Inspection on 29/04/08 for Acorn House

This inspection was carried out on 29th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Acorn House 198 Ditchling Road Brighton East Sussex BN1 6JE Lead Inspector Nigel Thompson Unannounced Inspection 29th April 2008 10:30 Acorn House DS0000069940.V359125.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 Acorn House DS0000069940.V359125.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. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn House Address 198 Ditchling Road Brighton East Sussex BN1 6JE 01273 271237 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) a.chaudry2@ntlworld.com Acorn (Watford) Ltd Mrs Monica Murtagh Care Home 10 Category(ies) of Learning disability (0) registration, with number of places Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 10. Date of last inspection 24 August 2007 Brief Description of the Service: Acorn House, 198 Ditchling Road is a home for up to ten adults with learning disabilities. All residents are female and for many of them this has been their home for almost twenty years. The home is a Victorian building situated close to Fiveways shopping area that also has a bank and a post office. Nearby are Blakers Park and Preston Park, there is also a choice of churches. A railway station within walking distance operates between Eastbourne and central Brighton. Parking is free locally and depending on the time of day can be undertaken outside the home or in the neighbouring roads. The home works directly with the Grace Eyre Foundation, a local charity that provides placements, day care and other activities for people with learning disabilities. Fees are under discussion at present. Additional charges are made for hairdressing, chiropody, newspapers and outside activities such as visits to the theatre. Intermediate care is not provided. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place over four hours in April 2008. It found that all the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Since the previous inspection there has been a change of ownership and this was the first inspection of Acorn House since the new providers took over in November 2007. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were nine residents living at the home. The inspection process involved a tour of the premises, observation of working practices, examination of records and documentation and discussion with four residents, two members of staff and the acting manager. Residents observed and spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: What has improved since the last inspection? Significantly since the previous inspection there has been a change of owner and a newly appointed manager, who are both evidently committed to improving the quality of life for people living at Acorn House. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 6 Since the last inspection, as required, residents’ individual care plans have been significantly improved and policies and procedures relating to the control, storage, administration and recording of medication have been reviewed and updated. An ongoing programme of redecoration and refurbishment is evidently in place throughout the house and an impressive new kitchen has recently been installed. A welcome safety development since the previous inspection has been the replacement of wooden door wedges with automatic closures on all internal doors. 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 Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Acorn House DS0000069940.V359125.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 Acorn House DS0000069940.V359125.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, 3 & 4 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The admission policy and procedure is unsatisfactory and does not ensure that prospective residents are fully assessed prior to moving into the home. Due to inadequate information currently made available, prospective residents do not know that the service is able to meet their individual care and support needs. EVIDENCE: The appointed manager confirmed that there have been no admissions to Acorn House for almost five years, however there is currently one vacancy at the home. It was noted that there is no satisfactory and up to date admission policy and procedure in place and no evidence of any effective and structured assessment process. Certain information made available to prospective residents was found to be inadequate and unsatisfactory. As discussed during the inspection, with the proprietor and appointed manager, documentation, including the Statement of Purpose and Service User Guide is in need of reviewing – in accordance with National Minimum Standards - and updating, to ensure that it accurately reflects the current situation within the home. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 10 The appointed manager confirmed that, prior to moving in, a prospective resident would be invited to visit the home to look around and get a feel for the place. During these visits the individual would also have the opportunity to meet with members of staff and existing residents. Higher dependency levels and the increasingly ageing client group at Acorn House was discussed at some length, as it also clearly has implications for future placements at the home. The proprietor and manager are evidently aware of the importance of compatibility in relation to any prospective resident. The proprietor confirmed that the changing care and support needs of existing residents at Acorn House was a major challenge. He added that, in attempting to address this and the many associated issues, several options are being considered, including a possible review of the home’s current registration. Acorn House DS0000069940.V359125.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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments reflect changing support needs. Systems for consultation and participation remain effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: ‘Person centred’ care and support plans have been developed and implemented for each resident. Individual plans that were examined contained personal risk assessments and comprehensive details of their physical, psychological and emotional support needs and were found to be accurate, up to date and generally well maintained. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 12 The appointed manager confirmed that care plans are reviewed and updated every three months, unless any significant changes occur in the interim period. Independence and individuality continues to be encouraged and promoted within the home and is reflected in the personalising of residents’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. The manager emphasised the importance of staff developing close working relationships with individual residents. Despite the variable and limited verbal communication of some residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation residents being supported in a professional, sensitive and respectful manner. Acorn House DS0000069940.V359125.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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social opportunities. Residents benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of service users are identified and recorded in their individual care plan. Despite, as previously documented, the increasing mobility issues of some residents, they continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 14 Residents are encouraged and supported to maintain links wit family and friends. Staff confirmed that visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Menus examined were found to be varied and balanced and are evidently based on residents’ identified likes and preferences. An alternative to the main meal is always available. The food prepared is healthy and nutritious and the menu discussed daily with the residents. Fresh vegetables and fruit are included daily and smoothies are also prepared for a specific resident. All meals are eaten in the dining area, with the exception of one resident who prefers to eat alone. Residents are encouraged and supported to help prepare simple puddings and snacks, two residents have been risk assessed to have a kettle in their room, and this continues to be regularly reviewed. Acorn House DS0000069940.V359125.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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by improved policies and procedures in place for the control and safe administration of medication. EVIDENCE: The manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. In accordance with their personal care plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 16 As previously documented, the proprietor, appointed manager and staff are evidently aware of the increasing dependency levels and changing care and support needs of the ageing client group at Acorn House During the inspection residents were observed being supported in a sensitive, professional and respectful manner. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. All residents are registered with local GPs and have access to other health care professionals, including district nurses occupational therapists and dentists, as required. It was noted that all medical appointments with, or visits by, health care professionals are recorded. Since the previous inspection, as required, policies and procedures relating to the control, storage, administration and recording of medication have been reviewed and updated. It was evident that medicines are now stored and recorded appropriately. As part of the home’s commitment to safeguarding residents and improving practices, all staff responsible for administering medication receive training, as part of their comprehensive induction programme, and are individually assessed and authorised to do so. In addition to this, the manager confirmed that all staff at the home have recently undertaken specific training relating to the ‘Care and control of medication.’ Following risk assessments, no resident currently has responsibility for selfadministering their own medication. Acorn House DS0000069940.V359125.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that residents, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Residents are protected through staff training relating to safeguarding vulnerable adults, however relevant policies and procedures must be reviewed and updated. EVIDENCE: The home has a pictorial complaints policy and procedure which has been implemented in this home. Copies are provided in their bedrooms and communal areas and in their own copy of the Service Users Guide. The complaints procedure should be reviewed and amended to include updated details of the new proprietor. Close working relationships and effective communication and consultation provides adequate opportunities for any concerns to be raised and discussed before they become complaints. Residents and members of staff confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 18 It was noted that there have been no concerns or complaints recorded by the home since the last inspection. The home has produced detailed policies and procedures, relating to adult protection and abuse, including a whistle blowing policy. However these documents have evidently not been reviewed and updated since September 2005, in accordance with the multi agency guidelines for the protection of vulnerable adults (Safeguarding adults). The manager confirmed that all care staff have undertaken, or are scheduled to undertake appropriate training in the near future, regarding abuse awareness and procedures relating to ‘Safeguarding Vulnerable Adults.’ This was confirmed through discussions with staff and evidenced by the training matrix displayed in the office and through individual training records examined. Acorn House DS0000069940.V359125.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, 25, 26, 28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The service is generally comfortable and homely despite ongoing redecoration and widespread refurbishment. However certain residents, with increasingly poor mobility, are at potential risk from unsatisfactory access to both the front and rear of the premises. EVIDENCE: During my ‘guided tour’ of the premises it was evident that the generally well maintained décor and adequate furniture and furnishings continue to provide a reasonably comfortable and pleasant environment for residents. An ongoing programme of redecoration and refurbishment is evidently in place throughout the house and since the previous inspection an impressive new kitchen has been installed. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 20 The manager confirmed that independence and individuality continue to be promoted within the home and, as previously documented, this is evident from the personalising of residents’ rooms, reflecting individual taste, preference and interests. A welcome safety development since the previous inspection has been the replacement of wooden door wedges with automatic closures on all internal doors. Although the majority of radiators throughout the home have, as required, been fitted with guards, it was noted that some, particularly in certain residents’ bedrooms still remain uncovered. Following discussion with the manager and proprietor, it was agreed that all radiators are to be covered. It was also agreed that the badly stained carpet in the dining room is to be replaced. Following further discussion, it is recommended that the old chest freezer currently in the dining area be removed and the unsightly and institutionalised white tiles in one resident’s room be taken down. Access via steps to the front of the house is unsuitable for people with limited mobility. At the rear of the premises, an uneven patio area leading from the kitchen to the garden is also unsafe for residents who are unsteady on their feet. The excessive amount of building materials, rubbish and general clutter in this area is currently also a potential hazard and should be removed. Residents, with staff support as necessary, are evidently responsible for keeping bedrooms clean and tidy. Care staff also have responsibility for cleaning bathrooms, staircases and other communal areas throughout the home. However on the day of the inspection, levels of cleanliness and hygiene in certain areas were found to be less than satisfactory. With such large premises to keep clean, it is a lot to expect of already busy care staff. Therefore, as discussed with the proprietor and manager, consideration should be given to employing domestic staff. Infection control policies and procedures are in place and clearly adhered to. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 21 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): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents benefit from there always being sufficient trained and competent staff on duty to meet individual assessed care and support needs. Satisfactory recruitment procedures, training and supervision help to ensure the welfare and protection of residents. EVIDENCE: Through discussion with the manager, care staff and residents, it is evident that sufficient staff are employed to meet the current assessed support needs of residents and to ensure consistency and continuity of care. The manager confirmed that staffing levels are closely monitored and are directly linked to the residents’ identified levels of dependency. A duty rota has been developed and implemented to detail the staff on duty at any given time and their designation. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 22 Appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and evidenced by training records examined: ‘There is always plenty of opportunity for training here’. Formal and structured staff supervision is provided on a regular basis and is appropriately recorded. The manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 23 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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents benefit from a competent management structure. They are protected by satisfactory health and safety procedures and their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: The recently appointed manager has been in her current position since November 2007. She has achieved the National Vocational Qualification (NVQ) level 4, in management and care, and has completed the Registered Manager’s Award (RMA). CSCI are currently processing an application to register her as manager of the home. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 24 The manager confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. She added that training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. This was also confirmed through discussions with staff and evidenced by training records examined. Effective quality monitoring systems are in place, including satisfaction questionnaires to obtain the views of residents’ relatives and other stakeholders in the community. Responses from a recent survey indicate an increasingly positive view of the home, the staff and the services provided: ‘The communication has certainly improved over the last few months.’ ‘…………(The manager) is excellent.’ COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 25 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 2 2 2 3 2 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 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 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation 4 (1), 5 & Schedule 1 Requirement It is required that an up-to-date statement of purpose and service user guide be developed and implemented and made available to all existing and potential residents. It is required that new residents are only admitted to the home on the basis of a full assessment of their care and support needs, carried out by a person competent to do so. It is required that residents are safeguarded from potential risk or abuse by robust and up to date policies and procedures. It is required that the premises are accessible, safe and suitable for the home’s stated purpose. It is required that all parts of the home are kept clean and reasonably decorated. Timescale for action 30/09/08 2. YA2 14 (1) 30/06/08 3. YA23 13 (6) 30/09/08 4. 5. YA24 YA30 23 (2) 23 (2) (d) 30/09/08 30/09/08 Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA22 YA24 Good Practice Recommendations It is recommended that the current complaints procedure be reviewed and amended to include updated details of the new proprietor. It is recommended that the badly stained carpet in the dining room be replaced. It is recommended that covers be fitted to all radiators. It is recommended that all building materials, rubbish and general clutter outside the kitchen door be removed. It is also recommended that the old chest freezer currently in the dining area be removed and the unsightly white tiles in one resident’s room be taken down. It is recommended that, in view of the size of the premises, consideration be given to employing domestic staff. 3. YA30 Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Acorn House DS0000069940.V359125.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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