Inspection on 28/08/07 for 94 Tennyson Road

This inspection was carried out on 28th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

94 Tennyson Road 12/05/09

94 Tennyson Road 01/07/08

94 Tennyson Road 15/01/08

94 Tennyson Road 13/10/06

94 Tennyson Road 03/02/06

94 Tennyson Road 19/10/05

94 Tennyson Road 11/03/05

94 Tennyson Road 22/12/04

94 Tennyson Road 29/03/04

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

CARE HOME ADULTS 18-65 94 Tennyson Road Luton LU1 3RR Lead Inspector Andrea James Unannounced Inspection 28th August 2007 10:00 94 Tennyson Road DS0000014976.V347680.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 94 Tennyson Road DS0000014976.V347680.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. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 94 Tennyson Road Address Luton LU1 3RR 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) 01582 725735 ann.dalton@advanceuk.org Advance Support Ltd Ms Ann Dalton Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2006 Brief Description of the Service: 94 Tennyson Road is a semi- detached house situated in a quiet residential road in south Luton. The home is owned by Advance Housing and Support Limited and provides accommodation for four service users with mental health needs. The home has four single bedrooms and a bathroom and toilet on the first floor. The ground floor contains a lounge, dining room, toilet laundry room and a kitchen. The service users use a garden at the rear of the house in the summer months. There is a parking area at the front of the house. The home is within walking distance of the town centre and two local parks and the bus stop. Mrs. Ann Dalton is the current registered manager. The fee ranged from £580.17£600.00 per week. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Andrea James on the 28th of August 2007. The inspection lasted for the duration of 7 hours. The registered manager assisted in the inspection process for some of the time. The inspection process followed a case tracking methodology where 50 of the people using the service were chosen. Where possible these users were spoken to and their files and documentation inspected. The care staff and external professionals also contributed to the inspection process. The inspection report consists of information received from the AQAA (Annual Quality Assurance Assessment) and surveys received from users and care staff. The inspector would like to thank the manager, care staff, external professional and users of the service for their contribution to the inspection process. What the service does well: What has improved since the last inspection? 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 6 Since the last inspection the service had made efforts to meet all the outstanding requirements from the also inspection. They had also reviewed their Statement of Purpose and their Service Users Guide, which was pioneered by a student Social Worker. The document now contains the information as requested by the users and appears to be more user friendly and easier to read. Care staff have received further training in areas that ensured they were able to meet the changing needs of people using the service. The home continued to ensure care staff were aware of the requirements of the National Minimum Standard by having a series of dialogued meetings that explored individual aspects of the regulations. The home had recruited a new team leader as the previous team leader was promoted to manage another of the services within the organisation. What they could do better: The service should ensure that: • • • • • • • • • A full and comprehensive assessment for all users is implemented within the care plan documentation. Clear safeguarding procedures are used when users safety is compromised. Satisfactory medication policies and procedures must be in place for receiving, recording and disposing of medication to include controlled drugs. Care staff are not at risk of harm due to the current lone working procedures in place. All users safety must be maintained at all times. Guidelines are implemented to ensure consistency in service delivery for all users of the service. Procedures for recruitment are robust in ensuring up to date Criminal Record Bureau clearances and satisfactory application forms are available and kept on file. All care staff receive satisfactory Induction and this is evidenced within the service. Satisfactory Quality Assurance systems are in place to monitor the views of people using the service. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 8 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 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5. People who use the service experience an adequate quality outcome in this area. We have made this judgement using a range of evidence to include a visit to the service. Systems were in place to ensure users received sufficient information about the service prior to admission in order to make an informed choice of whether or not to use the service, however further development was needed to ensure full and comprehensive assessments are undertaken in identifying the needs of people using the service, as a result users needs could be compromised. EVIDENCE: The home had made improvements to their Statement of Purpose and Service Users Guide. The inspector was informed that a student Social worker consulted the people using the service in what they wanted to see in these documents, as a result the documents were amended to include a clearer organisational structure, pictures and easy read information to inform users of what was provided by the service. The people using the service were provided with contractual agreements that had been signed and dated by both the users and the organisations representative. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 10 The home needed to ensure that all users had a full and comprehensive assessment of need on file to ensure that the care plan documentation can be clear as to what care needs have been implemented and why. Their was some evidence to suggest needs assessments reviews were undertaken but it was not possible to audit this information as the information was only in a tick chart format and the original assessment was not available. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. People who use this service experience a good quality outcome in this area. We have made this judgement using a range of evidence to include a visit to the service. Satisfactory systems were in place to ensure users were able to make decisions about their lives, participate in the day to day running of the home and take assessed risks in living an independent lifestyle, as a result users were able to maximise their independence. EVIDENCE: The home ensured all users had clear care plans in place with measurable and specific care interventions. There was also evidence that these were reviewed and updated on a regular basis. There was a clear audit of identified risks relating to the care interventions and users were consulted about the changes. This process could be improved by ensuring consistent guidelines are implemented for users whose behaviour challenged the service. The inspector was informed about some inconsistencies in the way carers delivered care to users. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 12 Users spoken to said they were enabled to make decisions about their lives. The inspector observed that users were able to go and come in the home as they wished. One user was seen to have done his shopping and prepared himself a hot meal. He explained that he also attended various day centres, places of leisure and accessed the community through various means. Care staff were seen to consult users about all aspects of their personal care needs and support was given in a respectful and professional manner. The documentations that existed in the home showed that users were encouraged to take risks. All these areas were risked assessed and the assessments were available on the users files. The inspector was informed that users were enabled to go far distances with the support of the care staff. One user said he was enabled to go to London for the day and he really enjoyed it. There was evidence to suggest all users had monthly one to one sessions with their link workers to formulate a dialogue of events undertaken and events that needed attention. A monthly report is also written on each user to chart progress in developing their skills and any issues related to these activities. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,16 &17. People who use the service experience a good quality outcome in this area. We have made this judgement using a range of evidence including a visit to the service. Opportunities were implemented in the home that ensured users were able to live and develop a full and active life style, as a result users were able to maximise their full potential. EVIDENCE: The care staff spoke of the various activities both in house and the wider community that was available for people using the service to be able to live a full and productive life. 2 of the users were enabled to attend colleges and various day centres. One user was able to attend a day centre that was able to meet his cultural needs. The staff encouraged the service users to improve their daily living skills in personal hygiene, shopping, budgeting, and healthy eating, visiting the bank and the post office. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 14 The manager said they assisted users to register their votes at an election and one user said he was able to attend the local gym. The inspector observed that all users had a personal key to both the front door and their personal bedrooms and care staff were seen to knock on bedroom doors before entering. The inspector was also informed that 2 of the 4 people using the service carried out their own food shopping and food preparation. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 &21. People who use the service experience a poor quality outcome in this area. We have made this judgement using a range of evidence including a visit to the site. Systems were in place to support users in the way they preferred to include their wishes in the event of their death, however further development was needed to ensure better medication policies and procedures are implemented, as a result users were at risk of possible medication errors. EVIDENCE: The people using the service received support in several areas of their lives and there was evidence that they had regular monitoring of their health care needs. Social workers and external professionals visited the users on a regular basis to ensure their needs are being met and they are being listened to. The inspector saw recorded evidence to suggest some users were consulted about the arrangements that were to be made in the event of their death. One user was in hospital and others had been admitted to hospital for both physical and mental support as and when required. The home had made appropriate arrangements for conducting risk assessments of the service users’ in the area of personal hygiene/self neglect, 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 16 health and safety, finances, using electrical appliances, cooking, staying in the bed, outdoor health and safety, use of cleaning materials, motivation, manage own shopping, maintaining family contact, smoking, use of public transport and eating. The home had a medication policy and written procedures for administering medication but these were not satisfactory in meeting the needs of the people using the service, as the procedures in various areas were unsafe and outdated. The inspector observed that two of the 4 users self medicated but the other two needed staff intervention. It was reported to the inspector that some care staff failed to follow the prescribers instructions in administering medication. For example one user who was to have medication at 8am did not have it until 2pm and he was also allowed to have his 4pm medication at 4pm, which did not leave enough time to lapse between medication times. The care staff also received medication from the Assertive Outreach team but these were hand written on MAR (Medication Administration Record) Sheets and some instructions were deleted with new instructions. There was no explanation for the change of instructions. The home also dispensed controlled drugs to one user but did not have a policy or satisfactory procedures in place for controlled drugs. They did not have a controlled drugs book to record the receipt and disposal of medication. They also failed to have satisfactory signature procedures as only one care staff signed for all the medication. The controlled drugs also needed to be double locked for security reasons and in line with the medication guidelines. The current procedure was that controlled drugs were kept with other day-to-day medication. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience a poor quality outcome in this area. We have made this judgement using a range of evidence including a visit to the service. Satisfactory policies were in place to ensure users are listened to and protected but insufficient procedures existed to protect users from abuse and as a result users were open to harm and neglect. EVIDENCE: The manager said they had not received any complaints or safeguarding issues since the last inspection but one user explained that he felt very concerned that his views and concerns of safety was not being listened to. The inspector found evidence to suggest one user was repeatedly verbally abusing another service for several months and on one occasion the user was threatened by another user using a knife. The anxiety level of this user had become very distressing and he said he used the complaints procedure but felt staff and manager failed to act to protect him. There was recorded evidence that the police was called on one occasion but no formal guidelines were in place to protect the users and care staff, as the user who was the perpetrator continues to live in the home. The home failed to instigate the safeguarding procedures and as a result steps were not taken to safeguard other users. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 18 On the day of the inspection another incident occurred where one user was verbally abused by another user, as a result the safeguarding procedures were implemented and procedures were put in place to protect users and staff. The inspector was informed that extra staffing was implemented and a due date was set to have the perpetrator sectioned under the mental health act. After the inspection the inspector was informed that one of the user who was also displayed behaviours that challenged was allowed to move back to the home after spending some time in hospital. Staff commented that other users were now scared of him and had to be eating their meals in their rooms because of the level of anxiety displayed by the user. The manager later informed the inspector that after interviewing the users that they did not feel unsafe and would alert her as soon as they felt threatened. She commented that the users felt it necessary to have their meals in their rooms only because one user was shouting. The home had a complaints policy and a copy of the policy was made available for the people using the service, but several complaints received by the inspector was not recorded in the home and as a result further development was needed to ensure satisfactory procedures are followed to ensure users feel their views are listened to and acted upon. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience an adequate outcome in this area. We have made this judgement using a range of evidence to include a visit to the service. The home was clean and free from offensive odours as a result users lived in a comfortable environment but safety could be compromised when answering the door to visitors, as a result users could be at risk. EVIDENCE: The home was clean and free from offensive odours as a result users lived in a comfortable environment but safety could be compromised when answering the door to visitors, as a result users could be at risk. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36. People who use the service experience a poor quality outcome in this area. We have made this judgement using a range of evidence to include a visit to the service. The home ensured that care staff received sufficient supervision and support and were trained in meeting the needs of people using the service, however further development was needed to ensure robust recruitment procedures are implemented and the users are supported by an effective team, as a result users safety could be compromised. EVIDENCE: The people using the service benefited from a team of staff that were trained and skilled to meet their needs. The inspector saw evidence to suggest care staff were trained in mandatory training and some course were undertaken to ensure they were able to meet the changing needs of people using the service. The care staff and manager explained that regular supervision was undertaken and this was evidenced in staff files. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 21 The home however only had 3 permanent members of staff to include a team leader because other staff had been promoted to other services within the organisation. The manager explained that they were in the process of recruiting another three members of staff but were using agency staff to cover shifts as an interim measure. ` It was concerning to the inspector that only one female member of staff worked from the hours of 8am to 9pm daily with users whose behaviour often challenged the service. There was also no night cover for the home and as a result users could be very vulnerable at nights. It was also noted that there was no door entry system and again users could open the doors and be at risk. The inspector viewed the records of the three staff and found that one care staff failed to have satisfactory Criminal Record Bureau checks and one file failed to have an application form. The home had clear induction packages linked to “Skills for Care”. The manager also implemented in house induction packages to ensure care staff were aware of the procedures. It was however noted that no completed induction packages were seen on care staff files to evidence the information provided. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40 &42. People who use this service experience a poor quality outcome in this area. We have made this judgement using a range of evidence including a visit to the service. Procedures were in place for the running of the home with monitoring systems and satisfactory health and safety processes but further development was needed to ensure clear accountability of managing the home were in place, users views are monitored and policies are reviewed on a regular basis, as a result users interest were not always safeguarded. EVIDENCE: The home had a management structure and there was evidence to suggest that the carers and manager worked as a team to benefit the users of the service. There was however little evidence to suggest the manager spent enough time at the service. Staff and users spoken to said they were able to speak to the manager when they needed to by visiting the service across the street. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 23 Staff were not clear about the emergency procedures in the event that they could not contact the manager except to contact another manager who would only be able to give advice. The home had some quality assurance procedures in place. One example seen was care staff regularly revisited the National Minimum Standards and had regular staff and residents meetings. However further development was needed to ensure the users and carer’s views are monitored and systems are in place to ensure their views are listened to and published using a cyclical development approach. The home also needed to ensure their policies and procedures are reviewed to reflect current practices. Policies inspected had not been reviewed for over three years, and as a result procedures followed were not in line with legislations. The home had various health and safety procedures that were satisfactory in safeguarding users and care staff. These included fire risk assessments, environmental risk assessments, recording for all incidents and accidents and temperature monitoring for hot water. It was however concerning that procedures for safeguarding users from unwanted visitors were not thought through and users could be at risk when answering the door to visitors. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 1 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 1 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 3 2 1 1 2 X 3 x 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 25 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 YA2 Regulation 14 (1) (a) Requirement Arrangements must be made to ensure all users have in place a comprehensive assessment of need. Arrangements must be made to ensure medication policies and procedures are reviewed and implemented satisfactorily to include controlled drugs. Arrangements must be made to ensure safe procedures are in place for receiving, recording and administering of all medications in the home. Arrangements must be made to ensure clear and effective procedures are in place for receiving and dealing with all complaints. Arrangements must be made to ensure the wells being of all users are safeguarded at all times. All staff must be trained in Safeguarding and the procedures to follow in reporting incidents that adversely affects users wellbeing. Arrangements must be made to ensure the home has an effective DS0000014976.V347680.R01.S.doc Timescale for action 30/09/07 2. YA20 13 (2) and 17 (1) 13 (2) 30/09/07 3 YA20 30/09/07 4 YA22 12 (3) 30/10/07 5 YA23 13 (6) 30/09/07 6 YA23 13 (6) 30/10/07 7 YA33 18 (1) (a) 30/10/07 94 Tennyson Road Version 5.2 Page 26 8 YA34 19 (1) (b) (d) 9 YA37 10 (1) 10 YA39 24 (1) (a) (b) 11 YA42 13 (4) staff team with sufficient number of staff to meet the needs of the users of the service. A thorough and robust recruitment procedure must be implemented to ensure all staff have satisfactory clearances and available information through an application form. Clear and accountable management structure must be available ensure the smooth running of the home. A clear quality assurance system must be in place that monitors and seeks the views of the users in order to meet the aims and objectives of the service. Arrangements must be made to ensure satisfactory safety systems are available to protect users when answering their door. 30/10/07 30/10/07 30/11/07 30/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA6 YA40 Good Practice Recommendations Arrangements should be made to ensure clear and consistent care interventions are recorded for all staff to follow. All policies and procedures should be reviewed to reflect current care practice procedures and legislations. 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 94 Tennyson Road DS0000014976.V347680.R01.S.doc Version 5.2 Page 28 - 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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