Inspection on 28/11/05 for 43, Florence Avenue

This inspection was carried out on 28th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

43, Florence Avenue 15/05/08

43, Florence Avenue 11/09/07

43, Florence Avenue 26/06/06

43, Florence Avenue 24/05/05

43, Florence Avenue 22/11/04

43, Florence Avenue 27/04/04

43, Florence Avenue 21/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Florence Avenue, 43 Morden Surrey SM4 6EX Lead Inspector Liz O`Reilly Unannounced Inspection 28th November, 6th & 19th December 2005 03:00 Florence Avenue, 43 DS0000027216.V272343.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 Florence Avenue, 43 DS0000027216.V272343.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. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Florence Avenue, 43 Address Morden Surrey SM4 6EX 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) 0208 646 5921 www.caremanagementgroup.com Care Management Group Limited Dawn Ann Louise Raw Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eight Adults (M/F) with Learning Disabilities Date of last inspection 24th May 2005 Brief Description of the Service: 43 Florence Avenue is a registered care home for up to eight adults with learning disabilities. The home is owned and managed by Care Management Group, a privately run company that owns a number of other establishments. The home is in keeping with neighbouring houses and is not identifiable as a care home. Public transport, churches, leisure facilities, local shops and the shopping centres of Morden, Sutton and Mitcham are close by. The home is set over two floors with a self contained flat for one resident within the grounds. All residents have their own bedroom and two residents within the main building have their own en suite bathrooms. The home is staffed twenty four hours a day. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 26th November and 6th December and one pharmacy inspector on 19th December 2005. The inspector had the opportunity to meet with all the residents, the registered manager and two staff. A sample of records were examined. What the service does well: What has improved since the last inspection? What they could do better: Further work needs to be carried out on the recording of complaints and staff need to be provided with training on dealing with and supporting residents to make complaints. The Registered Person must ensure that action is taken to repair or replace the call bell system. The laundry facilities in the home need updating. Staff must be provided with appropriate levels of first aid training. Care planning and reviews need to be accessible. A review of the service must be carried out on an annual basis. Further work needs to be carried out in relation to medication. Please contact the provider for advice of actions taken in response to this Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Florence Avenue, 43 DS0000027216.V272343.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 Florence Avenue, 43 DS0000027216.V272343.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&2 Information on the home is provided to prospective residents in the Statement of Purpose and Information Handbook. Assessments are carried out for each residents before they move in which makes sure that the home is able to meet their needs. EVIDENCE: The organisation has produced a Statement of Purpose and Information Handbook which sets out the aims and objectives of the home along with what residents can expect from the service. Efforts have been made to make parts of these documents more accessible, in particular the complaints procedure. This work should be continued to make key policies and procedures available in an accessible format. Before anyone is admitted to the home assessments are carried out by the placing local authority and the home to make sure that the home has the appropriate staffing and facilities to meet the needs of the individual. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 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&9 Further work needs to be done to make sure that up to date care plans are easily accessible to residents and staff. Individual risk assessments are in place. EVIDENCE: Action plans which set out the individual needs and wishes of residents along with how these will be provided are in place. Individual personal care guidelines were also available. Good information was seen to be available on the personal care needs of individuals along with guidance on communication and offering choices. Staff complete a monthly review for each person which provides general information on the activities over the month. Lists of the strengths and needs of individuals and their likes and dislikes were in place but were not signed or dated. Action plans were not signed or dated. In one instance the printed action plan was dated 2003. The registered persons must ensure that all documentation is signed and dated. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 10 Following discussion with staff on these issues the inspector was provided with information which is put together for each review. This information was seen to be more up to date and provided information on each resident in a more accessible format for staff. Consideration should be given to using these documents as the “working” care plan. Further work will need to be carried out to supply care plans to residents in a more accessible format. Individual risk assessments were seen to be in place which assists in ensuring the safety of residents. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Staff support residents to continue with and develop activities and educational opportunities. Residents confirmed they can meet with friends or relatives within or outside the home. EVIDENCE: Staff are aware of the individual needs and interests of residents. One resident is provided with the support of two staff when going out. This resident attends a Monday club and local pubs when able. Three residents attend college on a regular weekly basis. One resident goes swimming twice weekly and one resident has an outreach worker who visits once a week. One residents is fully independent in relation to social activities. Residents were seen to enjoy going out for walks, drives and visits to the local shops. Where residents have difficulty in taking part in activities or going out staff consult with the community learning disabilities team. Five residents have been supported to go on holiday this year. These have included trips to Hastings and Disney World Paris. Staff informed the inspector Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 12 that for one resident who spent a long week end away this was their first holiday. Residents told the inspector that they had enjoyed their holidays and were looking forward to planning more trips. Residents also said they enjoyed going to the pantomime, cinema, shopping and bowling. Residents confirmed they can have visitors to the home and that they can meet with people in the lounge or dining room or in the privacy of their own room. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Good information is available to staff on the personal care needs and preferences of individual residents. Staff must take care that any restrictions on personal choices are agreed and set out in the care plan. The health care needs of residents are met. The home has arrangements for the ordering, storage and recording of medication that includes the input of residents and has access to a pharmacist for advice. Minor omissions in recording and labelling were found although there was no risk to the health or welfare of any residents. EVIDENCE: Staff have recorded the needs and preferences of residents in relation to personal care needs. This information includes guidance on offering choices for residents on their appearance. Staff were observed to offer assistance and advice on personal care in a discreet manner. One resident informed the inspector that they would like to be able to have a drink whenever they wished. This was discussed with the resident and staff. Staff felt that sometimes the resident did not remember when they had taken a drink. The resident agreed that this might be the case at times. Staff must ensure that issues about choice are included in any care planning along with Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 14 any agreed restrictions or plan to assist residents in managing day to day choices. In instances where staff have serious concerns that the personal choices made by residents are impacting on their health and welfare it is recommended that a review, including all those concerned, is carried out to make sure that all parties are aware of the concerns of staff. Each resident is provided with a named key worker from the staff team. Staff confirmed that residents can request a change of key worker should they wish. Information is available to staff on the preferred routines of residents who cannot easily communicate their needs or wishes. All residents are registered with local GP practices. Arrangements are in place for residents to receive regular health check ups including optical and dental care. Staff informed the inspector that they had worked successfully with residents to improve dental care. All medications administered by staff along with the records relating to receipt, storage, administration and disposal of medication were examined. Medication was counted and compared to the amount that should be in stock from the records of receipt and administration and the person in charge interviewed. The policies and procedures were not reviewed on this visit as they were found to be satisfactory on a previous visit. Each resident has a list of all current medication detailing what the medication, side effects and, where the medication is prescribed when needed, the details of when it is to be administered. When medication prescribed when needed is given the reason for administration is recorded on the back of the administration record. The GP indicates on the administration record when medications are reviewed. The painkiller for one resident had been changed in the previous month. The corresponding administration record indicated that the old painkiller had been given rather than the new one. All the current administration records and the other previous months records had been completed appropriately and changes to medication clearly indicated. When medication is given to residents on leave from the home it is given in the original container. When the resident is away from the home for a short period and needs one dose of medication to be administered the medication is supplied in separate container. This container is not labelled with the full details of the medication. The amount of medication in stock and the completed records showed the correct medication had been given, although it was difficult to audit medication prescribed when needed, as the amount of medication carried over from one month to the next was not recorded. The receipt of one current medication and one previous medication had not been recorded. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 15 All other records were completed accurately, medication stored securely and under appropriate conditions and staff are trained in medication management through the organisation. No details of the training were seen. Florence Avenue, 43 DS0000027216.V272343.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 To ensure that the views of residents are listened to the home has a complaints procedure in place. Further work needs to be done in relation to recording complaints and training for staff. The home has policies and procedures in place relating to the protection of vulnerable adults. All staff have been provided with training on this issue. EVIDENCE: The home has a complaints procedure in place and residents are provided with information in a more accessible format about how to make a complaint. The home keeps a record of any complaint made to staff. This record was incomplete as information on the outcome of any investigation was not recorded. Staff must ensure that all complaints are fully investigated and recorded including the outcome and whether the person making the complaint was satisfied. All staff must be provided with training on dealing with and supporting residents to make a complaint. Discussions with two residents indicated they were well informed on the complaints process and one resident had taken concerns to the organisation directly. To ensure the safety of residents all staff working in the home have been provided with training on the protection of vulnerable adults. One resident raised concerns regarding staff who have previously worked at the home returning to visit present staff. This issue was being taken up with the Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 17 organisation. Staff must ensure that they do not receive visitors when they are on duty. Residents can deposit money with the home for safekeeping. Individual records are held for each resident. These records were found to be well maintained up to date and accurate. Daily checks are carried out on any money held in the home which assists in ensuring residents finances are protected. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 18 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 & 30 Residents are provided with a well maintained environment. Action must be taken to ensure that call bells are in good working order and that any unused equipment is removed. The home is clean and tidy. As noted in previous inspection reports the laundry area is not appropriate to meet the needs of the residents. EVIDENCE: Overall the premises were found to be well maintained. The inspector was informed that the call bell system had not been in full working order for some time. The Registered Person must ensure that action is taken to have this system repaired or replaced. Information on how staff are ensuring that regular checks are carried out on residents who are in their rooms during the day and particularly at night must be provided to the CSCI. It was noted that a bath seat was being stored in the garden. The registered persons must ensure that any unused equipment is removed or stored appropriately. The laundry area of the home is small and does not allow sufficient space or facilities for residents to be supported by staff to maintain or develop their Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 19 independence in this area of daily living. The inspector had been informed in the past that plans were in place for the home to be extended to provide better laundry facilities. No progress was seen to have been made in this area. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 20 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): 33, 34, 35 & 36 Staffing levels were seen to be flexible and adjusted to meet the needs of residents however the Registered Person must take care to ensure that sufficient staff are available in the home to meet the needs of residents and to allow the manager time to monitor the service provided. The checks carried out on staff before they start working in the home assist in protecting residents. Staff have been provided with improved opportunities for training. Further work needs to be done to make sure the training provided meets the needs of the home. All staff are provided with regular supervision. EVIDENCE: Staffing levels at night were seen to have been increased for a while in response to the changing needs of residents. At the time of this visit staff annual leave and training resulted in staffing numbers below what the organisation states would be “normally” in the home during the day. The homes’ Statement of Purpose states that there would normally be four members of staff on duty during the day. The manager stated that the home was unable to meet these staffing numbers when annual leave is taken or when a number of staff attend training. The Registered Person must review the staffing levels in the home to ensure that the Statement of Purpose Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 21 remains accurate and that the manager has sufficient time to manage the service. The home carries out the appropriate checks on new staff, including Criminal Records Bureau checks, before they commence work in the home. This assists in ensuring the safety of residents. Staff confirmed they received regular supervision from a more senior member of staff. Staff informed the inspector that improvements have been made in the choices and opportunities for training. This ensures that residents are supported by a well informed and up to date staff group. Five staff are in the process of completing NVQ level two training, one member of staff has completed and one member of staff is commencing NVQ level three training. The registered manager and deputy manager are completing NVQ level 4 training. The organisation has produced a training programme and staff were seen to have completed training in health and safety, food hygiene, Makaton, the protection of vulnerable adults and manual handling. Further work needs to be done to ensure that a qualified first aider is available on each shift. (See next section). Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 22 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): 39 & 42 Further work needs to be carried out to make sure that an annual review of the service is carried out taking into account the views of residents. Staff carry out regular checks on the building and equipment to ensure the health and safety of residents, staff and visitors to the home. Further work needs to be done to make sure a suitably qualified first aider is available on each shift. EVIDENCE: The Registered Person must ensure that an annual review of the service is carried out. This review must include consultation with residents and should include consultation with relatives, friends and other professionals involved with the home. The results of the consultation with residents must be made available to the presents and prospective residents. A copy of the report produced following the review of the service must be supplied to the CSCI. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 23 Records showed staff carry out regular checks on the building and equipment to ensure the health and safety of residents. The record of checks on the fire alarm system and the hot water system and the temperature of the fridge and freezer were up to date. Staff have received training on moving and handling. It was noted that staff had taken part in one day courses in first aid. The Registered Person must ensure that a qualified first aider, who has completed the longer course, is available on duty at each shift. Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 24 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 3 3 x x x Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x 2 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Florence Avenue, 43 Score 2 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x DS0000027216.V272343.R01.S.doc Version 5.0 Page 25 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 YA6 Regulation 15(1)(2) Requirement The Registered Persons must ensure that up to date care plans are accessible to residents and staff. All care planning and review documentation must be signed and dated. The Registered Persons must ensure that any restrictions of choice are included in the care plan for the individual. The registered person must ensure that all the containers given to residents who need medication when away from the home are labelled and that the label indicates the current dose. The registered person must ensure that the receipt of all medication is recorded accurately. The registered person must ensure that alterations to medication are made clearly and that the administration of all medication is recorded accurately. The Registered Persons must ensure that a record of the investigation process and DS0000027216.V272343.R01.S.doc Timescale for action 01/04/06 2. YA18 15(1) 12 13(2) 01/04/06 3 YA20 01/02/06 4 YA20 13(2) 01/02/06 5 YA20 13(2) 01/02/06 6 YA22 22(3) 18(1)(c) 01/04/06 Florence Avenue, 43 Version 5.0 Page 26 7 YA23 12(1) 13(4) 23(2)(c) 8 YA24 outcomes is available in the home in relation to any complaints received. The Registered Persons must ensure that all staff working in the home are provided with training on dealing with complaints. The Registered Persons must 01/02/06 ensure that staff are reminded they are not to have visitors while they are on duty. The Registered Persons must 01/04/06 ensure that the call bell system is repaired or replaced. Information on the systems in place for regular checks on residents when the call bell system is not working must be supplied to the CSCI. The Registered Persons must ensure that any unused equipment is removed or stored appropriately. The Registered Persons must review the staffing levels in the home to ensure that the Statement of Purpose remains accurate and that the manager has sufficient time to manage the service. The Registered Persons must ensure that a review of the quality of care provided in the home is carried out. A copy of the report produced following any such review must be provided to the Commission. The Registered Persons must ensure that a qualified first aider is available on each shift. 9 YA24 23(2)(l) 01/02/06 10 YA33 18(1) 01/04/06 11 YA39 24(1)(2) 01/05/06 12 YA42 13(4) 01/04/06 Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 27 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 YA1 YA6 YA18 Good Practice Recommendations The Registered Persons should ensure that key policies and procedures are made available to residents in an accessible format. The Registered Persons should ensure that service user plans are provided in an appropriate format for individual service users. The Registered Persons should ensure that where staff have serious concerns that the personal choices made by residents are impacting on their health and welfare a review is carried out to ensure that all those involved are aware of any concerns. It is recommended that the quantity of medication carried over from one month to the next be recorded on the administration record. It is recommended that training in medication handling be reviewed in line with current guidelines. 4 5 YA20 YA20 Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Florence Avenue, 43 DS0000027216.V272343.R01.S.doc Version 5.0 Page 29 - 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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