Inspection on 02/10/07 for Ashbridge Road (22)

This inspection was carried out on 2nd October 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 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.

Other inspections for this house

Ashbridge Road (22) 02/12/09

Ashbridge Road (22) 17/08/06

Ashbridge Road (22) 23/03/06

Ashbridge Road (22) 02/02/05

Ashbridge Road (22) 05/10/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Ashbridge Road (22) 22 Ashbridge Road Leytonstone London E11 1NH Lead Inspector Nurcan Culleton Unannounced Inspection 02 October 2007 10:00 Ashbridge Road (22) DS0000007277.V345399.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 Ashbridge Road (22) DS0000007277.V345399.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. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbridge Road (22) Address 22 Ashbridge Road Leytonstone London E11 1NH 0208 530 5339 0208 530 5339 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) Mrs Shirlene Hasmat-Ali Ms Claire Thorne Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2006 Brief Description of the Service: Sable Care is part of Sherico Care Homes group and provides care, support and accommodation for four adults with a learning disability (inclusive of services for people with challenging behaviour and autism). The home is a four bedded, Victorian style house situated in a residential road in Leytonstone within easy reach of an underground station, bus routes, local shops and amenities. The home has two upper floors, containing four bedrooms, two bathrooms and an office. There is a lounge with an adjacent visitors room/quiet room, a kitchen/dining area and a laundry room on the ground floor. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection on 02nd October 2007 took place in the presence of the Registered Manager and Director of the service. The inspector spoke with staff and one resident who also took the inspector on a tour of the premises. The inspection took into account the homes’ Annual Quality Assurance Assessment (AQUAA) and examination of the homes records and documents including resident and staff files; health and safety certificates and records; minutes of staff and residents’ meetings; correspondence and records of internal and external communications between staff and other professionals related to the needs of of the residents. In addition, the inspector received surveys as follows: four residents’ surveys; two from health professionals; five from staff members and two surveys from relatives. What the service does well: What has improved since the last inspection? What they could do better: Residents could benefit further from a well- structured programme of external activities. Recording practises must improve further to record significant discussions with staff and with Local Authorities and to ensure policies, Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 6 procedures and assessments are signed. Residents must be able to open and close their windows independently. There are recommendations to further improve care plans and risk assessments. 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. Ashbridge Road (22) DS0000007277.V345399.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 Ashbridge Road (22) DS0000007277.V345399.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): 1-5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective residents are met at Ashbridge Road prior to their admission. The service is flexible to promote and respond to the individual and diverse needs of individual residents. EVIDENCE: Residents have access to information about the home in a Service User’s Guide available in pictorial form. Assessments are completed by the placing local authority, followed by pre-admission assessments completed by the manager of the home. The home demonstrates its ability to respond to and meet the needs of residents who have a range of needs, including people who have a physical disability who require one to one assistance and support with personal care; residents who are non-verbal in communication where staff use picture references, actual objects of reference and Makaton to enable communication; and currently two residents who have mental health needs. Key working sessions and one to one support from staff are used to target individual support areas. The manager seeks to ensure that the home is well informed about individual needs. In addition to consulting with medical professionals in one case, for example, sending off for written information from abroad about a Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 9 rare physical syndrome in order for staff to know how best to respond to the needs of one resident. However funding is an issue between the home and Local Authority as regards the additional one to one mental health needs of one resident, though the home continues to provide the level of support she needs. The home is accommodating of individuals who have religious and cultural needs. Residents are encouraged to attend places of worship of their own choice. The home’s menu reflects the residents’ own ethnic preferences; individual ethnic CDs, tapes and DVDs are used by residents chosen by them, as evident throughout the day of inspection. Residents are invited to visit as part of the home’s admissions procedures. Contracts are made between the placing authority and the home. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 10 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): 6-10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans identify residents’ needs, however their needs could be more clearly defined and further integrate needs with goal setting. Risks to residents are clearly identified and risk prevention strategies in place, though their assessments could improve further. All personal information must be confidentially maintained. EVIDENCE: Care plans undertaken for all residents on a regular basis or following a review or major change in circumstances and are randomly checked through monthly monitoring visits by the Director. Care plans identify needs, intervention and support strategies and are signed by the resident and Manager. Whilst care plans identify needs, they are descriptive in some areas and do not always clearly identify goals aimed to be achieved. Goals are identified in a separate Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 11 part of residents’ files. It is recommended that care plans further improve to integrate needs and goal setting as part of an overall care plan. Whilst the home undertakes their own internal reviews, the local authority reviews are overdue for some residents by several months, and in one case, for two years. There is in addition no evidence that the home has communicated their request for reviews with the local authorities. It is recommend that any significant contact with Local Authorities is recorded, including all requests for annual reviews. Current residents are unable to manage their own finances, however this is identified in their care plans and how support is expected to be given, including records of personal and mobility allowances. Residents meet on a monthly basis and their meetings are recorded. There are issues as regards communication for non-verbal residents, however staff use their skills and pictures or symbols as described above to gage residents’ views. Risk assessments identify the specific behaviour of concern, indicators leading to the risk behaviour and preventative strategies. They are satisfactory to this extent, however could be improved further by identifying the level of risk in each identified risk area. However two of the risk assessments are not signed to identify the author. Risk assessments are also completed for holiday travel and copies sent to the relevant local authority. Resident’s files are confidentially maintained in locked files. Their personal, family and professional contact details are also listed in a residents’ register book, however the office is kept locked to maintain residents’ confidentiality. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 12 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): 11-17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ social, emotional and communication needs are identified and addressed. Planned daytime activities suitably engage residents according to their individual choices and needs. Meals are nutritious, balanced and include individual preferences. EVIDENCE: Peoples’ social, emotional and communication needs are identified in their care plans. Their ongoing development is monitored through the observation and interaction by staff, internal reviews and progress reports. Despite residents’ support needs, semi-independent living skills are promoted as part of individual plans and group living, and take into account residents’ strengths, areas of need and activities they enjoy. Rotas are displayed in the kitchen and utility room for laying the kitchen table, washing and ironing, with support Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 13 from staff. One resident informed that she likes cleaning the sink, washing and ironing. Individual choices are recorded against, for example, residents’ personal hygiene requirements and the menu. Residents attend daytime activities identified to suit their needs and choices. They include attendance at groups that help to develop skills such as gardening; attendance at an African Caribbean group and advocacy. Residents also have a group trip out every weekend, on a bus or train, for example, to have lunch out or go to the pub. However one comment received in a preinspection survey stated that more external activities are needed. The Manager informs that all activities depend on the motivation of residents to engage in activities and the availability of activities suitable to individual choices and needs. However there is a commitment in continuing to explore other community resources that may be of interest to residents. One resident said she goes out and enjoys her activities. Residents in the home engage in activities including arts, crafts, playing music, watching TV and DVDs. The resident spoken to informed that staff also read to her as she is unable to do this for herself. Additionally, residents have summer holidays, spent this year in Yarmouth. Contact with family and persons significant to residents is maintained. Comments received in surveys show that family members have a high opinion of the service and that their relatives are made to feel at home. Residents’ access to the front door is monitored for their protection and an alarm is activated if residents try to go out. Residents have been assessed as not being suitable to have their own keys as they have been observed to become forgetful and distressed. A menu including pictures is on display on the kitchen wall with a choice of varied and balanced meals, as chosen by residents to suit their personal, cultural or ethnic preferences. Residents prepare their own lunch if they are able. The resident spoken to informed that she likes the food she eats in the home and that she also eats lots of fruit of her choice, particularly bananas. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 14 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): 18-20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ privacy is respected and dignity is respected. The home ensures that residents’ health care needs are met. Medication administration practises are safe. EVIDENCE: Residents’ privacy is respected and one resident commented that staff treat her well. She receives private phone calls, staff read for her, care for her well and knock on her door. Residents have postal votes. Correspondence, reports, review notes and health care appointments in residents’ files demonstrate that residents’ health care needs are met on an ongoing basis. Health care professionals such as psychiatrists, community nurses, dentists and GPs are currently monitoring residents. Surveys received from health professionals confirm that the Manager is in regular contact with them and seeks help from professionals promptly when required. Staff Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 15 complete forms recording all contact and advice received by health professionals. The home knows when to involve other professionals to help assess the changing physical and mental health needs of residents, for example, making a referral to a psychiatrist for one person with complex needs who is deteriorating and is awaiting a dementia test. There is also speech and language therapy and occupational support for someone who has difficulty chewing and communicating. Staff administer medication at the home. Staff have each received medication training from the chemist supplying the medication. The Director checks medication administration and records on a monthly basis as part of his regular monitoring visits. Medication administration records were correctly completed at the time of examination. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 16 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. Complaints are appropriately responded to and people are aware of how to complain. Significant discussions with staff must be recorded to ensure the safety and protection of residents. EVIDENCE: Whilst the whistle blowing procedure has been updated, it is not dated, making it unclear for staff whether this is a current policy and when it is due for review. There have been no complaints or incidents since August 2006. The complaints procedure is also available and given to residents in pictorial format. The Manager has addressed an issue with staff as regards the use of loyalty cards used by staff when making purchases using service users’ money. Residents now use their own loyalty cards when purchasing items belonging to them. However, whilst this has been addressed with staff and at a team meeting, these significant discussions have not and must be recorded. Ashbridge Road (22) DS0000007277.V345399.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): 24-30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The environment is clean, homely and suitable to meet the needs of the residents. The home needs to ensure that the garden also maintains a pleasant environment. EVIDENCE: The inspector was satisfied that the premises is suitable for the stated purpose, it was observed to be clean and well maintained. One bedroom was observed containing the residents’ personal possessions, including a television and radio. The water in the basin of the room remained cold for a considerably long time before it warmed up. The boiler system must be examined to address this. Additionally, the window in this room is only able to open at the top part of the window and is out of reach for the resident to open or close themselves. This is unsatisfactory and must be addressed. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 18 The home listens to residents’ views as regards the choice of colour in their rooms and one room has been redecorated according to the residents’ preference and a programme of redecoration is ongoing. The environment is furnished to a good standard and pictures on the walls, including in the hallway, create a homely atmosphere. The appearance of the garden however, which is generally well kept, is affected by mops and buckets left at the side which look unsightly and would benefit from some storage, and an overturned table intended to prevent it becoming waterlogged. It is recommended that more suitable garden furniture is purchased for residents. Ashbridge Road (22) DS0000007277.V345399.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): 31-36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who are familiar with their needs and are able to respond well to them. Robust checks are made as part of staff recruitment to ensure the safety of residents. EVIDENCE: Staff are clear about their roles and responsibilities and have received job descriptions. The Senior Care Officer confirmed that the staff are familiar with residents’ needs. Care workers share similar responsibilities however not all care workers are key workers. Staff observe the residents daily and key workers complete monthly progress reports. Residents’ daily needs and events are recorded and communicated verbally in handover. Team meetings take place monthly. Staff are each qualified to a minimum of NVQ Level 2 or 3. The two deputies cover for the Managers’ sickness or absence and have an NVQ level 2 and 3. There are two staff per shift and two wake in staff at night. There is low turnover of staff and staff express that a good team spirit exists among staff. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 20 One new staff member has been employed since August 2007, however staff files are mainly kept in the head office, so their records could not be examined. Staff records, either their files or a checklist of staff employment records, must be kept on site for the purpose of inspection. A checklist must include confirmation of whether the documents seen are deemed satisfactory. Other staff files examined contained all required documents, with the exception of confirmation that staff are physically and mentally fit. The inspector was advised that new application forms are now being used which have a health declaration in them. This will need to be checked in staff files for new staff at the next inspection. Staff receive induction and a staff training programme is in place. Monthly training records are kept for all staff who have attended training in a separate training file. The manager and deputies supervise monthly. These are recorded. Staff have received appraisals within the year, however appraisals were recently due for a couple of staff, though it was explained that the Manager was on holiday during this period. The Manager has a Personal Development Plan in her file. Recorded supervision notes are up to date in staff files. The majority of staff express a positive experience of working in the home and that residents are happy, well respected and their needs are met. One staff member commented that the home is overall of an average standards as more external activities could be organised. Ashbridge Road (22) DS0000007277.V345399.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): 37-43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The standard of service is generally raised and is reflective of improved management practises. Attention to detail is required to improve recording practises and procedures. EVIDENCE: The Manager demonstrates competence and experience in the management of the home, an intimate knowledge of the residents’ needs and a good relationship with them. The Manager is keen to have a service which is responsive to the diverse needs of the residents. She has an NVQ 4 Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 22 qualification and a range of training in relevant aspects of working with this user group, including communicating approaches in learning disability and person centred planning. There is a good working relationship between the Manager and staff, confirmed by staff spoken to. Regular checks are in place to monitor staff compliance with systems and procedures, such as medication, petty cash, incidents, complaints and the homes’ daily records. Monthly checks include reviews of care plans and risk assessments. The Director conducts monthly monitoring visits and monthly reports are produced. Surveys to parents and social workers seek out their views about the quality of the service. These are being conducted annually rather than every two years as previously. All comments seen in the surveys were positive about the service and a high level of satisfaction is expressed, particularly from the relatives. Policies and procedures are available in the home, though not all are dated. Recording practises have generally improved, though there remains areas requiring improvement, which have been highlighted in sections within this report. There is generally compliance with health and safety procedures, with the exception of that there are two fridges in the home, however staff take fridge and freezer temperatures for only one fridge. Weekly fire alarm and smoke detector tests are carried out and tests to ensure the emergency lighting. There are monthly fire drills. The maintenance and repair book records all work undertaken and prompt action taken. Areas requiring attention as identified at the previous inspection have been addressed: the fridge door has been replaced; the garden door and broken cupboard door in one bedroom repaired. A protruding hook in the shower has been removed. All safety certificates are available, with the exception of the water safety certificate which is currently awaited following the recent safety check. The public liability insurance was renewed in September 2007 and the business plan updated. Ashbridge Road (22) DS0000007277.V345399.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 3 2 3 3 3 4 3 5 3 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 1 25 3 26 3 27 3 28 2 29 N/A 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 2 3 1 3 Ashbridge Road (22) DS0000007277.V345399.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 YA23 Regulation 13(6) Requirement Discussion with staff about the use of loyalty cards when making service users’ purchases must be recorded. Ensure residents have access to and are safely able to open and close their bedroom windows. Staffing records (their files or a checklist of their employment records) must be kept on site for inspection purposes. Ensure the water in residents’ basins are sufficiently warm for their needs. All fridge freezer temperatures must be taken. Timescale for action 26/11/07 2. 3. YA24 YA34 23 19 10/12/07 10/12/07 4. 5. YA42 YA42 23 23 26/11/07 26/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Further improve care plans to integrate needs and goal setting as part of an overall care plan. DS0000007277.V345399.R01.S.doc Version 5.2 Page 25 Ashbridge Road (22) 2. 3. 4 5 6 7 8 YA6 YA9 YA9 YA14 YA24 YA28 YA40 All significant contact with Local Authorities to be recorded, including all requests for annual reviews. Improve residents’ risk assessments further by identifying the level of risk in each identified risk area. Ensure all risk assessments are signed by their author. Further explore external community resources to broaden residents’ day time activities. Provide more appropriate storage for the mops and buckets in the garden to improve the appearance of the garden. Purchase more suitable garden furniture suitable for the needs of the residents. All policies and procedures (including whistle blowing) must be dated. Ashbridge Road (22) DS0000007277.V345399.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Ashbridge Road (22) DS0000007277.V345399.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. 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