CARE HOME ADULTS 18-65
AUTISM INITIATIVES - 1-2 LILFORD COURT Havisham Close Birchwood Warrington WA3 7JZ Lead Inspector
David Jones Unannounced 26 and 27 April 2005 12:00
th th 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 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 Stationary 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. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Autism Initiatives - 1-2 Lilford Court Address Havisham Close Birchwood Warrington Cheshire WA3 7JZ 01925 817103 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Autism Initiatives Mrs Lindsey Briggs Care Home 8 Category(ies) of LD Learning Disability (8) registration, with number MD Mental Disorder (8) of places AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 The home is registered for a maximum of 8 service users to include: * Up to 8 service usrs in the category LD (learning disability under the age of 65 years. * Up to 8 service users in the category MD (mental disorder, excluding learning disability or dementia, under the age of 65 years). * Up to 8 service users may be in both categories LD (learning disability under 65) That Mrs Lindsey Briggs achieves the Registered Managers Award by the end of July 2005. The registered person, must at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2 3 Date of last inspection 4th February 2005 Brief Description of the Service: 1-2 Lilford Court is located at the head of a cul-de-sac within a residential part of Warrington town. The home is established to provide care specifically for service users with Autistic Spectrum Disorder and is provided in two adjoining, four bedded houses, which share the same staff team. Each house is set within spacious gardens and provides separate entrance and entrance hall, a lounge, kitchen, dining room, multi sensory room, office space, individual single bedrooms and domestic style bathing and showering facilities. The premises are not adapted to accommodate the needs of people who have a physical disability. Access to local amenities and public transport is good and the service is provided with two minibuses, which are used on a daily basis. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was a routine unannounced inspection carried out as part of the Commission for Social Care Inspection’s duties. The inspection took place over two days for a duration of 7 hours. Three members of staff and the registered manager were spoken with during the inspection. Five service users were also spoken with but discussion was limited due to communication difficulties. The inspector observed staff interacting with and supporting service users. The gardens and some parts of the building were looked at, as were some records and the case notes of three service users. What the service does well:
The home provides comfortable, spacious and well-equipped accommodation, which has been decorated and furnished in accordance with service users’ personal needs and wishes. The support staff team work closely with service users, their family members and health and social care professionals to identify the individual’s needs and provide appropriate arrangements for support and care. Admissions to the home are carefully planned and new service users and their families are enabled to “test drive” the home prior to admission. The majority of staff who are employed to work at the home have been specially trained to meet the needs of the service users with Autistic Spectrum Disorder and are able to help them cope with challenging situations. Care plans are detailed and provide clear guidance as to how each service users needs are to be met. Service users are enabled to make decisions and are supported to take measured risks as part of the development of an independent life style. Each service user is enabled to take part in range of chosen activities including visiting local community facilities such as shops, cafes and pubs. Visitors are made welcome at all reasonable times and support staff help service users to maintain family links and personal relationships.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 6 The home’s atmosphere was relaxed and sociable. Staff were seen to interact positively with service users offering discreet but timely prompts to enable them to take part in day-day activities in the home. Service users, who were at ease in the home’s environment, interacted confidently with staff and were able to make their needs known. What has improved since the last inspection? What they could do better:
Staff must take more care when writing reports to ensure that the incidents referred to are accurately described. Senior staff must review reports and analyse incidents where physical restraint has been used to ensure that care and support is provided in accordance with service users needs. Service users advocates including family members, social workers and health care staff should be notified of incidents where physical restraint has been used to ensure that they may speak on the service users behalf if this is necessary. Agency staff must only be used when the manager is satisfied and can demonstrate that they have been appropriately inducted and are sufficiently trained, experienced and able to meet the service users needs. This will ensure, as far as possible, continuity of care which is important to service users with Autistic Spectrum Disorder.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 7 The manager should obtain an up to date copy of Warrington Borough Councils Adult Protection Protocol. This will provide staff with further guidance as to what action to take in the event of an incident or suspicion of abuse. 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. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4. New service users are admitted only on the basis of a full assessment undertaken by competent persons and involving the prospective service user and his/her family members and health and social care advisors. Prospective service users visit the home and they and their advocates are assured that their needs, likes, dislikes and wishes are known and will be catered for. EVIDENCE: Perusal of case records and discussion with management and staff confirmed that service users were admitted to the home subsequent to appropriate assessment and admission processes which involved the service user, their family members and their health and social care advisors. Assessments seen were derived from initial care management assessments provided by placing agencies and were subsequently developed via comprehensive monitoring and review arrangements. Care plans reflected each individual’s aspirations and personal goals and confirmed how all identified needs were to be met. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, and 9. The home’s assessment and care planning systems ensure that service users and their representatives are placed at the centre of decisionmaking and the development of detailed and risk assessed plans of care. This enables the service user aided by his/her representatives to better understand how their assessed and changing needs are to be met in the development of independent lifestyle. EVIDENCE: Care plans seen were comprehensive in design and provided clear indications at to how each individual service user’s needs were to be met. There was clear evidence that care and support plans were drawn up with the involvement of the service user and their representatives. The strategies relating to behaviour management were linked to a S.C.I.P model (strategies for crisis intervention and prevention). Information provided by the manager and perusal of the minutes of review meetings confirmed that these strategies had been discussed and agreed at recent review meetings, which had involved service users’ representatives. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 11 Discussion with staff, observation and perusal of the home’s record systems confirmed that risk assessment and risk management was central to the home’s operation. Service users were enabled to take risks in the interests of the development of an independent life style and were supported by strategies designed, implemented, evaluated and reviewed within a risk management framework. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Service user are enabled to engage in a range of activities suitable to their individual needs and preferences and are supported to access the local and wider community and maintain family relationships. EVIDENCE: Each service user has a comprehensive activities programme covering the seven day week which is designed and structured to individual needs and personal preferences. Activities included attendance at the organisation’s day services, social activities, visits to community facilities including the pub, shops, parks, public swimming baths and other places of interest. Staff enable service users to access and take advantage of opportunities presented to them in the local community. Strategies to enable service users to access places, where the presence of other unfamiliar people may present the service user with challenges, such as the pub were designed and implemented, monitored and evaluated with the full involvement of the service user and his/her representatives.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 13 It was not possible to converse with service users because of communication difficulties and or to ascertain their views as to whether the range of activities were appropriate to their needs. However, perusal of the home’s record systems, including minutes of review meetings at which family members and other representatives were present, confirmed that service users were assisted to make choices and personal preferences were understood and respected. Staff support service users to maintain family links inside and outside the home. Case files perused as part of the case tracking exercise and discussion with staff confirmed regular contact with service users family members. Visitors were made welcome in the home and the birthdates of family members were recorded to help the service users to remember and send birthday cards when required. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18. Procedures and practices for the recording and analysis of incidents where staff deploy positive intervention techniques including restraint, service users were not sufficiently robust to ensure that care is provided in accordance with agreed strategies. Unless such incidents are recorded accurately and are thoroughly reviewed by senior staff service users are not assured that care will be provided in a manner which maximises their independence and control over their own lives. EVIDENCE: Reports relating to incidents where staff had deployed positive intervention techniques in the interests of the welfare and protection of service users were examined as part of the case tracking exercise and were subsequently discussed with members of staff involved and the registered manager. It was evident that a report relating to an incident, which occurred in the home on 20th April 2005, was misleading and another report relating to an incident where physical restraint was used, which occurred on a canal boat during an outing on 24th April 2005, was inaccurate. The registered persons must ensure the accurate recording of such incidents and that an analysis is made of each incident that involves any form of restraint to ensure that care and support is provided in accordance with agreed practices and procedures. See requirement 1.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 15 It is recommended that the relevant service users advocates including family members and health and social care professionals are notified of incidents involving physical restraint in the interests of the advocacy and protection of individuals concerned. See recommendation 1. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. Policies and procedures on adult protection ensure that appropriate action will be taken to protect service users in the event of any suspicion of abuse. EVIDENCE: The home maintains a copy of the internal adult protection policy, which includes reference to the Department of Health guidance ‘No Secrets’. Information provider by the corporate director of Autism Initiatives confirmed that the organisations policies where under review to ensure consistency with the local authority’s adult protection procedures. The registered manager had acquired a draft copy of the local authority’s adult protection procedures. It is recommended that the current version of these procedures is acquired for future reference. See recommendation 2. Information provided by the registered manager indicated that all staff had received guidance in the implementation of adult protection procedures. Training needs identified during a recent staff training needs analysis were to be addressed in the near future. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The premises are suitable for its purpose and provide service users with comfortable, clean and well equipped accommodation. EVIDENCE: Service users live in a homely and comfortable environment. The home was found to be spacious, bright, cheerful, airy and clean throughout. The premises are in keeping with the local community and have a style and ambience that reflects the home’s purpose. Each of the two houses reflects the personalities needs and preferences of the respective service user groups. The gardens were well maintained and new carpets were being fitted to the hall, stairs and landing and dining rooms in each house. The door to a service user’s bedroom, which was a fire door had been damaged in a recent incident as had plaster in the hall way adjacent to the bathroom. Interim repairs had been made and the door from the shower room had been removed and refitted to the bedroom door to ensure the service users privacy. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 18 The shower room door was not a fire door and whilst it was recognised that this was not an ideal solution it was evident that the manger had taken all reasonable steps to ensure that the health, safety and rights of service users were preserved. The manager advised that she had reviewed the home’s fire risk assessment and had reported the matter to the housing association. It is expected that the housing association will carry out the necessary repairs in the near future. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35. Sufficient numbers of staff are provided and a satisfactory stafftraining programme for permanent staff is in place. However, there is high usage of agency staff, with little evidence that they have undergone appropriate training. This could result in a lack of continuity of care and support for service users. EVIDENCE: Staffing rotas looked at during the inspection and discussion with staff and the registered manager confirmed that staff were deployed in appropriate numbers in accordance with the assessed needs of service users. Staff were deployed flexibly to meet varying requirements throughout the day with a minimum of five and a maximum of eight support workers on duty when service users were at home or going out. When service users were at the day centre numbers of staff were reduced according to the specific needs of those who remained in the home. Agency staff worked approximately 30 shifts each week at the time of the inspection. Staff spoken with during the inspection raised concerns about this and an incident was highlighted where an unprepared member of staff had reportedly given rise to a service user’s anxiety.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 20 Information provided by the manager indicated that the incident in question had occurred in December 2004 and the member of staff had not since been used in the home since. The vast majority of agency staff were said to be familiar with the needs of service users, their care plans and agreed strategies. All agency staff were said to be inducted and familiarised with service users’ needs and care plans prior to being deployed in the home under the supervision of a member of the support staff team. Induction records were available for only one of the eight agency staff currently being used in the home and the manager was in the process of gathering training data for each agency worker from the respective agencies. It is recommended that the registered persons maintain comprehensive staff induction records and that training records relating to agency staff are obtained prior to them being deployed in the home, wherever this is reasonably practicable. See recommendation 3. The continuity of care of service users will remain at risk until such time as the registered persons are able to demonstrate that all staff deployed in the home are suitably inducted and trained to meet service users needs. See requirement 2. It was positive to note that the registered manager had made good progress in recruiting staff from the Warrington Area. An open day had been held in the local shopping centre and advertisements had been posted in the local press. This had resulted in a number of job applications being made by local people. The registered manager had conducted a staff training needs analysis and was in the process of identifying appropriate training opportunities via the organisations staff-training programme. The home has an allocation of 14 support staff, excluding 3.5 vacant posts. One member of staff had achieved an NVQ at level 2 and one at level 3. A further five staff were working towards the NVQ awards and a further 3 were provisionally booked on to the organisations training programme to commence the qualification. The manager is an NVQ assessor and is able to support 3 members of staff through the qualification and arrangements had been made to appoint an external assessor to assist with the remaining staff. The registered persons should ensure that at least 50 of the staff team attain qualification at NVQ level 2 in care or above. See recommendation 4. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 41. The registered manager is qualified, competent and sufficiently experienced to run the home and meet its stated purpose aims and objectives. Records required by regulation for the protection of service users were found to be either misleading or inaccurate and the home’s reporting procedures did not afford service users appropriate levels protection. EVIDENCE: The registered manager who presented as a committed and caring professional has in excess of two years experience in a supervisory capacity has a Diploma in Health and Social Welfare, a degree in Psychology and had recently completed the Registered Managers Award course and was awaiting assessment and certification. Staff spoken with spoke highly of the manager indicating that she was knowledgeable, provided leadership and was supportive and accessible.
AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 22 As identified above in this report under the heading “Health and Social Care” records relating to two incidents in the home where staff had deployed positive intervention techniques were either misleading or inaccurate. See requirement 1. An incident, which involved the physical restraint of a service user by two members of staff on an outing in the community, should have been reported to the Commission for Social Care Inspection under the provisions of regulation 37. See requirement 3. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 2 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
AUTISM INITIATIVES - 1-2 LILFORD COURT Score 2 x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 x x F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 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 18 Regulation 12 and 17 Requirement Timescale for action 30.05.05 2. 32 and 33 18 3. 41 37 The registered persons must ensure that records maintained to promote and make proper provision for the welfare of service users are accurate and are reviewed as required to ensure that care is delivered in accordance with agreed strategies. The registered persons must 30.05.05 ensure that the deployment of tempoary staff does not prevent service users from receiving such continuity of care as is reasonable to meet their needs. The registered persons must 30.05.05 ensure that the Commission for Social Care Inspection is notified of any incident that affects the well being of a service user without delay. AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 18 23 32 Good Practice Recommendations The registered persons should make sure service users advocates and health and social care professionals are notified of incidents involving physical restraint. The registered persons should obtain a copy of Warrington Borough Council’s adult protection procedures for future reference. The registered persons should maintain comprehensive staff induction records and obtain training records relating to agency staff prior to them being deployed in the home, wherever this is reasonably practicable. The registered persons should ensure that at least 50 of the staff team attain a qualification in care at NVQ level 2 or above. 4. 32 AUTISM INITIATIVES - 1-2 LILFORD COURT F51 F01 S27020 Lilford Court V223425 260405 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Unit D, off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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