Inspection on 16/06/06 for Brandley Ltd. (Orchid House)

This inspection was carried out on 16th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brandley Ltd. (Orchid House) 23/01/06

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Edenvale

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Brandley Ltd. (Orchid House) Orchid House 49 Elsenham Road Manor Park London E12 6JZ Lead Inspector Anne Chamberlain Key Unannounced Inspection 16th June 2006 10:15 Brandley Ltd. (Orchid House) DS0000062815.V298770.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 Brandley Ltd. (Orchid House) DS0000062815.V298770.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. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brandley Ltd. (Orchid House) Address Orchid House 49 Elsenham Road Manor Park London E12 6JZ 0208 478 1517 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) Beverley.beaupierre@btinternet.com Brandley Ltd. Ms Beverley Beaupierre Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To allow the home to provide continuous care for a named service user, who is now over the age of 65 years. 23rd January 2006 Date of last inspection Brief Description of the Service: Orchid house is run by Brandley Residential Homes. The home is a three bedroomed property in a residential road in the borough of Newham. The home is registered for three adults between the ages of 18 and 65. However a variation has been obtained for a service user who is now over 65 years of age. The service users all have a learning disability. The home offers care and support in a homely environment. There are pleasant shared spaces including a family kitchen and a nice little garden. Showering, bathing and toilet facilities are good. The office/sleep in room is located upstairs with an en-suite shower room. There are currently three service uers living at Orchid house and they are supported by one staff member on every shift, including sleep in night staff. Service users have access to day services and they are enabled to participate in community leisure activities. Service users are supported and encouraged to be as independent as possible. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two short days. It was unnanounced. The aim was to cover the key inspection standards and to monitor progress in meeting requirements from the previous inspection. The inspector spoke with one service user and one member of staff. The manager and a second member of staff were also interviewed by her. Feedback was sought from staff at two day centres attended by two of the service users at the home. The inspector looked around the house and garden (with the exception of two bedrooms). She viewed key documentation as well as three service user files and three staff files. The also inspected the arrangements for the administration of medication were inspected. The inspector would like to take this opportunity to thank the service users, manager and staff at Orchid House for their co-operation and assistance with the inspection. What the service does well: What has improved since the last inspection? The home has responded very positively to previous requirements with only one being restated in this report. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 6 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. Brandley Ltd. (Orchid House) DS0000062815.V298770.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 Brandley Ltd. (Orchid House) DS0000062815.V298770.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Needs are assessed and service users have individual contracts. EVIDENCE: Three service user files were inspected. The inspector saw evidence of comprehensive assessment of needs. The previous inspection required that the manager ensure service users have contracts. The inspector viewed contracts on the files of service users and these were signed and dated by both parties. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Care plans and risk assessments are in place and service users are supported to take decisions. EVIDENCE: The previous inspection required the manager to ensure that service users (care) plans were drawn up and that these are reviewed and updated regularly. Care plans have been developed and these are sufficiently detailed. The manager stated that there will be continuous development of these plans as the needs service users change. The care plans will be reviewed annually. Care plans and risk assessments evidenced that service users are encouraged to take decisions. A day centre which a service user attends stated that he is Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 10 very well supported from home, always coming in with the right things for any activity he had chosen to do. The previous inspection required that comprehensive risk assessments be developed. The inspector viewed the risk assessments on file. Risks are listed on long risk assessment and are then addressed on specific risk assessments. There were risk assessments for off site activities and lone working. The documentation was satisfactory. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16 and 17. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Service users take part in a range of appropriate educational, leisure and recreational activities in the community. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. EVIDENCE: Two of the service users attend day centres which they seem to really enjoy. One has retired from his day centre but attends a music class at college once a week, and has a programme of activities in the home and community. He particularly likes to walk to the local park. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 12 The support worker interviewed was able to give the inspector lots of examples of service users enjoying trips out and about. Service users attend a mid week club locally. They spend time with their peers from Sunflower House, the sister home, and generally get on very well together. Over the recent Easter weekend the service users went caravanning in Clacton. They enjoyed the break and walking to the local attractions. The home supports relationships with families and does all it can to promote contact. The manager was able to report on visits and the inspector felt that there has been some consolidation of contact. The inspector viewed the daily logs for service users. These supported the foregoing evidence regarding social inclusion and community activities. They also evidenced service users daily routines. The manager and support worker were able to talk in detail about the differing skills and strengths of service users, and how these are supported and developed through domestic and other activities. The inspector saw the record of food consumed by service users. Also laminated sheets with illustrated meals ideas. She felt that these would be very useful for stimulating discussion and encouraging people to express preferences around food. The manager stated that all the service users eat well and they particularly enjoy eating out in cafés and pubs. The mealtime environment at Orchid house is particularly good as the house has a ‘family’ kitchen which looks out over the garden, and service users eat together there. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The personal care, health and emotional needs of service users are well met. EVIDENCE: The inspector was told that service users have a choice of shower or bath and will use both. The inspector believes that communication between staff and service users is good and that this supports preferences in personal care as well as other areas. The previous inspection required that some recording of the meeting of emotional, physical and health needs be available for inspection. The inspector found that service user files showed all the service users recently saw the hygienist. There was also evidence of a service user seeing the specialist nurse for epilepsy. The home appears to be responsive to the emotional needs of service users, understanding that to one individual her dolls are very important. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 14 The inspector viewed the arrangements for the administration of medication. Only one service user in the home regularly takes medication. She does not self medicate. The inspector checked her Medication Administration (MAR) chart against her remaining medication and there was no discrepancy. There were however two medications which had been discontinued and the chart was not clearly marked to show this. Also one of the medications was still retained (an empty tube of ointment). The MAR chart must clearly show when a medication has been discontinued and the medication should be disposed of. The previous inspection required the manager to amend the medication policy, removing the word summary from the title and referring appropriately to other policies to which it is linked. The word summary has been removed but the reference to other policies is not quite correct and the manager undertook to amend this. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Service users views are valued and they are protected from all forms of neglect and abuse. EVIDENCE: At the previous inspection the inspector viewed the complaints recording and the adult protection procedural guidelines, which were both satisfactory. The manager stated that there have been no complaints since the last inspection. Since the previous inspection the situation with the service users benefits has been resolved. They are now all in receipt of appropriate benefits from the benefits agency. The home continues to pay the personal allowances (recovering these from the funders), so that any hiccoughs in payments are not directly felt by service users. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 24 and 30. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The environment at the home is good, homely, clean and hygienic. EVIDENCE: Orchid House is comfortable and homely. The rear garden on inspection was tidy and welcoming and the inspector understands that the service users make full use of it in the summer. The previous inspection required the manager to replace the two sofa’s in the sitting room. This has been done and the room is now comfortably furnished. There are however a stack of waste paper bins in the room and the inspector recommends that waste bins not in use be stored in a cupboard. There is also a mirror resting on the floor behind a sofa, because it is large and difficult to hang. The inspector recommends that the manager resolve the issue of the heavy mirror, so that it is either hung or removed. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 17 The home is clean, hygienic and free from offensive odours. It is small and domestic in scale and the manager explained that as the washing machine is located in the kitchen, there is a policy that laundry is only dealt with outside of meal times and when no-one is cooking. Laundry is done during the day after breakfast. Service users can help with folding and putting away later in the day when they are home. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home recruits staff carefully, trains them adequately, and ensures that they are competent and qualified to support service users effectively. Staff are adequately supervised. There are however two requirements made to improve staffing practice. EVIDENCE: The previous inspection required the manager to take out the sentence In exceptional circumstances verbal references may be sought and accepted., from the staff recruitment policy. This has been done. The manager was also required to ensure that staff have two written references and that they have service contracts on file, signed and dated by both parties. The inspector viewed the staff personnel files, and their supervision records. Both the above requirements have been largely met. The files evidenced a robust recruitment procedure, but there were a number of minor points which the inspector brought to the managers attention. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 19 One staff record lacked a contact telephone number, one lacked an appraisal date, one lacked a staff signature on a contract and one had no leave chart. The manager must ensure that staff files are kept in a uniform way, with all necessary information and documentation. Although there is some documentary evidence, and the inspector is satisfied that all staff have current Criminal Records Bureau (CRB) checks in the name of the home, it is unfortunate that the manager has not retained the serial numbers of these checks. The manager has undertaken to obtain the numbers from the staff themselves, who have their own copy of the disclosure. She stated that she now has nearly all of them. The manager must ensure that she has available for inspection the serial numbers of the CRB checks of all staff working at the home. The manager stated that the four regular staff members all have NVQ 2, except one who is working towards it. The most recently recruited member of staff has NVQ 3. One staff member has NVQ 3 in multimedia. The previous inspection required the manager to ensure that staff receive induction and basic training, core elements being renewed regularly. Also that staff have up to date training profiles available for inspection. The staff files had training profiles which evidenced induction and basic training The previous inspection required the manager to ensure that staff have supervision six times per year. This was evidenced with clear records of supervision sessions. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to the service. The home is generally well run on a day to day basis, but four requirements have been made with regard to safety, one of which is a serious concern. A requirement has also been made with regard to quality assurance. EVIDENCE: The previous inspection required that service users have contracts with terms and conditions, signed by both parties, with a copy kept on the service users file. As previously stated the inspector noted on service user files, contracts, properly signed and dated. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 21 The manager does not have a deputy at Orchid House but she stated that should she need someone to deputise she could call on the deputy of the sister home to assume that role. The inspector had a discussion with a member of the care support staff regarding equality and diversity within the service. He was able to give excellent examples of how the service advocates for service users in the community, and works to achieve normalisation for them. The staff group is culturally diverse and the ethos of the service strongly underpins equal opportunities. The inspector felt that although the service users have lived a relatively short time in the home, there is evidence of the success of this ethos. This was echoed in the feedback from the day services. Staff there remarked on how much more independent one service user was and said another had come on by “leaps and bounds”, since moving into the home. The inspector believes that service users are consulted on most aspects of the running of the home. She viewed the minutes of the residents meetings where they are encouraged to plan holidays etc. The organisation has a five year plan, shared with the sister home, but not an annual development plan. The manager agreed that it would be appropriate to have an annual plan tailored to the needs of service users where goals are set to be achieved by them with the support of the staff. The manager agreed to develop an annual plan. The previous inspection required the manager to ensure that incident sheets are completed appropriately and retained as a record. The inspector viewed a completed sheet for an incident some months ago and the manager stated that there had been no incidents since then. The inspector viewed the arrangements for storing cleaning and other items which should be stored in compliance with the Control of Substances Hazardous to Health (COSHH) 1999 Regulations. There is a locked cupboard in the kitchen for these. However two large bottles of liquid bleach were stored under the sink in an unlocked cupboard. The worker who was assisting the inspector stated that none of the service users ever go to these cupboards, and the bleach was stored in the unlocked cupboard because the bottles were too big to go into the locked cupboard. This failure to comply with safe storage of hazardous substances is a serious concern. The manager must ensure that hazardous substances are locked away under all circumstances, in compliance with the Control of Substances Hazardous to Health (COSHH) 1999 Regulations. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 22 The inspector checked four items kept in the home against the list of products used, and product information sheets. They were all listed and product information for them was available. The inspector felt that the COSHH information retained was satisfactory. The inspector viewed the records of monitoring of water temperatures, which were satisfactory. She viewed the fire protection arrangements. Fire drills were acceptably frequent but rarely involved staff, being undertaken by the manager. The manager must ensure that staff members have an opportunity to participate in fire drills. The manager stated that the home undertook its own fire safety assessment upon opening and the fire officer called and issued a Fire Certificate. The inspector saw a Fire Prevention Sheet by MJL a quality assurance company which the home consults. The manager stated that they also have fire equipment checked by an outside contractor on an annual basis, when a certificate is issued. The inspector saw evidence (in the visitors book) that Portable Appliance Testing (PAT) had been undertaken recently. The report had not yet arrived. The inspector viewed the monitoring of refrigerator and freezer temperatures. These had not been undertaken on a weekly basis. The manager must ensure that there is proper monitoring of refrigerator and freezer temperatures. The inspector checked the contents of the refrigerator and noted an inconsistency in labelling of food with date of opening. The french dressing had been labelled but not the mayonnaise. The manager must ensure that all perishable food kept in the refrigerator is labelled with the date of opening. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 3 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 3 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 2 x 3 3 2 x x 2 x Brandley Ltd. (Orchid House) DS0000062815.V298770.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 YA20 Regulation 12 Requirement The manager must ensure that MAR sheets are clearly marked when a medication is discontinued. Also that unused medication is disposed of. The manager must ensure that the medication policy makes appropriate reference to other policies to which it is linked (previous timescale of 01/04/06 not met). The manager must ensure that staff files are kept in a uniform way with all necessary information and documentation. The manager must ensure that she has available for inspection the serial numbers of the CRB checks of all staff working at the home. The manager must develop an annual development plan for the home. The manager must ensure that hazardous substances are locked away under all circumstances, in compliance with the Control of Substances Hazardous to Health (COSHH) 1999 Regulations. Timescale for action 01/07/06 2. YA20 12 01/07/06 3. YA34 19 01/08/06 4. YA34 19 01/08/06 5. 6. YA39 YA42 24 13 01/12/06 01/07/06 Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 25 7. YA42 23 8. YA42 16 9. YA42 16 The manager must ensure that staff members have an opportunity to participate in fire drills. The manager must ensure that there is weekly monitoring of refrigerator and freezer temperatures. The manager must ensure that all perishable food kept in the refrigerator is labelled with the date of opening. 01/08/06 01/08/06 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA24 Good Practice Recommendations Waste bins not in use should be stored in a cupboard. The inspector recommends that the manager resolve the issue of the heavy mirror. Brandley Ltd. (Orchid House) DS0000062815.V298770.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 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 Brandley Ltd. (Orchid House) DS0000062815.V298770.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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