Inspection on 04/06/07 for Ambleside

This inspection was carried out on 4th June 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.

Other inspections for this house

Ambleside 18/08/06

Ambleside 12/04/06

Ambleside 29/11/05

Ambleside 07/04/05

Ambleside 04/11/04

Ambleside 05/05/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Ambleside Wengeo Lane Ware Hertfordshire SG12 0EQ Lead Inspector Mrs Jan Sheppard Unannounced Inspection 4th June 2007 10:00 Ambleside DS0000019267.V343049.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 Ambleside DS0000019267.V343049.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. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ambleside Address Wengeo Lane Ware Hertfordshire SG12 0EQ 01920 460415 01920 466089 hilary.porter@turning-point.co.uk www.turning-point.co.uk Turning Point Southern Area Office 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) Ms Hilary Porter Care Home 6 Category(ies) of Learning disability (6), Physical disability (1) registration, with number of places Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate up to one person with a physical disability when associated with a learning disability. 27th February 2007 Date of last inspection Brief Description of the Service: Ambleside is a residential care home for adults with a learning and physical disability. The secluded house is spacious, detached and is located at the end of a private road approximately one mile from the town centre of Ware. The building is owned by Hertfordshire County Council but the home is run by Turning Point Ltd, which is a voluntary organisation. The building was renovated and first registered as a Care Home in 1998. It comprises six single bedrooms, offices and a staff sleeping- in room, and has communal spaces consisting of a large hall, lounge, dining room, kitchen, activities room and two assisted bathrooms. The home has a well-designed and accessible rear garden with a large patio accessible from the lounge. Adequate parking space is provided to the front of the building. The current fee for the residents, who are all sponsored by Hertfordshire County Council, is £511.40 per week. Information concerning the services offered by this home along with previous inspection reports are held in the office and are available to visitors and relatives. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day when one inspector spent six and a half hours visiting the home speaking with the homes manager and all the staff on duty. All six residents were spoken to or communicated with. A tour of the premises was also made with the homes manager. The comments in this report reflect the findings made during that visit and also take account of information sent periodically to the Commission by the manager and other information from relatives and stakeholders in the home. The afternoon routine of the home when the residents returned from their day activities was observed and a number of key records were spot-checked. This was a positive inspection the residents were all well, looked happy and well cared for. Improvements noted at the last inspection had been maintained and consolidated. The home had a calm peaceful and homely atmosphere where staff and residents were seen to be interacting positively. All the key standards inspected were met. There were no outstanding requirements from the last inspection. Two recommendations to further improve practice are made following this inspection. What the service does well: What has improved since the last inspection? The recently acquired full staffing compliment has enabled progress with improvements to all aspects of the care delivery to the residents. The care planning and record keeping has been revised and improved. The arrangement maintenance and organisation of the staff records has been Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 6 improved. The variety and frequency of activities and social outings has also been expanded for the benefit of the people who use the service. The home is benefiting from a number of renovations and building works which have been carried out or are in process. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. Before their move into Ambleside the resident’s needs were fully assessed. EVIDENCE: Ambleside Home opened nine and a half years ago when all it six residents transferred from a long-term hospital setting. At that time their needs were assessed and they and their families were able to visit the home and meet with the staff. Their compatibility as a group of residents was carefully considered. Since that time there have been no new admissions to the home so it is not possible to examine any recent admission records or procedures. However discussions with the homes manager evidenced that she has a good understanding of the necessary procedures according to the policies, which will be followed when this situation does arise. Comments received from relatives have always been very positive about the home with its great contrast in style and quality of living from the previous old hospital setting. The home has all the required information about the service, Statement of Purpose and Service Users Guide, and this along with a tenancy contact are lodged on each residents file. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The residents care plans are individually focussed and provide an up to date record of their needs, how these may be changing and how they will continue to be appropriately met. To ensure the continued safety of the people who use the service comprehensive risk assessments are regularly reviewed to accommodate changing ability and need. EVIDENCE: Since the last inspection the residents care plans have been rewritten following a Person Centred approach. This is a great improvement on the previous format and showed better evidence of the resident’s involvement with the preparation of their care plans. Picture menus and picture activity plans are Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 10 being prepared to add to the individual information, which the residents can keep in their rooms. The records gave evidence of the one to one individual ‘talk-time’ meetings that the key workers have regularly with their residents to ensure that they are consulted and that as far as it is possible to do so their views are understood and acted upon. There is a robust system of risk assessment in place, which enables the residents to take reasonable risks whilst maintaining an appropriate degree of independence. The manager spoke with the inspector about her recent work in preparing a contingency plan to provide safe and suitable alternative accommodation for the residents if ever the Ambleside house became un-useable. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Residents take part in a varied range of activities based upon their individual needs and choices and are supported appropriately by staff to use local community facilities. The residents receive a healthy diet of freshly prepared good quality food which is prepared in a manner which meets their individual needs. EVIDENCE: All the residents have an individually planned day activities programme encompassing three or four weekdays. Two local day centres are used where various small group activities and classes are attended. To meet his specific needs one resident has a one to one individual programme with many outings into the community arranged from the day centre. Since the commencement Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 12 of this individual programme a very definite improvement in the service users mood has been noticed by staff and by his family. The staff continue to arrange a number of outings into the local community. These are usually at the weekends and take advantage of the long warm summer days when social events are frequently occurring in their locality. The better staffing levels now present in the home have assisted with the development of an expanded activities programme. The provision of the homes new larger bus will assist with the arrangement of these outings. Plans are almost completed for all the residents to take a staying away holiday over the next summer months. Staff work very hard and over long hours to facilitate these holidays which are usually arranged for one or two residents at a time rather than for the whole group together. Past holidays have proved to be very beneficial for the residents some of whom have exhibited considerable improvement in their behaviours and social skills following such holidays. Staff support to maintain relations with the relatives and friends of the residents who are able to visit them and enables residents to write cards and e-mails to others who are not able to visit. One relative has recently helped with the provision of a new water feature for the garden, which is much appreciated by all the residents. During the afternoon of this inspection when the residents arrived home from their day activities they were seen to take tea on the patio area leading from their dining room and then some residents played a ball game with a staff member whilst others just sat relaxing in the sun. The menus are chosen weekly with visual menu cards used to assist residents in making choices. A healthy eating plan is followed with fresh vegetables and fruit freely available. None of the residents has any serious under or over weight problems but their weights are regularly recorded and records also made of food actually eaten. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Personal care is provided for the residents in a way that meets their needs and takes account of their own preferences and expressed choices. Residents have good access to all health services. The homes medication system is robust thereby ensuring safety for the residents. EVIDENCE: Care plans were seen to include full details of the care needs of the residents and how they should be met in ways that the residents prefer. Staff explained to the inspector about the very detailed understanding of the resident’s wishes that they had to build up through visual means to ensure that their care could be delivered smoothly to them. The particular bathing routine of one resident was mentioned along with the individualistic manner of dressing adopted by another. Failure to learn understand and follow these routines by the staff could lead to great disruption and distress of the resident. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 14 The care plans also gave ample evidence of the involvement in the resident’s care of a range of health professionals. One resident whose mobility has recently deteriorated is currently being assessed for surgery by a Consultant whilst for two other residents OT assessments have recently been completed for bathing aids and for a wheelchair. The residents all have regular dental and sight checks and chiropody treatment; hearing tests are arranged as and when needed. The home reports good attention from the local GP service and that visits from the District Nursing service are available promptly when required. Staff are currently completing the new joint Health and Social Care documentation ‘My Health’ concerning all health and social care needs for each resident. There have been no changes to the homes medication storage and administration systems since the last inspection. Medication records were spot checked and found to be satisfactory. The manager described the improvements to the space and storage facilities that would be possible with the new improved office facilities that were being built at the time of this inspection. Whilst none of the residents is able to control or administer their own medication one who likes to participate in the application of a cream is assisted to do so. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Policies and procedures are in place to protect residents from abuse, neglect and self-harm. Staff observe the residents who have limited verbal communication skills closely so as to understand their moods and wishes. EVIDENCE: A comprehensive complaints policy and procedure is in place and is well publicised in the home and to the relatives. A copy of the Turning Point visual complaints policy was seen on all the residents’ files; the manager explained that key workers went through this with the residents but that she did not judge that any of them would be able to understand this. There have been no complaints since the last inspection. Recent compliments from a visiting parent were shown to the inspector. All the staff have received training in the issues and procedures around the Safeguarding of Vulnerable Adults. Whilst there have been no formal safeguarding adult issues in the home since the last inspection the manager discussed with the inspector a situation that had arisen outside of the home which might have left a resident vulnerable and it was agreed that she would take further advice about this. Further training concerning safeguarding adults Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 16 issues particularly concerning reporting protocol and procedures would be advantageous. All the staff spoken with were very aware of their role in protecting this very vulnerable group of residents none of whom have any speech and several spoke of strategies that they adopt to judge residents mood and well being. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 17 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 this service experience good quality outcomes in this area. This judgement has been made using a variety of evidence including a visit to the service. The physical layout of the home enables the residents to live in a safe, well maintained and comfortable environment where their independence can be encouraged as far as it is safely possible to do this. EVIDENCE: On the day of this unannounced inspection the home was clean and tidy with evidence of the routine house keeping processes being maintained up to date. Decoratively the home is much improved and the provision of new furnishings has assisted with this so that the home now has a light and airy appearance, with a comfortable and homely feel. The manager was able to demonstrate the continual maintenance plan and pointed out items still needing attention with the planned timeframe for these. She also spoke of recent purchases including kitchen cooking appliances, microwave oven steamer and slow cooker, a replacement boiler for the home, repairs to the garden shed, new perimeter Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 18 fencing, a new water feature for the garden, insulation of the loft, new bedroom furnishings including a rise and fall bed for one resident and replacement French Doors into the lounge which allow the resident in a wheelchair free access. Major building works were being carried out during this inspection to create a further office and to provide a staff toilet and shower facilities, which the home has never previously had. These improvements are being implemented following recommendations made following the Peer Inspection of the home in January. Improvements to the assisted bathroom are to be made including the provision of upgraded shower facilities. The manager explained that the home’s bus is to be replaced shortly and is currently being fitted with the internal seating and wheelchair safety measures to meet the specific needs of their residents. All the residents’ bedrooms were appropriately decorated and furnished to meet their needs and to reflect their tastes and styles. Personal items evidenced their interests, e.g. cars, soft toys and art works. The home was found to be hygienic and clean and the staff reported that the improved laundry equipment is working well and save staff time. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 19 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): 32,34 and 35. People who use this service experience good quality outcomes in this area. This judgement has been made using a variety of evidence including a visit to the service. Staff in the home are experienced, trained and have sufficient skills to support the people who use the service. There are sufficient staff to maintain the smooth running of the service for the benefit of the people who use the service. The recruitment policy and practices provides adequate safeguards for the residents. EVIDENCE: There have been no changes in the staffing group since the last inspection and the home remains fully staffed. The last intake of new staff, two experienced workers who commenced during the autumn of 2006 told the inspector that they remained very happy to be at the home, were appreciative of the training opportunities offered them and confirmed that they were well supported by the homes managers. One said, “ there is good team working here now we all just want to do our best for these residents”. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 20 As there have been no new staff appointed since the last inspection it was not possible to examine recent recruitment records but those seen during the last inspection in February 2007 were found to be in order. The manager discussed with the inspector the homes now very much decreased use of agency staff and explained that following a recent incident when she was unhappy with the quality of service offered by one of these staff she was now in process of recruiting extra bank staff specifically for the home so that the need to use any agency staff could diminish further. The Manager confirmed to the inspector that the recent attainment of full staffing for the home, the first time this had been the case for many years, had enabled all aspects of the service to progress. The staff confirmed this position when they spoke independently with the inspector. All staff regularly undertake training and since the last inspection courses on Food Hygiene, Skip training, Person Centred Care Planning, Fire Safety Awareness, First Aid , Medication Administration and Management and Manual Handling have been undertaken or are planned. Two staff hold NVQ level 2 qualification and five more are studying for this. Two other staff have applied to go on an NVQ level 3 course. The manager has commenced her NVQ level 4 Registered Managers Award. All the staff are to attend a 2 day Equality and Diversity training course on 22nd of June. Records evidenced that staff supervision is carried out regularly and the minutes of recent staff meetings were seen last on 22/5/07. It is recommended that the minutes of staff meetings are dated, signed by the minute taker and that an action section with timeframes for required actions is included. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 21 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 and 42. People who use this service experience good quality outcomes in this area. This judgement is based on a variety of evidence including a visit to the service. The home benefits from the calm, kind and consistent management style of the experienced manager. The quality assurance system is adequate and enables the management to assess information to enable them to improve the care experience for the residents. The good record keeping promotes the health safety and welfare of the residents. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has the required qualifications and experience; and is competent to run the home. She has a clear understanding of the key principles and focus of the service. Her aim is to continually improve the quality of life for the residents and to enable them to maintain their independence. She is part way through her studies for the Registered Managers training award. She reports that the support that she receives from Turning Point is now more consistent with regular management Regulation 26 visits being made, along with an improvement in budgetary support that has enabled various much needed improvements to be made to the building and to the office facilities. The home now has Internet access and staff are working to improve their typing skills and knowledge of the programmes to facilitate the best use of this. There are clear operational policies and procedures in place, which the staff had good knowledge and an open awareness of where to go to find any information that they could not immediately remember. The records were very well maintained, neatly and accurately recorded; and following the refurbishment of their office appropriately and safely filed and stored. Spot checks made of these records including fire, accidents, water temperatures, risk assessments, made during this inspection evidenced that they were well maintained and that routine management checks are carried out. In discussion staff demonstrated an awareness of the requirements of the Data Protection Act. See standard 35 for comments concerning minutes taking of staff meetings. All six staff who were on duty during the time of this inspection spoke with the inspector positively about the recent changes in the home. They spoke appreciatively of the Turning Point Peer Inspection that had been carried out on 22nd January 2007, how this report had helped them to focus on areas where care quality improvements could be made and that these were now achievable following the full staff employment in the home. They recognised and appreciated this new period of stability and seemed to be well motivated to use this for the best advantage of the residents. The records evidenced that staff are appropriately supervised and that a programme for annual staff appraisal is in place and is up to date. Ambleside DS0000019267.V343049.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 YA35 YA41 YA23 Good Practice Recommendations To ensure clarity, minutes of meetings should be signed and dated with time scales for action points clearly indicated. The manager should ensure that all staff have a good understanding of the local safeguarding adult reporting and sharing protocols. Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Ambleside DS0000019267.V343049.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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