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Inspection on 09/07/07 for Abbotsford

Also see our care home review for Abbotsford for more information

This inspection was carried out on 9th July 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has undergone a period of managerial change that has unsettled the staff team, however a new manager has recently taken up post within the home and is committed to improving on the quality of care that residents receive and to improving the level of staff support in order to achieve this. Work had taken place on updating the homes policies and procedures, and during a recent staff meeting roles and responsibilities were discussed to ensure that all staff were fully aware of the responsibilities. The admission procedure ensures that the needs of people that use the service are fully assessed prior to entering the home, and there is ongoing support from the placing authorities. There is a commitment to improving on the quality of the care plans in place and the level of information provided within them

What has improved since the last inspection?

The rear of the property has been made more secure. Improvements have taken place with the management of medication. Improvements have taken place in food safety management, temperature readings of the fridge and freezer and probe temperature readings of cooked foods are now being recorded.

What the care home could do better:

In general the lifestyle in the home matches the residents expectations, however more one to one time spent with staff could further enhance the residents well being. Training in dementia care awareness would further promote the philosophy of person centred care.Training in safeguarding adults would ensure that all staff were made aware of the value of promoting the residents citizenship rights and entitlements regardless of their age or cognitive abilities. All moving and handling equipment needs to be serviced to ensure that it is safe and in good working order. Consideration need to be taken to ensure that there is a means of access through the front door from the outside. Staff should only be employed after a Criminal Records Bureau (CRB) check has been carried out through Msaada Organisation; portability of CRB clearances for adult services is not acceptable practice.

CARE HOMES FOR OLDER PEOPLE Abbotsford 443 Wellingborough Road Abington Northampton Northants NN1 4EZ Lead Inspector Irene Miller Key Unannounced Inspection 9th July 2007 11:00 X10015.doc Version 1.40 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 Abbotsford DS0000040840.V340755.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 Older People. 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. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsford Address 443 Wellingborough Road Abington Northampton Northants NN1 4EZ 01604 636729 01604 636729 abbotsfordcare@majproperties.co.uk 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) Msaada Care Limited Post Vacant Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users whose rooms are on the second floor, should be able to mobilize independently. 19th July 2006 Date of last inspection Brief Description of the Service: Abbotsford is a care home for 16 people over the age of 65 years who have dementia related conditions. Accommodation is set over three floors, rooms on the second floor and annex the are single with en-suite facilities, rooms on the first floor are all shared and do not have en-suites. There are two lounges and a separate dining room. The home is located on a main road and is opposite a park. The town centre is two miles away and is on the local bus routes. The current fees range from £348 to £420 per week and additional charges are made for hairdressing services and chiropody. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for people using the services and their views of the service provided. This visit was unannounced and focused on the ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care of three people living at the home was looked at in depth this involved looking through written information available on their care, such as the residents individual care plans (a care plan sets out how the home aims to meet a residents personal, healthcare, social and spiritual needs). During the period of 1pm to 3pm observations were made to determine the general well being of people living at the home, time was spent observing their daily routines and interactions between each other and staff. In addition discussion took place with people living at the home, visitors, staff and the registered manager. Sample checks were carried out on the homes policies and procedures and records in relation to staff recruitment, the homes medication and quality assurance systems, in addition health and safety records on the general maintenance and upkeep of the facility were viewed, and general observations on the environment were made. The Commission for Social Care Inspection sent out to the home an Annual Quality Assurance Assessment form (AQAA) for completion by the registered manager and the AQAA was returned to the Commission for Social Care Inspection prior to the visit, which provided information on the homes management and administration and quality assurance processes. In addition to this information time was also spent prior to the visit reviewing the homes service history, which details all contact with the home including notifications of events reported by the home, telephone calls, letters, and details of any complaints and concerns received. The manager Janet Ballshaw was available at the home throughout the visit. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: In general the lifestyle in the home matches the residents expectations, however more one to one time spent with staff could further enhance the residents well being. Training in dementia care awareness would further promote the philosophy of person centred care. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 7 Training in safeguarding adults would ensure that all staff were made aware of the value of promoting the residents citizenship rights and entitlements regardless of their age or cognitive abilities. All moving and handling equipment needs to be serviced to ensure that it is safe and in good working order. Consideration need to be taken to ensure that there is a means of access through the front door from the outside. Staff should only be employed after a Criminal Records Bureau (CRB) check has been carried out through Msaada Organisation; portability of CRB clearances for adult services is not acceptable practice. 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. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (standard 6 is not applicable to this service). Quality in this outcome area is good. The admission procedure ensures that the needs of people that use the service are assessed prior to entering the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was pre assessment information within the individual care plans looked at that also included assessments made by the placing authorities, and for residents that are cared for under the Care Programme Approach there was evidence of ongoing support from healthcare professionals. The home cares for people living with dementia and all residents when asked about whether they had chosen to live at the home, where unable to recall how they came to live at the home. Visitors spoken with during the visit said that the manager had carried out assessments and that they had been fully involved with the admission of their relative. They said that they had been Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 10 provided with sufficient information to enable them to make a decision as to whether the home could meet their relative’s needs. Within the front lobby of the home there was an area, which was intended to be used for displaying information on the home, such as the homes statement of purpose and service users guide, however there was no information on display at the time of the visit. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 & 10 Quality in this outcome area is good. Having more information within the care plans could improve how the staff meeting the emotional needs of the people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the residents living at the home have advanced dementia and residents may not fully understand the need for staff to perform certain healthcare tasks and sometimes result in residents displaying behaviour that challenges the staff. The manager explained that there were plans to improve on the level of detail within the care plans, in order that there is a consistent approach on how staff responds to the emotional needs of the individual and the level of care tailored to meet their needs. From the three care plans viewed there was basic information on the residents, personal care, mobility, nutritional and medical needs. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 12 Within one of the care plans looked at work had begun on providing greater detail on how the staff are to respond to the emotional needs of the resident, the assessment information was more detailed, and had captured the individuality of the person. In order to ensure that information was communicated effectively from shift to shift the care staff write up a brief report after each shift, morning, evening and night. The manager said that this had help with responding to residents changing needs proactively. Within the care plans there were records of visits by the general practitioner, chiropodist and district nurse, on the day of the visit there was a visiting optical service at the home, staff were observed sensitively supporting residents with limited verbal communication whilst attending their appointment. The storage and administration of medication was sample checked and was seen to be in order; there was one medication that had been opened in February 2007, there was no information available as to the shelf life once this medication was opened, the manager agreed that this would be checked with the dispensing pharmacist, eye drops had the date of opening available to ensure that they were disposed of after twenty eight days. The homes medication policy had recently been reviewed, and one trained member of staff had been assigned to ensure that all the staff that holds the responsibility for administering medication had read the updated medication policy. Staff were observed to respect the residents rights to privacy and to be treated with dignity and respect, although there was no intention to be disrespectful, some staff were observed referring to residents as ‘love’ This was discussed with the manager at the time of the visit. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is adequate. In general the lifestyle in the home matches the residents expectations, however more one to one time spent with staff could further enhance the residents well being. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five residents were closely observed over a two-hour period that began in the dining room and followed through into the large lounge. Nine residents in total were within the dining room with support from two members of staff. There was some evidence of institutionalised practices taking place such as the residents meals all being plated up in the kitchen, most of the residents within the dining room were fairly independent eating their meals, a group of four residents were sitting at one of the dining tables waiting for their meal, when asked what was for lunch residents said ‘whatever it is I know it will be nice’ ‘I’m not a fussy eater’, ‘if we don’t like it they will always find us something else’. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 14 Staff were observed in offering support and encouragement to the residents over the mealtime, however there were some instances where staff could have initiated better social contact with the residents and provided greater practical and emotional support. Time was then spent with the same group of residents within the large lounge this period of observation lasted for 1hr 10mins. The television was on although the volume was very low; at first three members of staff came into the room, and spend approximately 5 minutes with the residents one member of staff initiated contact with all residents within the room and all the residents responded well to this member of staff. The three members of staff then left the room over the next 1 hr 10 minutes the residents had very little contact with staff, during which time staff entered the room for brief periods of time. However although the contact was brief the impact had a positive effect on lifting the resident’s mood. One member of staff acknowledged that the volume on the television was low and asked the residents whether they wanted to continue watching television or listen to some music. Once the music was put on many of the residents responded positively tapping their feet in time with the music, a small group of residents were offered to look at the daily newspaper, and one resident was given some large Lego building blocks to put together, this residents responded very well to this physical activity and others smiled and chatted with the staff. Within the dining room there was a notice board that had displayed upon it the daily activities for each day of the week, however in discussion with the manager it was established that this was no longer in use. In discussion with visitors this was verified that they had not witnessed any of the activities as advertised on the notice board take place. The manager said that representatives from the local Baptist and Anglican Churches visit the home, however no church services take place within the home, residents do have access to holy communion if they wish. None of the residents attended any of the local church services. The manager said that outside entertainers visit the home to provide music and movement and acknowledged that more needs to be done to provide residents with individualised (person centred), meaningful and therapeutic activities to build upon their remaining skills and provide enjoyment. In discussion with visitors they said that they were always made welcome when they came to visit, that they like to sit outside with their relative in the small courtyard. Saying that sometimes they take their relative out of the home to have contact within the local community, and that it would be nice for more of the residents to have the opportunity to go over to Abington Park where a brass band often plays. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. People who use the service and their representatives can be assured that their any concerns or complaints they may have will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission for Social Care Inspection had received two complaints about the service since the last inspection visit, the provider was instructed to investigate the complaints under their own complaints procedure; the Commission was satisfied that the complaints had been fully investigated. Visitors spoken with during the visit stated they that they knew how to raise concerns but had not had cause to do so, the visitor said that they had confidence that any concerns raised with the manager would be acted upon. In discussion with the manager it was established that refresher training was planned to tale place on safeguarding adults, the manager said that the home was hoping to access an e-learning programme through Northamptonshire County Council on Safeguarding Adults, and recognised that not all staff were computer literate and that other channels of training in this area would have to be sourced to meet this need. The manager said that there were plans to send staff on training on how to support residents who behaviour can challenge, and dementia awareness. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 16 The organisation were in the process of updating all staffs criminal records bureau checks (CRB) Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is adequate. Improvements to the internal and external environment would benefit the well being of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was carried out and in general residents rooms had been personalised with pictures, ornaments and small items of furniture. The bathrooms and toilets were clean and free from offensive odours and bathing aids and adaptations were available, however it was noted that a bath hoist within one of the first floor bathrooms was overdue an engineers service inspection. On speaking with the manager it was discovered that this piece of equipment had developed a minor fault. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 18 The kitchen was viewed, which was clean and tidy, there were records of food hygiene safety monitoring checks having been carried out. The front garden leading to the property was overgrown and in need of landscaping, the rear garden of the property was in a similar condition, in discussion with a visitor, they said that they had brought in plants to put in the small border within the small courtyard seating area. The paved pathway leading to the rear garden was uneven and in need of levelling to reduce tripping hazards for residents and staff. The gate leading out of the rear garden had been made secure, however in discussion with the manager it was explained that the front door had a dead lock fitted and that there was no access by key into the home from the outside. This was particularly concerning in the event of any emergency, such as a fire, where staff may not be able to reach the front door, to allow access for the fire safety. During the visit it was noted that within the lobby of the home, there was wheelchairs without footplates in place, this was addressed with the manager who immediately acted upon this by ensuring that the footplates were returned onto the chairs, one wheelchair was in need of repair and this was immediately removed from the area. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is adequate. Further training on adult protection and dementia care awareness would equip the staff with greater skills to ensure that the rights of people using the service are promoted, protected and respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit the staffing levels were sufficient to meet the needs of the residents. In discussion with the manager it was established that refresher and updates to training was planned however these had not taken place at the time of the visit. The manager said that she planned to purchase a training pack ‘how to be a great care assistant’ which was available through Skills for Care. The outcomes for the residents based upon the short observation period that was carried out and other documentation available within the care plans, was that the residents basic needs were being met. However to fully meet the social and emotional needs of people with dementia the staff team needs to update their knowledge in the field of dementia care and be equipped with the skills to provide flexible person centred care. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 20 Staff recruitment files viewed had evidence that recruitment checks had been carried out, however a member of staff had taken up employment based upon a previous, (although recent) Criminal Records Bureau Check (CRB). It was explained to the manager that the implementation of the POVA scheme has restricted CRB portability in relation to regulated services for adults. The Care Standards Act requires that new staff are checked against the list prior to being offered employment or on moving from a non care position to a care position. To commence employment prior to receiving a CRB clearance check is acceptable only under exceptional circumstances and in this event the home must ensure that the member of staff works under close supervision, whilst undertaking their induction training. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 & 38 Quality in this outcome area is good. People using the service and their representatives can be assured there is a managerial commitment to improving the care that they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has undergone a period of managerial change that has unsettled the staff team, however a new manager has recently taken up post within the home and is committed to improving on the quality of care that residents receive and to improving the level of staff support in order to achieve this. The manager has submitted an application with the Commission for Social Care Inspection to become a registered manager and in discussion with the Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 22 manager it was established that she has the necessary skills, knowledge and experience to discharge her responsibilities fully. Work has taken place on updating the homes policies and procedures, and during a recent staff meeting roles and responsibilities were discussed to ensure that all staff were fully aware of their individual and collective responsibilities. Records were available to support that staff one to one supervision had recently been reinstated. There is a commitment to improving on the care planning processes. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23 (2) (o) Timescale for action The rear garden must be suitable 30/09/07 for, and safe for use by the people that use the service and appropriately maintained. Wheelchairs for residents use 31/07/07 must be maintained in good working order. All bath hoists must be safe and in good working order. Care staff must only commence employment upon receipt of a CRB and POVA 1st clearance A staff-training programme must be in place to include Dementia Awareness and Safeguarding Adults. 31/08/07 31/07/07 31/07/07 Requirement 2 OP22 23 (2) (c) 3 4 5 OP22 OP29 OP30 23 (20 (c) 19 Schedule 2 18 (1) (a) Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 25 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 OP12 OP1 OP38 Good Practice Recommendations There should be arrangements in place for all people that use the service to engage in local, social and community activities according to their needs and preferences. The homes statement of purpose and service users guide should be available within the home for all people that use the service and their representatives. The front door should be accessible to unlock from the outside. Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 Abbotsford DS0000040840.V340755.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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