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Inspection on 04/10/05 for Bromley Road (44)

Also see our care home review for Bromley Road (44) for more information

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The environment is well maintained and decorated in a comfortable and homely way. There are aids and adaptations located throughout the home, including specific bedrooms. Residents are able to continue with their usual activities during their stay and the home offers a relaxed and friendly environment.

What has improved since the last inspection?

There has been some progress in medication practices improving the safety and well-being of residents in their care. The home has also ensured that the regular checks are undertaken on the fire alarm and the fixed wring within the home has been checked. Since the last inspection the Provider has agreed that staff recruitment records are kept in the home and terms and conditions of residency have now been developed, giving the residents and their relatives full information on the care provided. There has also been progress in the monitoring procedures. Monthly visits take place to check procedures are being implemented and to ensure the quality of care provided. These visits are supported by the regular checks and audits made by the Manager on a number of areas. The monitoring is important as they identify any shortfalls in the care and action can be taken to manage the areas of concern.

What the care home could do better:

The care planning and risk assessment procedures are adequate. However, the inspection identified some gaps and shortfalls in the information required to enable staff to support and care for the service users. This information related mainly to risks to service users and guidance on how well-being may be maintained. The home now maintains the staff records with related recruitment information. However, not all the documents have been obtained which could potentially place residents at risk. This must be addressed. The inspectors have raised, on a number of occasions, the need to ensure the home meets the NVQ 2 requirements for support staff.

CARE HOME ADULTS 18-65 Bromley Road (44) 44 Bromley Road Beckenham Kent BR3 5JD Lead Inspector Wendy Owen Unannounced Inspection 4th October 2005 09:30 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bromley Road (44) Address 44 Bromley Road Beckenham Kent BR3 5JD 0208 658 7829 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) valerie.beazleyromley.gov.uk London Borough Bromley Care Home 7 Category(ies) of Learning disability (6), Physical disability (3), registration, with number Sensory impairment (6) of places Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered as a (CRH) Care Home, with a service category of (PC) Care Home only, with a Service User Category of (LD) Learning Disability 6, (PD) Physical Disability 3 and (SI) Sensory Impairment 6 of both sexes for all categories. Registration is subject to the office accommodation for the cluster Houses/Supported Living being relocated as agreed in the letter dated 13 June 2003 from Margaret Howard (Assistant Director Adults) 10th May 2005 2. Date of last inspection Brief Description of the Service: 44, Bromley Rd is a purpose built care home owned by the London Borough of Bromley. The Registered Provider is the London Borough of Bromley Adult Division. The home is managed and staffed by employees of this service. It is located within a residential area of Beckenham and is close to transport links and Beckenham town centre, with its range of shops and leisure facilities. The home has recently been registered to provide respite care to a total of 7 adults. The home provides care to adults within the following groups; 6 with a learning disability; 6 with a sensory impairment and 3 with physical disabilities. Communal and private accommodation is set on three floors accessed by stairs. A newly appointed manager is now in post and is in the process of completing an application to be registered with the Commission. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of one day and included a tour of the building: discussions with the Manager and viewing of records. Only two service users are in respite care at present both of whom were out on the day of the inspection. Comment cards were left to enable residents and other interested parties to provide feedback. Three feedback cards were subsequently received. What the service does well: What has improved since the last inspection? There has been some progress in medication practices improving the safety and well-being of residents in their care. The home has also ensured that the regular checks are undertaken on the fire alarm and the fixed wring within the home has been checked. Since the last inspection the Provider has agreed that staff recruitment records are kept in the home and terms and conditions of residency have now been developed, giving the residents and their relatives full information on the care provided. There has also been progress in the monitoring procedures. Monthly visits take place to check procedures are being implemented and to ensure the quality of care provided. These visits are supported by the regular checks and audits made by the Manager on a number of areas. The monitoring is important as they identify any shortfalls in the care and action can be taken to manage the areas of concern. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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): 5 The home provides residents with good information on what they can expect from the home, enabling decisions to be made on whether the service provided is appropriate and suitable for the individual. EVIDENCE: The home has, over recent months, developed terms and conditions for residents who are in respite care. The contract covers many of the areas required by the Regulations and standards. Whilst the documents details some of the rights and obligations of service users and Provider, there is a need to detail the circumstances under which a respite may be cut short to ensure residents and their relatives are fully aware that this may occur. The Manager should also review the document taking into consideration standard 5. Each resident has a copy of the terms and conditions on their files and the Manager has started the process of gathering residents and their representatives’ agreement and signatures. (See recommendation 1) Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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 & 9 There are gaps in the information staff require to meet the individual needs, which place service users potentially at risk. EVIDENCE: One care plan was viewed in detail. This contained “pathways to independence” information, a care plan identifying strengths and weaknesses, risk assessments on daily living tasks and some guidance on mental health, in particular, relapse prevention. However, some information identified areas of risk such as challenging behaviour and self- harm. There was very little information on the potential risks; their triggers, signs or the action the home can take to minimise the risks and ensure the individuals safety. This information would provide staff with the required information to provide this support. (See requirement 1) A previous report identified the need to develop individual risk assessments, where there is a potential for residents to go missing, such as residents who leave the home unsupervised or the likelihood of absconding. This has yet to be developed. (See requirement 2) The dependency level of residents on respite care is mixed. Some are able to make decisions and choices in all aspects of their lives whilst others can only make minimal choices. The home works with individuals to their capabilities. It Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 10 is expected that residents participate in the daily chores within the home, they choose where they would like to go for their weekend meals and choose how they wish to spend their days, within their agreed plan of care. The Manager expressed her desire to start regular house meetings to ensure regular consultation with residents. This would be a positive move giving individuals the opportunity to give their views on how the home should be run. The three written feedback received were all positive regarding the care provided. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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): 15 & 16 The service users are able to maintain their lifestyle whilst in the home, enjoying stimulation and activity throughout their stay. EVIDENCE: The home provides residents and their families with an opportunity to take a break from their home situation. Many aspects of their lives remain the same, such as their day centre activities. They may also continue their friendships or relationships where this is important to them. However, for many the break allows them to meet other residents or continue friendships made in the home on previous visits. The Manager is aware of the need to respect residents rights, through ensuring they are kept safe; are aware of any restrictions which may affect them and ensuring they are treated without discrimination. However, there is a need for the home to ensure that any rules of the home are made clear to all residents. This includes any restrictions on the use of alcohol and drugs. It is also important that the individual’s care plan details clearly possible restrictions on their daily lives. For one service user the “guidelines” regarding behaviour, recorded possible sanction/ restrictions to be used to encourage improvement in the behaviour. The resident and their representative should be consulted over these restrictions and agreement reached. This would provide an open and inclusive relationship with clear boundaries set. (See requirement 3) Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 12 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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): 19 & 20 The home continues to access appropriate healthcare services for residents ensuring their physical and emotional health needs are met. The medication practices have improved and some further improvement will ensure residents health and well-being is met. EVIDENCE: These standards were inspected briefly to review the implementation of previous requirements. The Manager stated that residents who are admitted into the home for a period of transition are registered with a local GP. Other healthcare is accessed through the Community Learning Disability Team (CLDT). There is evidence of occupational therapy assessment, access to specialists such as psychologist, CPN and members of the CLDT behavioural team (IBIS). There are two residents currently in the home, one of whom self-medicates. The resident’s room was locked but the medication was not stored in a lockable unit, within the room. The home has developed risk assessments and guidance for the management of those resident who self-medicate. This should be elaborated slightly to include how the home monitors compliance. For another resident, prescribed “as required” medication, there are guidelines written by the consultant on when staff should administer the medication. The Manager also monitors the medication practices regularly. A homely remedy policy has also been developed. However, this is slightly confusing and Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 14 conflicting and needs to be made clearer. There are no homely remedies at present. (See requirement 4 & recommendation 2) Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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 & 23 There are procedures in place, which provide service users with the opportunity to raise concerns about the care provided and to ensure they are appropriately investigated and managed. EVIDENCE: There are two complaints procedures detailed in the home. One relates to complaints against social services and is relevant as the Local Authority as the Registered Provider of this provision. The home has also developed a leaflet regarding complaints made against the registered provision, as required by the Care Homes Regulations 2001. If viewed together the procedures meet the Regulations. However, this could be made simpler and clearer for residents or other interested parties to acquire a full understanding of how issues or complaints made be raised and managed. The Manager should consider reviewing the information provided. There have been no complaints made since the last inspection nor is the Commission aware of any complaints made external to the home. The home is currently overseeing the monies of one resident. An audit of the monies was undertaken and found to be satisfactory. The records kept in relation to the monies were adequate although suggestions for improvement, such as ensuring two signatures for monies taken from the bank and transferred to the resident’s account or taken from the residents’ monies within the home, would safeguard the member of staff from potential allegations. (See recommendation 3) Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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): 24,25,27,28,29 & 30 The home is, in the main, well maintained, furbished and decorated, providing the residents with a homely and comfortable environment. The standards of cleanliness are adequate but the lack of appropriate infection control facilities in the laundry lead to potential risks to service users. EVIDENCE: The home is reasonably maintained, furbished and decorated. Some of the private accommodation is rather bare with no pictures or personal possessions. This is understandable as the rooms are used by a number of different residents for short stays. However, improvements could be made through simple additions such as hanging pictures etc. Bedrooms contain furniture including wardrobes, bedside tables; chest of drawers and bed. The wardrobe in Room 7, currently the room used as the transition room, is broken with no doors attached. The chest of drawers also requires fixing. The Manager said that a new wardrobe has been ordered. (See requirement 5) The communal areas are well furnished and decorated in a comfortable and homely fashion. There are sufficient bathrooms and WCs, all of which are spacious. One bathroom and one bedroom on the ground floor have been fitted with ceiling hoists. Other bathrooms and WCs are fitted with grab rails; handrails and the kitchen counters are of a lower than normal height to ensure those who are wheelchair users are able to manage. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 17 The laundry contained two industrial laundry machines: one tumble dryer and the other a washing machine, with a sluice facility. The laundry also contains a sluice. There are no hand-washing facilities or alginate bags for soiled laundry. These are needed especially as there are times when service users are incontinent. (See requirement 6 & recommendation 4) A tour of the home showed that the home is clean and odour- free. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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): 32,33 & 34 Whilst there has been progress in the recruitment procedures the current practices places vulnerable service users at risk. There has been little progress in ensuring staff are qualified to provide the support required to service users. EVIDENCE: There has been no progress on the number of staff with NVQ 2 or above. There are currently no members of staff with the qualification nor are there any residents registered to undertake the award. This has been raised on a number of inspections, yet there has been no action taken by the Provider to address this even though the December 2005 timescale is fast approaching for 50 of staff to have this qualification. The Manager must obtain details of the agency staff used and whether they have achieved this qualification. (See requirement 7) There has been one member of staff recruited since the last inspection. Previously the documents and information required had not been maintained in the home. There as been some progress in this area with application form and two written references in place. However, there was no current Criminal Records Bureau checks (or POVA), no proof of identity or photograph. The Manager was made aware of the need for the required checks to be completed prior to employment. (See requirement 8) The home continues to use a high number of agency staff, although the home is making efforts to recruit new staff. As stated previously, one new employee has joined the staff team, since the last inspection and the Manager spoke of Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 19 further interviews next week. The home asks that the same agency staff be used to ensure continuity of care. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 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, 39 & 42 Whilst the monitoring of the homes’ practices and procedures has improved, some practices still place service users health and welfare at risk. EVIDENCE: A number of service records were viewed and, in the main, were in date and in order, except the fixed wiring. An immediate requirement raised in an earlier inspection, required the fixed wiring to be inspected. This has now been addressed. However, the inspection certificate viewed showed it to be unsatisfactory, yet no action has been taken to address the urgent remedial work required. The home has been recording fridge and freezer temperatures. The records showed constant temperatures of 5 degrees for the fridge and 18 degrees for the freezer. On viewing the thermometer in the fridge this read 10 degrees. It appears that staff may have been reading the temperature recorded on the outside of the fridge. This shows what the temperatures should be not what they are. (See requirement 9) The monthly visits to monitor the quality of care provided are now being undertaken by Managers from other provisions. The Manager stated that these visits were beneficial. The records of these visits were viewed and found Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 21 to cover a number of areas. However, the inspector asked the Manager consider making clear any actions that arose from these visits were made clearer. The Manager also audits procedures and practices within the home. Areas covered included health and safety; medication and finances. The home should consider elaborating on this to include areas such as assessment and care planning; meals and decision-making and consultation. There is also a system for consulting with service users and their relatives in the form of questionnaires. The Manager was advised that once these had been collated the Commission would require a copy of the report which highlights areas for improvement and the action the home is to take to make the required changes, where this is reasonable and realistic The Manager has been in post for approximately four weeks, having transferred from another service provision working with service users with learning disabilities. She is qualified to NVQ 4 in Care and has achieved the Registered Manager’s Award. The Commission has not yet received the Manager’s application for registration. The Manager agreed to send in the completed application form without delay. Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 22 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 x x x 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 3 3 3 3 2 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score x 2 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bromley Road (44) Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x DS0000038244.V254216.R01.S.doc Version 5.0 Page 23 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 6&9 Regulation 13 & 15 Requirement The Registered Person must ensure that care plans and risk assessment guidance include information for staff on potential risks, triggers, signs and symptoms of deterioration and the action the home takes to minimise the risks and support the service user. The Registered Person must develop individual risk assessments for residents who are likely to go missing. This is an outstanding requirement. Previous timescale 1/08/05 The Registered Person must ensure the care plans contain clear guidelines where restrictions may be placed on service users. The restrictions must be part of an agreed plan of action. The Registered Person must ensure that where service users self-medicate the medication is stored securely in a lockable space in residents’ rooms. The Registered Person must repair the set of drawers and DS0000038244.V254216.R01.S.doc Timescale for action 01/11/05 2 13 13 01/11/05 3 6 15 01/11/05 4 20 13 01/11/05 5 25 23 01/12/05 Bromley Road (44) Version 5.0 Page 24 6 7 30 32 13 18 8 34 18 9 42 13 wardrobe in Room 7 or purchase new furniture. The Registered Person must ensure there are hand-washing facilities located in the laundry. The Registered Person must provide the Commission with the action plan with timescales for staff to achieve the NVQ 2 (or above). This is an outstanding requirement. Previous timescale 1/08/05. The Registered Person must ensure recruitment procedures are robust. Specifically, the required documents are obtained including the Criminal Records Bureau Check and proof of identity. The Registered Person must ensure that staff ensure the fridge/freezer temperatures are checked and that accurate records are made in relation to the temperatures. 01/11/05 01/11/05 01/11/05 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 5 Good Practice Recommendations The terms and conditions of residency should include the areas detailed in Standard 5 and information on the circumstances in which a resident may be asked to cut short their stay. The homely remedies policy should be amended to ensure the information provided is clear and unambiguous. There should be two members of staffs’ signatures recording withdrawal of residents’ monies. The home should use alaginate bags for the laundering of soiled linen and clothing. 2 3 4 20 23 13 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Bromley Road (44) DS0000038244.V254216.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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