to adhere to when administering and recording medication. Medication records were sampled during the inspection and there were no gaps in the recording of administration. Medicines are stored securely. Homeground (4) DS0000028669.V304851.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 and 23 Service users views are listened to and acted upon. Where possible service users are protected from any form of abuse. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: One service user survey reported that they did not know who to speak to if they were not happy. However during the inspection the service user told the inspector that they did know what to do if they were unhappy or sad. Observation of the staff team would indicate that any complaints or concerns would be listened to and acted upon appropriately and within agreed timescales. Since the last inspection there has been one complaint made. The home has a complaints log, which on inspection confirmed that there has been only one complaint made. The home has provided each service user with an addressed post card to enable them to submit any concerns or complaints directly to the Trust. One care plan demonstrates that the complaints procedure has been explained to the individual. All service user guides contain a pictorial copy of the complaints procedure. 100 of the relatives’ surveys returned report that they know how to make a complaint if necessary but have not needed to do so. The majority of staff who met with the inspector confirmed that they knew the procedure to follow for reporting alleged abuse. One new member of staff commented that they had not yet attended abuse awareness training but they understood the procedures for reporting under the ‘No Secrets’ guidance. The home has a ‘whistle blowing’ policy in place. Homeground (4) DS0000028669.V304851.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 and 30 4 Homeground provides a comfortable and homely environment for the staff and the people who live there, although staff need to receive training in the prevention of cross contamination. At the time of the inspection the home was found to be clean and hygienic. Quality in this outcome area is adequate. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: The home remains fit for purpose. The premises are safe, comfortable and furnishings are of a good quality. The lounge has photographs of service users around the room. Each bedroom was clean and decorated to suit the individuals’ needs. The building is in keeping with the local community. The bathroom and toilets were clean and hygienic with no unpleasant odours. There is a new bathroom suite in place. During the inspection two unnamed nailbrushes were found, one on the floor in the toilet and the other in the bathroom. To avoid any cross contamination it is recommended that each service user have their own labelled nailbrush, which is kept in their own toilet bag. The home has a copy of Wiltshire’s guidance on infection control to refer to however staff report that they have still not received any training in Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 17 infection control. As this as a recommendation set at the last inspection there is now a requirement to be met within the set timescale. The home has a domestic style washing machine and a tumble drier that suit the needs of the home. There is anti-bacterial hand wash available in all hand washing locations. Homeground (4) DS0000028669.V304851.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, 34 and 35 Generally service users are supported by competent and qualified staff however the home do not appear to be reaching the targets set for staff to achieve their National Vocational Awards by 2007. Some unexplained gaps in employment records could put service users at potential risk. The Trust has an ongoing training programme for 2006. Quality in this outcome area is adequate. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: The staff members who met the inspector appeared to have an understanding of the each service users needs. They confirmed that they have received training in specific areas that relate to service users such as diabetes and epilepsy. The staff report that the Trust is good at providing any additional training, which they feel they may need. During the inspection staff members appeared to be comfortable with the service users and to be good communicators. The manager reported that only one staff member currently holds a National Vocational Award (NVQ). It is a requirement that by 2007, 50 of the staff team should have achieved a NVQ level 2. The training programme for 2006 demonstrates that there are plans for various training courses to be available. The programme also shows that refresher courses are also available. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 19 Three staff recruitment records were sampled during the inspection. One application form showed some gaps in the employment history, which did not appear to have been explored fully or documented. The manager investigated these gaps and reported her findings back to the inspector after the inspection. To safeguard service users all gaps in employment history must be explored and recorded. Files demonstrated that checks are made with the Criminal Records Bureau (CRB) prior to commencing employment. Staff are also checked against the Protection of Vulnerable Adults (PoVA) list. All staff receive a copy of the terms and conditions of their contracts and a job description. All new staff complete an induction period. One new staff member informed the inspector that they are still shadowing more experienced staff, whilst still on their induction. They reported that they felt that they had been given adequate information with regards to enabling them to provide good quality care to each service user. There is evidence that the Trust recruits staff members of different nationalities. The manager commented that some service users are very pleased to have a male member of staff now working at the home. She reported that one service user had indicated that they wanted the male member of staff to support them in preference to a female. Homeground (4) DS0000028669.V304851.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 and 42 The current temporary manager has managed the home in the absence of a permanent manager. The home has a quality assurance tool in place. Service users health, safety and welfare are protected where possible. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: Generally it appears that although there has been a temporary manager in position, staff feel that they are looking forward to having the managers post filled. In the absence of a permanent manager the Trust have been providing support from the Assistant Care manager. The Quality Audit for 2006 demonstrates that fifty-three questionnaires were sent out to families and thirty-four people replied. Some of the comments received include: 28 agreed that the staff are well trained, 5 tended to agree and 1 neither agreed nor disagreed. 32 people felt happy with the quality of care provided and 2 tended to agree. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 21 10 people felt that service users were treated with dignity and 4 tended to agree. 28 people state that they know who to complain to, 3 tended to agree and 2 neither agreed nor disagreed. The inspector spoke to one care manager who spoke highly of the provision of care and reported to have no concerns or complaints. Surveys returned to the commission contained very complimentary and positive comments on the service. Health and safety records were examined and indicate that safe working practices are in place. Accidents are being recorded appropriately. All toxic materials are stored securely in the kitchen along with all the relevant data. There is evidence that regular fridge/freezer temperature checks are being recorded. Hot food is regularly probed. The Trust has a health and safety committee who meet regularly. Minutes show that their last meeting took place on 28/02/06. There are risk assessments in place to ensure safe systems of work. The home has a current gas safety certificate dated 16/02/06. The Fire log was examined and it showed that staff have received regular fire training and fire drills have been completed. All checks on fire fighting equipment and emergency lighting have taken place as required. Records show that audits for Legionella take place regularly. Homeground (4) DS0000028669.V304851.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 3 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 4 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA32 Regulation 18(1)©(i) Requirement The registered person must ensure that staff receive appropriate training to achieve targets in agreed timescales. The registered person must ensure staff receive Infection control training. The registered person shall ensure that any gaps in employment history are explored and recorded. Timescale for action 05/03/07 2. YA37 18(1) 05/12/06 3. YA34 Schedule 4 (6)(f) 05/10/06 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 3 Refer to Standard YA13 YA30 YA7 Good Practice Recommendations It is recommended that the cultural needs of service users are explored further. It is recommended that all nail brushes are labelled to avoid cross infection. It is recommended that Person Centred Plans are in place. Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Homeground (4) DS0000028669.V304851.R01.S.doc Version 5.2 Page 25 - 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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