Inspection on 10/02/06 for 5 Greenbrook Court

This inspection was carried out on 10th February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

5 Greenbrook Court 13/08/07

5 Greenbrook Court 07/06/05

5 Greenbrook Court 21/12/04

5 Greenbrook Court 28/04/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 5 Greenbrook Court St Michaels Road Newcastle Staffordshire ST5 9QB Lead Inspector Mr Keith Jones Unannounced Inspection 10th February 2006 10:00 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 5 Greenbrook Court Address St Michaels Road Newcastle Staffordshire ST5 9QB 01782 628190 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) Choices Housing Association Limited Mrs Tracey Flanagan Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (6), of places Physical disability over 65 years of age (6) 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Minimum age on admission for PD and LD - 55 years Date of last inspection 7th June 2005 Brief Description of the Service: Greenbrook Court is a care home registered for six older people over 55 years of age with a learning and physical disability. The accommodation is owned by The Beth Johnson Housing Association, and the registered provider is Choices Housing Association. The property is located on the outskirts of Newcastleunder-Lyme and is within easy reach of a range of local community facilities. The property is a conversion of three bungalows into the one building, surrounded by a few other linked bungalows in a small cul-de-sac that has been developed to meet the needs of older people. It comprises six bedrooms (although one of these is now put to alternative use due to its small size), a large lounge/dining room, a small domestic kitchen, and an assisted bathroom with toilet, a shower room and an additional separate toilet. In addition there is a small laundry room and a separate office. The lounge has patio doors fitted that lead out on to a patio with an enclosed lawn. There are communal gardens and shared parking facilities at the front courtyard. The home has shared access to appropriate transport to take wheelchairs that is available on a prebooked basis. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in a professional and cordial atmosphere with two duty carers. The last inspection report was discussed, and it was noted that all but one of the requirements made at the last inspection have been dealt with satisfactorily. On the day of inspection there were 4 residents and one new person on preadmission visits. A tour of the Home allowed free and open access to all areas for inspection. The opportunity was taken to speak with a number of service users with members of staff. Throughout the entire inspection a sense of homeliness and familiar confidence pervaded into all aspects of daily activity expressed by those people met. A sampled review of the administration arrangements confirmed solid practice and effective management. The inspector thanked all concerned for their contribution to a pleasing and constructive inspection. A verbal report was offered at the end of the inspection to both carers. What the service does well: Greenbrook Court presents a high standard of care and service, is well organised, with a committed care team. Emphasis goes into involving the residents and their families in the process of care, ensuring a highly personal approach to meeting individual needs. The Inspector was impressed with the depth of knowledge and understanding demonstrated by two competent carers on duty and a newly appointed carer on induction. Assessment procedure and care planning is of an excellent standard, offering detailed information on each resident’s progress in the meeting of objectives. The staff and residents all contribute to the team approach. Maintenance of good staffing levels, staff training and supervision are well established in safeguarding the interests of residents. Overall the attitude in meeting caring and organisational demands is highly commendable, with forward thinking, involvement and application contributing to an excellent service. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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): 2,3,4 The needs and aspirations of the current service users who have each lived at the home for some time now were assessed prior to admission. EVIDENCE: Greenbrook court is registered for 6 people, but for practical purposes operates a 5-bedded service. The vacated room has been converted to a ‘snoozelum’, offering an impressive facility, with plans to widen the scope of activities to include a full range of sensory stimulation. At the point of inspection there were 4 residents, with a fifth on pre-admission assessment, involving visits and short stays. It is expected that full admission will be within a month’s time. All of the remaining 4 service users have lived at the home for some time, and their personal files were examined, showing that a full assessment had been made of their needs prior to admission. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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): 6,7,8,9 and 10 Service users are made aware that their assessed and changing needs and personal goals are included within their individual plan of care. There were ample evidence that a personal centred planning approach focused on positive behaviour, ability and willingness of the individual. Records inspected showed that service users freely make decisions about their life in the home and what they are going to do with their time, based on a detailed risk assessed basis. The philosophy of care, as laid out in the Statement of Purpose, promoting a home environment that will afford service users greater security, choice, independence and a good quality of life. EVIDENCE: Assessments, care plans and risk assessments were examined and found to offer an excellent record of daily living, which were comprehensive, and included a provider assessment; a person centred plan, a health profile and assessment, and a planned intervention, rehabilitation and therapeutic programme based on a 24 hour support plan. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 10 All staff evidenced that they were actively engaged in the process, which were kept in the resident’s bedroom and seen to actively encourage family involvement. It was noted that each day had a different schedule of events encouraging therapeutic and social activities geared to meeting service users sense of belonging and personal goals. Two residents were case tracked with an examination of care records, health records including risk assessments, records of reviews and action plans. Records inspected showed that residents freely make decisions about their life in the home. Altogether the communication ‘package’ offers a comprehensive appraisal of resident’s needs and aspirations. Risk assessments were carried out on an individual basis and reviewed. Those residents spoken with were freely outspoken of the love and attention received, very complementary of the lifestyle offered to them. During the inspection the inspector was impressed with the friendly environment and cheerful banter, it was most encouraging to see how much work had gone into promoting personal awareness and a sense of belonging. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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): 11,12,13,14,15,16 and 17 The Home has successfully integrated with the local community, with evidence that neighbours play an active part in the social life of residents, and individuals being involved in various social opportunities. Recent conversations with an immediate neighbour had resulted in an attempt to control noise through soundproofing. Nevertheless the Home enjoys good relationships with family and friends in the community. Dietary needs of residents are well catered for with a balanced and varied selection of food personal likes and dislikes being taken into account. EVIDENCE: Greenbrook’s main objective is to respect the individual, thus delivering care in a relaxed and easy environment, with routine flexible to accommodate needs, and not dictate daily life of service users. Personal choice and relative selfdetermination are respected in policy and action. Those who wish to bring in personal possessions were seen to be encouraged to do so. Domestic activities were in evidence on the inspection day and a programme of in-house routines was available. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 12 Choices were available for every aspect of daily living and menus provided a varied and good choice of food available on a flexible, resident orientated programme. The Home offers an excellent service, to which all service users spoken to were highly complimentary of all aspects of quality. Residents were freely expressive over the love and care they enjoy in the Home. Service users’ life-styles and interests are recorded in their care plans, discussed with their relatives prior to admission, and documented as far as possible to enhance a position of supported independence. The management demonstrated the strength of protecting service user’s rights, which was secured through the robustness of the procedures in place. This was confirmed on examination of records. The tour of the Home demonstrated a high degree of expressed individuality in each of the bedrooms inspected. The dining area was very pleasant, offering conducive ambience for a social meal. The kitchen was seen to be clean, well organised and with modern equipment, although small. Residents in wheelchairs have difficulties in using routine kitchen facilities. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 and 21 Observations of staff indicated that they had a very good understanding of the residents personal, emotional and physical support needs. The medication at this home was well-managed clear and comprehensive arrangements being in place to ensure resident’s medication needs are met. Referrals are made to other health professionals as required and appropriate action taken following their advice. EVIDENCE: It was pleasing to see that the administration of medicines adhere to procedures to maximise protection to service users, the storage was secure. A senior member of staff completed MAR sheets accurately, with accountability recorded throughout the process. Boots the Chemist arrange ongoing training sessions for staff. The philosophy of promoting individuality and self-determination, as laid out in the Statement of Purpose, continues to be seen to be exercised in many aspects of care. The general atmosphere throughout the home was one of family, confidence, warmth and contentment. Staff were observed in addressing service users in a respectful and dignified way. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 14 Records show that the service user’s spiritual needs are attended to with respect. Relatives are involved and have free access at all times as desired by the service user. It was noted that an appraisal of any special preferences or observances is recorded on admission, and is regarded as integral in the assessment process. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 On discussion with the duty carers it was apparent that residents’ individual concerns and complaints were listened to, documented and dealt with sympathetically. All necessary policies and procedures were in place. The management showed satisfactory evidence of a protocol and response to anyone reporting any form of abuse, to ensure effective handling of such an incident. EVIDENCE: The home had a meaningful complaints policy, clearly identifying the CSCI as a resource to approach with a complaint or grievance. Each service user has a ‘Residents Complaints Procedure’ in a pictorial format that shows all of the relevant information in an easy to follow style. A complaints book is maintained which shows a responsible approach in handling complaints appropriately, confirming the level and category of complaint, each being resolved at a local level to mutual satisfaction. Minor complaints being received in-house and resolved to complainant’s satisfaction. Residents’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care, planning and policies in place i.e. the complaints procedure. This process was evidenced on examination, and case tracking as previously reported upon. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 through to 30 Greenbrook Court provides a pleasant home for the service users, with particularly pleasing bedrooms that provide pleasure to the service users. Consideration is needed to make parts of the home safer, having recognising that several remedial improvements have been made to facilitate more accessibility for the service users, and to aid staff to assist them. EVIDENCE: The home continues generally to maintain a high standard of decoration and fitments. There is an attractive and spacious lounge/ dining area, and bedrooms are particularly pleasant and well personalised. Each room has a lockable facility available although there are no locks on the bedroom doors. Some areas of the home are awaiting redecoration by the housing provider; the kitchen worktops have been replaced to a good standard. The water tank has been covered with louvre doors. Nevertheless the kitchen area is small when considering that each residents use wheelchairs and manoeuvrability is extremely difficult for even the most routine of domestic actions. Currently they are restricted in their access to the kitchen, which compromises their lifestyle. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 17 The home has a shower room with separate toilet and an assisted bathroom with toilet. The bathroom presents some problems for staff as there is no room for them to manoeuvre around the bath when attending to the personal care needs of the service users. This bath is also quite complex mechanically, and has at times broken down leaving the Home in some difficulties. The empty bedroom has been converted to a snoozelum offering sensory diversion. This new facility has been established with enthusiasm and is popular with residents. Consideration should be given into extending the facility to involve movement, music and aroma therapeutic activities. The spaciousness of the communal lounge and wide corridors continue to be compromised by the fact that both the front door to the property has been ramped but the finish still presents an obstacle for wheelchairs. The rear patio door requires ramps to be fitted to allow independent access to the outside, and to allow better wheelchair access. The staff are struggling to manoeuvre wheelchairs out of the doors, which must be far from comfortable for the service users. Once outside the slabs on the patio are very uneven which presents a health and safety hazard. The uneven patio must be made safe, as recommended at the last inspection. The gardens are extremely valuable additions to the Home, which need a positive address to maintain a safe and pleasant facility to residents. Garden chairs and hut were observed to be rotted, dirty and hazardous. These items are to be reviewed and replaced as appropriate. The other environmental improvements highlighted above must be considered. This must result in an action plan being provided to the Commission as to the conclusions reached as to how the problems can be addressed, with a timescale for any resulting works to be provided. This programme is to be submitted to CSCI by the 31/03/06. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 through to 36 Staffing levels were seen to be satisfactory, the daily care staffing rota showed adequate balance between skills, qualifications and numbers to provide a good standard of care. The thoroughness of staff selection has a significant effect upon the provision of cares to ensure protection of service users. Discussions with staff indicated that a broad spectrum of clinical and allied subjects were covered through training, ensuring that staff fulfil the aims of the home and meet the changing needs of service users. EVIDENCE: An effective staff team supports service users, staff were seen to interact well with the service users, and be mindful of their individual needs and capabilities. The numbers and skill mix of the staff adhered to issued Notice of Staffing. Staffing had maintained consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of long serving experienced staff. Staff on duty were interviewed and found to provide satisfactory evidence of good personnel management that promoted protection of vulnerable service users. Mandatory training needs to be updated up to date with attention drawn to fire awareness programme, annual movement and handling, abuse awareness and annual food hygiene training. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 19 It was recognised that six carers had a level III NVQ, and 5 staff with level II. Staff were alerted to a code of conduct in the induction programme, which would be complemented with the securing of the General Social Care Council’s Code of Conduct for all staff. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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 through to 42 Greenbrook Court is a well run home that overall provides a safe environment for all of the service users, staff and visitors. The Home has in place a highly effective and motivated care team, sensitive to the needs of each resident, organisational demands and the professional standing of services to people with learning disabilities. EVIDENCE: The care management have demonstrated competence in running Greenbrook Court, in establishing a solid purpose and policy portfolio that has been implemented, to achieve a high standard of set aims and objectives. The inspector observed at first hand the confident interrelationship that exist between management and staff, and between staff and residents. There was strong evidence of openness and honesty in speaking with service users and staff, in which day to day events and episodes are freely discussed. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 21 Evidence was secured to confirm a quality monitoring system has been introduced, based upon audit of standards, care plans and feedback from service users and staff. Discussion with staff indicate that standards are addressed at staff meetings, daily reports, direct observation and involvement and one to one staff meetings. The procedures manual was randomly examined and found to offer a very comprehensive reference. Fire safety appears to be a high priority for all staff evidenced in routine maintenance checks, regular fire drills and frequent staff training sessions on evacuation procedures were recognised. Discussion with staff members indicated that supervision sessions and individual training programmes are areas that with continuing improvements, will enhance the desired impact on quality of service. The administration and management of the home is efficient, uncomplicated and sensitive to the needs of service users. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 4 27 3 28 2 29 2 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 4 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 3 X 3 3 3 x 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? yes 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. 2 Standard YA24 YA35 Regulation 23(2) o Requirement Timescale for action 31/03/06 3 YA24 Refit the paving slabs to the patio area. Replace/remove rotted garden chairs and hut. Ensure the establishment of a 18 (1) (c ) staff training programme to 31/03/06 accommodate mandatory and specific training needs 23(2) a Consider all of the environmental 31/03/06 issues as detailed in the report, and provide the Commission with a report on the outcome of the review, with timescales where work is to be undertaken. 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 YA24.9 YA34.5 YA24.9 Good Practice Recommendations Address to be given to the size and scope of the kitchen area. Ensure the provision of the GSCC code of conduct for all staff. Make good the front door ramp and facilitate the provision of a ramp access to the rear door. DS0000004947.V281808.R01.S.doc Version 5.1 Page 24 5 Greenbrook Court 4 YA24.9 Consideration to the effectiveness of the assisted bath. 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 5 Greenbrook Court DS0000004947.V281808.R01.S.doc Version 5.1 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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