Inspection on 06/12/05 for Brooke House Care Home

This inspection was carried out on 6th December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brooke House Care Home 11/05/06

Brooke House Care Home 30/09/05

Brooke House Care Home 22/07/04

Brooke House Care Home 25/05/04

Brooke House Care Home 19/01/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Brooke House Care Home 123 Millbrook Road East Freemantle Southampton Hampshire SO15 1HQ Lead Inspector Janet Shipman Unannounced Inspection 10:00 6 December 2005 th Brooke House Care Home DS0000037569.V270943.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 Brooke House Care Home DS0000037569.V270943.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. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brooke House Care Home Address 123 Millbrook Road East Freemantle Southampton Hampshire SO15 1HQ 023 8023 5221 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) heron.house@craegmoor.co,.uk Park Care Homes (No 2) Ltd Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 September 2005 Brief Description of the Service: Heron House closed its service towards the end of 2004. The home has reopened under the new name of Brooke House. Brooke House provides a transition service catering for adults who have a learning disability but may also have a diagnosis of Autism and/or Asperger’s Syndrome. The aim of the service is to support service users in developing life skills to live independently or in supported accommodation. Brooke House is located close to the city centre of Southampton and is within easy access to all main amenities, transport links and local shops. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced visit to the home this year. The Inspector was assisted throughout the inspection by a member of staff and later joined by a manager from another Craegmoor home who is providing some management cover. The current manager for Brooke House was absent. The inspector spoke with three members of staff and observed the interactions between staff and service users. Discussions were held with three service users. Access to any information requested was provided where possible. Some information could not be located due to the absence of the manager and these will be viewed at the next inspection. What the service does well: What has improved since the last inspection? Brooke House opened in October 2005, the first unannounced inspection was carried out 30 September 2005 when service users had not been admitted to the home. Therefore there is no baseline for which improvement can be measured on this occasion. Brooke House Care Home DS0000037569.V270943.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. Brooke House Care Home DS0000037569.V270943.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 Brooke House Care Home DS0000037569.V270943.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): 3, 4 & 5 Standards 1 & 2 were assessed at the last inspection. Prospective service users are assessed through the care management process and by the home prior to being offered a placement. In the absence of the manager the assessments were not available at the time of the inspection. The remit of the home is unclear as one service user who has been admitted to the home appears not to meet the current aims and objectives of a transition service to move on to independent living. Service users and their family have an opportunity to visit the home and meet the staff and other service users before deciding to move in. Service users are given a written contract of terms and conditions of the home; however, these were either incomplete or not available at the time of the inspection. EVIDENCE: Four service users have been admitted to the home since it opened at the beginning of October. The inspector viewed all four files. There was evidence that care managers assessments had been completed and although the inspector was informed that the home’s assessment had been carried out these could not be found in the absence of the home’s manager who was absent on the day of the inspection. The inspector was concerned about one service user who has been admitted whose needs appear not to meet the aims and objectives of the home. The inspector spoke with the service user’s care manager who visited on the day of the inspection and was under the impression that the home was a long term Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 9 placement for his client and that the particular needs of his client would mean that he would not be moving on to independent living. Two staff and a service user expressed concerns to the inspector that the needs of this particular person and the measures being considered to address some of the person’s behaviours infringe the rights of other service users living in the house. For example locking the kitchen at night to prevent other service users food being taken. The home needs to be clear about its purpose and to reflect this in the statement of purpose, admissions criteria and where appropriate in the service user guide. The inspector will also discuss these perceptions with the manager at a pre-arranged meeting taking place on 15th December 2005. All service users are issued with a service user contract of terms and conditions; however, the inspector found on one file that the contract was incomplete. The other contracts could not be found in the absence of the manager. Contracts will be viewed again at the next inspection. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Staff are currently working with service users to develop their own person centred care plans. The plans when completed should clearly outline how individual service users need to be supported on a day to day basis as well as identifying their hopes, dreams and aspirations for the future. However, without completed plans, some staff felt they did not have clear guidelines or objectives to work towards with individual service users. Service users are involved and supported, where possible in both making decisions about their own lives and in the day-to-day running of the home. For three service users risk assessments have been completed to enable service users to lead a full and varied lifestyle. However, for one service user, risk assessments were found not to be in place. EVIDENCE: As the home has only recently opened service user’s person centred plans are still under development. The information that has been completed has been by service users with the support of staff. However, two staff expressed to the inspector that they felt unclear about what they were supposed to be doing to support service users. The current manager has been providing support to another home within the Craegmoor Company and the staff felt that the Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 11 manager has not been at the home on a consistent basis. One member of staff said she had concerns with working with one service user as she had little experience working with people with his particular needs. The member of staff told the inspector that they were given a book to read on his syndrome rather than any training. Service users are involved in the day-to-day running of the home, going shopping, keeping the home clean and tidy, involved in cooking meals. The home plans to set up service user meetings. Risk assessments are generally in place, however for one service user a risk assessment was not completed although there was a history of potential risk to other service users through this person’s potential inappropriate behaviour. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 The emphasis for the home is to provide a transition service to enable service users to develop life skills to live in supported or independent living. Staff are working with individual service users to develop a programme of educational, supported employment opportunities and leisure activities to meet individual needs. Family support is encouraged where appropriate and visits to relatives are facilitated. Service users privacy is upheld and staff observed to interact in a friendly and respectful manner with service users. Service users are supported to buy their own food and cook their meals. Although staff respect service users rights an issue of a service user smoking in his room has caused difficulty in staff being able to address this issue and get the service user to smoke in the designated area outside of the home. This poses a health and safety risk to other service users. EVIDENCE: At the time of the inspection visit one service user was attending her day service. Two service users were accessing the community for shopping and undertaking an activity. One service user was also going to attend a local college literacy course for the first time in the evening. He told the inspector Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 13 that he was really looking forward to going and went to his room to get the details of the course to show the inspector. The service user also told the inspector that he was also going to start working on a voluntary farm scheme. Other activities that have been arranged are attending a gym, membership to a snooker club, use of local facilities for example pubs. These activities have been documented on service users personal plans. One of the service user’s has chosen not to join in any activities and rarely comes out of his room. Concerns were expressed by staff on the relevance of his placement if he does not want to partake in any activities to develop his independence skills and coupled with the care manager view that the placement is long term it makes it unclear as to the purpose of his admittance to the home. When the inspector looked at the activities for service users at the weekend the staff told the inspector that the range of activities are often limited as there is not enough staff on duty at those times. The duty rota showed only two care staff are working at the weekends. The situation was unable to be clarified due to the absence of the manager. The home has a dedicated vehicle for activity use; the staff also use public transport as much as possible to develop service user skills. The home supports service users to maintain family and friends relationships where appropriate. Service users individual plans document important people in their lives as well as family members and relationships and any particular arrangements that the person has to visit family and friends. Throughout the inspection the staff were observed to treat service users with respect and encouragement to undertake the tasks for the day. However, two staff expressed that they were unsure how to work with certain service users due to the specific disability or with a service user who presents aggressive behaviour towards them. Although there are no restricted areas in the home, the home is considering locking the kitchen door at night to prevent a service user going down to the kitchen and taking other peoples food. Concern was raised that this is going to infringe on other service users rights. One service user told the inspector that he couldn’t understand why the person was in the home and he was fed up of having his milk taken. Staff confirmed that this was happening and felt the only option was to lock the kitchen and would discuss this with all the service users and complete the infringement of rights document. The home has a non-smoking policy; the designated smoking area is outside of the home in the back garden. There is one service user who consistently smokes in his bedroom, despite staff informing him that he must smoke outside. The service user can respond in an aggressive manner and two staff said they could feel intimidated by him. Service users are supported to plan their menus, be involved in shopping for food and preparing and cooking their meals. Each service user has a menu plan in their personal file. On the day of the inspection the inspector observed one service user unpacking his groceries that he had just bought. He had his own lockable cupboard and a shelf in the fridge. The service user has a budget of £30.00 a week and had purchased all organic food, which was a conscious Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 14 choice. However, some of the items were expensive and with a restrictive budget staff need to assist the service user in making some compromises with food items to fit into his budget as part of developing his independence skills. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 15 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, 19 & 20 Service users personal care needs are identified and met in line with preferences and support needs. Health care needs are met by the home in conjunction with specialist services. Service users say they are treated with respect and have their privacy protected. Only one service user requires medication, which is self-administered. EVIDENCE: Individual person centred plans identity each service user’s needs in the area of personal care. There is a section within the person centred plan that identifies health and emotional needs. Service users have completed the information giving guidance to what staff need to do if they are feeling unwell or displaying certain behaviours. The home has links with the specialist community health teams and will make referrals to meet specific health needs. Day and night time routines are also documented which details how the person likes to get up in the morning and what they like to do before going to bed. Throughout the inspection the care staff were observed interacting with service users in a respectful and dignified manner. Service users spoken to felt that staff were “friendly and caring” and that staff listened to problems. Only one service user takes medication and this is self administered, guidelines and assessment are in place. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has a complaints policy and procedure which is available to service users. Service users are safeguarded from abuse. Policy and procedures for access to the safe needs to be reviewed to ensure that a safe key is available at all times. EVIDENCE: The home has a complaints policy which is made available to service users or their representatives in the service user guide. The complaints policy should ensure that all complaints are appropriately investigated within twenty-eight days. Staff spoken with were aware of what procedure they should follow should a service user or their representative made a complaint. One service user told the inspector that he would talk to staff if he was unhappy and seemed confident that staff would sort it out. Craegmoor has appropriate policies and procedures for example whistleblowing, financial procedures and an adult protection policy that links in with the local authority procedures. Training on adult protection forms part of Craegmoor’s induction training. Three service users manage their own finances and have a lockable petty cash tin in their bedrooms, which is kept in their bedside cabinet and has a lockable draw. One service user chooses to have his money kept in the office safe and for staff to support him to budget. Financial procedures are in place to ensure that service users could not be financially abused within the home. On the day of the inspection there was an issue about access to the safe as none of the staff on duty had a safe key. Although this did not hinder the activities for the day. The situation needs to be reviewed to ensure that appropriate access to the safe is available throughout the day and evening. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 17 Craegmoor’s recruitment and employment procedures should ensure that unsuitable people are not employed to work with the home. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 18 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 & 30 The home provides a safe and attractive accommodation. Service users bedrooms provide appropriate equipment to meet their needs. The home is clean, tidy and has no offensive odour. EVIDENCE: Before the home re-opened all the rooms had been re-decorated and new furniture purchased. Each room has a lockable bedside cabinet and service users can personalise their rooms with their own personal possessions. The service users spoken to were very pleased with their rooms. One service user spoken to by the inspector said he really liked his room and that he had all that he wanted. Both staff and service users are involved in cleaning and tidying the home. Laundry is undertaken by the home and service users are supported to do their own washing. The washing machine at the home is capable of washing to appropriate temperatures. The home has policies and procedures in place for the control of infection. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The home employs sufficient care staff to meet service users’ needs. The recruitment of staff is safe and places the protection of service users first. The provision of induction and related training needs to be clarified as staff opinion differed as to the quality and quantity provided to support them to meet the specific needs of individual service users. EVIDENCE: Currently the home employs six staff to support four service users, but this will increase as more service users are admitted to the home. The recruitment process ensures that all the necessary references are taken up. The inspector was able to view one file for a member of staff who is due to start working at the home shortly. There was evidence on file of the application form, record of the interview; two references with follow up telephone call, CRB, Pova check and copies of birth certificate, driving licence and qualifications. One member of staff told the inspector that she had very little induction and training to meet the specific needs of service users. The member of staff gave the example of training in Aspergers syndrome and said that the staff had been given a book to read. Another member of staff on duty said that this was their experience too. However, a third member of staff spoken to by the inspector felt that she had a good induction and had received a range of training to meet the needs of service users. The inspector will discuss these perceptions with the manager at a pre-arranged meeting taking place on 15th December 2005. Two members of staff informed the inspector that they were leaving although they had only been in their job for a number of weeks as they felt unsupported Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 20 and were unclear about their role. The third member of staff spoken to by the inspector said that she enjoyed the job and felt that other members of staff lacked motivation to ensure service users needs were being met appropriately. The inspector sat in a handover meeting, which was strained. One member of staff expectations of tasks that should have been completed during the day had not been completed. The staff who had been on duty during the day appeared to take no responsibility or accountability for the tasks that had not been completed, despite the member of staff saying that they had been written down. Opinion of staff differed on the amount of supervision that they had received. Training, staff supervision records and staff meeting minutes were not available in the absence of the manager and will be looked at the next inspection. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The home needs a permanent full time manager to ensure that service users and staff are supported. Quality monitoring systems need to be developed within the home. Policies and procedures are appropriate and the home provides a safe environment for service users, staff and visitors. The issue of a service user smoking in his room poses a health and safety risk to other service users and must be resolved. EVIDENCE: Currently the manager appointed for the home is providing management support to another Craegmoor home in the local area and although additional support has been provided by another manager again from another Craegmoor home, the issues raised by some staff and the disharmony within the staff team are a cause for concern. The home requires a permanent full time manager to ensure that the service users and staff team are well supported. The manager also needs to ensure that the necessary management processes are in place in order to build a competent and cohesive staff team. As the home has only been opened for a short while the quality monitoring systems have not yet been developed within the home. This standard will be looked at during the next inspection. Service users spoken with during the Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 22 inspection said that they felt they could give their comments to staff about the home, particularly if they were not happy and something would be done. During the unannounced inspection a variety of records were inspected. These included fire equipment safety check log, care plans, and risk assessments, staffing rotas, insurance certificates, maintenance records and menus. All were found to be maintained and stored appropriately. As mentioned earlier in the report the home has a non-smoking policy, however one service user smokes in his bedroom, despite staff informing him that he must smoke outside. The service user can respond in an aggressive manner and two staff said they could feel intimidated by him. Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 2 2 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brooke House Care Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X 3 X DS0000037569.V270943.R01.S.doc Version 5.0 Page 24 No Are there any outstanding requirements from the last inspection? Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 25 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 YA3 Regulation 4 (1) (a) Requirement The manager must ensure the Statement of Purpose and admissions criteria is reviewed to ensure service users are admitted who meet the home’s aims and objectives. The manager must ensure that risk assessments are in place for all service users who may pose a potential risk to other service users. The manager must ensure that appropriate measures are taken to prevent smoking in a service user’s bedroom to ensure service users health and safety are not compromised. The manager must review the arrangements for appropriate access to the safe during the day and evenings. The manager must ensure that all staff receive appropriate support, induction, supervision and training in order to build a competent and cohesive staff team. The manager must ensure that a quality monitoring system is developed for the home. Timescale for action 30/03/06 2 YA9 13 (4) (c) 31/01/06 3 YA42YA16 12(1)(a) 13(4)(a c) 30/12/05 4 YA23 16 (2) (m) 30/03/06 5 YA37YA35YA32 18 (1) (2) 30/03/06 6 YA39 24 (1) 30/03/06 Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Brooke House Care Home DS0000037569.V270943.R01.S.doc Version 5.0 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!