Inspection on 24/05/07 for Belchford

This inspection was carried out on 24th May 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Belchford 24/05/06

Belchford 31/01/06

Belchford 10/08/05

Belchford 12/11/04

Belchford 12/05/04

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

CARE HOME ADULTS 18-65 Belchford Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB Lead Inspector Mr Paul Emmerson Unannounced Inspection 24th May 2007 09:30 Belchford DS0000007457.V339840.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 Belchford DS0000007457.V339840.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. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belchford Address Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB 01429 836286 F/P 01429 836286 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) londonroad@tiscali.co.uk Milbury Care Services Limited Miss Claire Jackson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2006 Brief Description of the Service: Belchford provides residential care for up to seven people who have a learning disability. The home is a detached house with large grounds, in a rural setting. The centres of Durham and Peterlee are easily accessible by car. The home is run by Milbury Care Services Limited, an organisation that specialises in services for people with a learning disability. The Milbury organisation is part of the Paragon Group. From information provided by the home, the current scale of charges ranges from £1,145 to £1,633 per week. Additional charges, between £8 and £25 per week, are made as a contribution towards the home’s car. Belchford DS0000007457.V339840.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 6 hours, on the morning and afternoon of Thursday 24th May 2007. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for the people who live in the home. The inspector looked around the building and a number of records were examined. The manager and 3 members of staff were interviewed. Within the limits of their communication and understanding, the people who live at Belchford were also spoken to. On the day of the inspection there were no visitors to the home. However, 3 relatives and a care manager returned CSCI inspection questionnaires about the service. What the service does well: What has improved since the last inspection? Management and staffing arrangements are much more settled. More activities are being arranged. The people who live at Belchford have been away on holiday to Blackpool. Other outings are regularly arranged. Administrative arrangements are better organised. Care reviews have been carried out with other health and social care professionals. Care planning arrangements in the home have been revised. Documents used are easier to read. Pictures are used to help understand them. Where more information is required, detailed support plans are written. Some parts of the home have been redecorated and refurbished. Belchford is much more homely. The lounge looks attractive, feels comfortable and is a Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 6 pleasant place to sit. Bathrooms have been refitted and are better suited to meet the needs of the people who live at Belchford. 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. Belchford DS0000007457.V339840.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 Belchford DS0000007457.V339840.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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move in. A recent admission to the home was very well managed. EVIDENCE: Belchford is registered to accommodate up to 7 people with learning disabilities. On the day of the inspection 6 people were living there. One bedroom is vacant. Most of the people who live at Belchford have been there for some time. However, one person moved in earlier this year. The inspector was unable to communicate with most of the people who live at Belchford about their experience of moving in to the home. However, one person who lives at Belchford provided positive feedback. He said, “I like it here. I like my room, I like the garden”. In a CSCI inspection questionnaire a relative wrote, “Decisions have to be made for (our relative) by the staff. I feel the care home fills all his needs. He seems to be very happy with the staff and his environment, I can only go by his manner whether he is happy or not. Most of the time he is.” There is documentary evidence to show that prior to people moving in to Belchford appropriate assessments were carried out. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 9 After admission, more detailed care plans were prepared. The home has its own assessment and care planning documents for this purpose. A copy of assessment documentation and other relevant information from the local authority social services department was also obtained. In addition to trial visits, any move into Belchford is on a six-week trial basis. At the six-week stage a formal review meeting is held to consider permanency. The person who has just moved in to Belchford visited the home on numerous occasions before staying overnight. A record was kept of these visits. These document the person’s reactions to the visits and the people there. From speaking to this person he is settling in at Belchford well. The actions taken by the home to achieve this are commended. Belchford has a ‘Statement of Purpose’ and a ‘Service Users Guide’ to provide people with information about the home. The ‘Service Users Guide’ has been re-written in an easy to read pictorial format. The work required to do this is acknowledged. Belchford DS0000007457.V339840.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, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Within the limits of their communication and understanding the people who live at Belchford are offered choice and people’s diverse needs and aspirations are recognised. EVIDENCE: Although the inspector was unable to communicate with the people who live at Belchford to any significant degree, the inspector spent time in their company and spoke to the manager and staff on duty in the home. The people who live at Belchford have a high level of diverse care needs and can exhibit some quite challenging behaviour. However, they were seen to be well supported, well cared for and comfortable in their home. Staff who work at Belchford know and understand the people who live there well. The people who live at Belchford are on the whole dependent upon staff, family and significant others to make choices and decisions on their behalf and best interests. A lot of these decisions are limited by the learning disabilities and understanding of the people who live at Belchford. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 11 However, such limitations are noted on personal files. Within the limits of their communication and understanding, choice is offered to the people who live at Belchford. Preferences are provided for. Staff know the people who live at Belchford well and understand their behaviour and communication. During the inspection staff were able to explain to the inspector the meaning of people’s gestures. Where they did not immediately comprehend what was being gestured, staff asked appropriate questions to find out what was wanted. Staff were also heard to ask the people who live at Belchford if they wanted drinks, where they wanted to sit, what they wanted to do. In this albeit small way, staff were seen to be respecting people’s rights. Care plans have been prepared for all the people who live at Belchford. They have been rewritten in a pictorial and user-friendly style. These documents contain much information. Likes, dislikes and lifestyle preferences are recorded. The extra work involved to do this is acknowledged. Care reviews have been held. Detailed risk assessments have also been prepared. Risk management arrangements ensure that the people who live at Belchford can live as independent a lifestyle as possible. For example, 2 people who live at Belchford are able to make drinks and other snacks for themselves. Although limited by the inadequacy of the home’s kitchen facilities, they were seen to do this during the inspection. Care plans examined consider challenging behaviour in depth: any events or circumstances that may trigger such behaviour, and the various responses that staff can use to de-escalate it, are documented. The home operates a key-worker system. From discussions with staff and observations made by the inspector, staff are familiar with the needs of the people who use the service. Day-to-day communication in the home, recorded handovers between staff and house meetings ensure that any changes in need are identified and brought to the attention of other staff. Belchford DS0000007457.V339840.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): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are arranged. Contact with family / friends is supported. Dietary needs are met. EVIDENCE: Staff interviewed spoke about activities that have been arranged. Trips out include shows such as ‘Disney on Ice’ and rides out to the nearby coast. One day a week, one person who lives at Belchford attends a ‘Life Skills’ project in Hartlepool. The home has a people carrier car, which is used as transport. This is well used. Activity plans are kept for all the people who live at Belchford. These record activities planned and arranged. On the day of the inspection some people went shopping. Later in the day others went to Hartlepool Marina. Wherever possible, contact with family and friends is supported. Visitors are welcomed. If relatives do not have transport, staff assist by providing transport to and from the home. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 13 A wholesome and nutritious diet is provided. Fresh meat, fruit and vegetables were seen to be available. If people require assistance it is provided. Wherever possible, people are given a choice of meals and preferences are catered for. Since the last inspection of the home, menus have been revised. Likes and dislikes are accommodated, but a ‘healthier diet’ is being provided. Dietary needs are now being met much better. Belchford DS0000007457.V339840.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, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are appropriately met. Any medicines required are dealt with correctly. EVIDENCE: Although the inspector was unable to communicate with the people who live at Belchford to any significant degree, he spent time in their company and spoke to the manager and staff on duty. The people who live at Belchford have a high level of diverse care needs. However, they were seen to be well supported, cared for and comfortable in their home. From observations made by the inspector and from discussions with management and staff, where personal support is required it is provided appropriately. Care plans examined show that wherever possible, people are provided with guidance and encouragement to undertake their own self-care tasks, thus promoting independence in a dignified and respectful manner. In a CSCI inspection questionnaire a relative wrote, “We are very happy with (our relative’s) care. He is always nice and clean and well taken care of. The staff are always very nice to us when we visit. He is very happy at the home and loves living there.” Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 15 In a CSCI inspection questionnaire a care manager wrote, “They provide a good standard of support for very disabled and challenging people who are totally reliant upon staff for help with all aspects of daily need.” Appropriate moving and handling assessments have been carried out. Where necessary, advice has been sought from occupational therapists. However, as highlighted in the previous inspection report, to ensure safe moving and handling, the registered person must make proper provision for the care of one person who lives at Belchford. As detailed in the occupational therapist’s report a suitable portable hoist must be acquired. It is of some concern that the previous timescale of 1/9/06 has not yet been met. The care plans read by the inspector were seen to document people’s diverse personal and health care needs and the actions required and being taken to meet them. Care plans are thus a record of the care provided, but also inform the delivery of care within the home. They have also been rewritten in a pictorial, user-friendlier format. Care plans have been reviewed and updated. Where necessary, contact has been made with other professionals to ensure appropriate interventions required by staff are carried out. Although none of the people who live at Belchford retain, control or administer their own medication, because of their needs and dependency this is considered appropriate. Senior support workers administer medication in the home. These people have received appropriate training in this area. Other staff also receive instruction to understand the medicines prescribed, potential side effects etc. Medicines are correctly stored. The home uses a monitored dosage system. There are adequate policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines. Belchford DS0000007457.V339840.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. Within the limits of their communication and understanding, the views of the people who live at Belchford are obtained. Complaints and adult protection systems in the home serve to safeguard the people who live there. EVIDENCE: The home, through its parent organisation, has detailed complaints and adult protection procedures. These are available for staff use. Pictorial information about complaints, how and who to make them to, is included in the home’s ‘Service Users Guide’. Complaints are dealt with appropriately. House meetings, serve as an additional forum to discuss any issues. Staff spoken to voiced their commitment to the people they support and their rights. The home has a policy and procedure to follow in the event of an adult protection issue and there is an ongoing programme of training in the Protection of Vulnerable Adults. Training has also been provided to enable staff to respond to challenging behaviour and procedures are in place to safeguard the financial affairs of the people who live at Belchford. Belchford DS0000007457.V339840.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. Belchford is homely, clean, tidy and safe. People’s bedrooms are personalised. EVIDENCE: Belchford provides residential care for up to 7 adults (aged 18 – 65) with learning disabilities in 7 single bedrooms. 6 people live there at the moment. There is 1 vacancy. The occupied bedrooms have been personalised. The home is a detached house with large grounds, in a rural setting. The centres of Durham and Peterlee are easily accessible by car. The lounge has been redecorated and refurnished. The lounge looks attractive, feels comfortable and is a pleasant place to sit. There is a bathroom on both floors. There is a new bath upstairs. The ground floor bathroom has been made bigger - a walk-in shower and a high-low bath have been installed. However, the home’s kitchen also needs refitting. Not only are the units and appliances past their best, but the size and layout of the kitchen is unsuitable Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 18 for the needs of the people who live at Belchford. In particular, the current kitchen layout makes it difficult to promote the independence and safeguard from injury the 2 people who live at Belchford who are able to use the kitchen. The home’s kitchen arrangements should be reviewed. The inspector looked around the building, which was found to be clean, tidy and odour-free. Since the last inspection of Belchford, the laundry has been made bigger and is much more accessible to staff and the people who there. However, it was noted that the washing machine in the laundry is of a standard domestic type. To ensure that soiled laundry is washed properly, a more appropriate heavy duty washing machine with adequate sluice facilities should be acquired. Belchford DS0000007457.V339840.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 & 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Sufficient staff are employed. The home has a settled, well-trained and well-led staff team. EVIDENCE: Care is provided by a committed, well-trained and well-led staff team. Since the last inspection of the home, staffing and management arrangements are more settled. The staff know the people who live there well. 70 of staff have NVQs (National Vocational Qualifications) at level 2 or 3. Most of the home’s staff have also completed LDAF (Learning Disability Award Framework) training courses. An audit of staff training needs has been carried out. Staff training needs having been identified through formal supervision arrangements in the home. Although it is recommended that additional staff training about equality and diversity should be arranged, any training required is being provided. Activity in this area is commended. From discussions with staff, safe recruitment practices are followed. Recruitment procedures through Milbury’s regional office are considered to be Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 20 satisfactory and safe. Appropriate references are obtained and CRB (Criminal Records Bureau) disclosure checks are carried out. Due to the needs of the people accommodated, the agreed staffing levels for the home require at least four, sometimes 5 staff to be on duty throughout the waking day. At times, some of the people who live at Belchford require 2 staff to work with them and 6 staff are required. With night staffing arrangements (1 person awake, 1 person asleep) this equates to 493 weekly care hours for the home. These staffing hours are appropriate to the needs of the people who live at Belchford. Belchford DS0000007457.V339840.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 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Belchford is a well-run care home. EVIDENCE: The home’s manager has an NVQ (National Vocational Qualification) level 4 in care. She also has a ‘Registered Managers Award’ qualification. She provides effective leadership to the home’s staff team. Staff interviewed spoke of good communication and effective teamwork. One member of staff interviewed said, “This is the best job I’ve ever had”. Appropriate systems are in place to ensure the health and safety of the people who live at Belchford, and the staff who work there, is protected. For example, risk assessments and control measures relating to activities outside the home are appropriately carried out. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 22 In a CSCI inspection questionnaire a care manager wrote, “Residents’ daily care needs present a challenge, which the staff seem able to meet well. Belchford is an honest environment where what you see is what you get and I have no evidence to suggest cause for concern.” Milbury Care Services Limited has policies, procedures and systems relating to quality assurance, and regular audit checks are undertaken and forwarded to the regional office. An annual service review is conducted. As part of this review the views of various stakeholders are sought. Monthly visits by a senior manager as required under Regulation 26 of the Care Homes Regulations 2001 are carried out. A report of these visits is written and copies are provided to the manager of the home. Belchford DS0000007457.V339840.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 4 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 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 3 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 Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA18 Regulation 12 Requirement As highlighted in the previous inspection report, to ensure safe moving and handling, the registered person must make proper provision for the care of one person who lives at Belchford. As detailed in the occupational therapist’s report a suitable portable hoist must be acquired. The previous timescale of 1/9/06 has not been met. Timescale for action 01/09/07 Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA24 YA30 YA35 Good Practice Recommendations To promote the independence and safeguard from injury of the people who live at Belchford who are able to use the kitchen, kitchen arrangements should be reviewed. To ensure that soiled laundry is washed properly, a more appropriate heavy duty washing machine with adequate sluice facilities should be acquired. To improve staff awareness about issues relating to equality and diversity, staff training in this area should be arranged. Belchford DS0000007457.V339840.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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