Inspection on 02/08/05 for Buxton Street (131-133)

This inspection was carried out on 2nd August 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.

Other inspections for this house

Buxton Street (131-133) 10/07/07

Buxton Street (131-133) 10/04/06

Buxton Street (131-133) 05/04/05

Buxton Street (131-133) 28/09/04

Buxton Street (131-133) 08/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Buxton Street (131-133) 131-133 Buxton Street Whitechapel London E1 5AR Lead Inspector Anne Chamberlain Unannounced Inspection 2nd August 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Buxton Street (131-133) Address 131-133 Buxton Street, Whitechapel, London, E1 5AR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0207 247 2004 0207 247 2004 Outward Post Vacant CRH - PC Care Home Only 5 Category(ies) of LD - Learning Disability (5) registration, with number of places Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No Persons with wheelchair dependency - Imposed: 1 April 2002 Date of last inspection 5th April 2005 Brief Description of the Service: 131-133 Buxton Street is a 24 hour residential service for people with learning disabilities and complex needs. It is situated in Tower Hamlets in a central location close to public transport links and with local shops and a market. The home is located in two terraced cottages which have been converted to provide two independent flats - 131 and 133. The flats have separate front doors but there is an intercommunicating door inside. The upper flat is occupied by three more independent service users and the loweer flat is occupied by two service users who have rather higher needs. The provisions share a small but pleasant and private garden. The two provisions are run spearately from one office which is located ground floor in number 133. The staff team currently consists of a manager, deputy manager and eight care staff. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, carried out over four and a half hours on one day. The inspector spoke with three service users and interviewed the new manager and one member of staff. She made a tour of most parts of the premises including the garden. In addition the inspector looked at various documents and records. The inspector would like to take this opportunity to thank the service users and staff at Buxton Street for their co-operation with the inspection. What the service does well: What has improved since the last inspection? The home now has a permanent manager who is working with the deputy manager and other staff. Staff feel more supported and effective, and issues of training and supervision have been addressed. The home is starting a new system for the administration of medication which is expected to be an improvement on the previous system. It will offer staff training and medication audits in addition to the dispensing service. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 standard(s) 1,3,4 and 5. Information is available for prospective service users but needs some amendment. The home could not currently assure new service users that their needs could be met. Should this situation change the home would offer prospective service users opportunities to visit. Tenancy agreements need to be updated. EVIDENCE: The manager stated that he has not yet amended the service user guide so the requirement of the last inspection (and two previous inspections) to do this is restated. There is an expectation that with the new manager in post the requirement will this time be complied with. The service user guide must be expanded to include all the necessary information to comply with the regulations. This is a restated requirement. There have been no new admissions to Buxton Street. There are however issues with the existing service users, one of whom the manager feels is inappropriately placed. This service user had left the building unescorted in June 2005 and had been at some risk in the community. The inspector was concerned that the proximity of the front door to the street outside increases Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 9 the vulnerability of this service user who does not have road awareness. The inspector also agrees that the service at Buxton Road which is a small flat is not suitable to meet the needs of the service user as described by the manager. The manager believes that there are also compatibility issues as the other service user who shares the flat is unable to reach his potential for independence in the light of the overwhelming needs of his flatmate. The inspector understands that there is to be a full review of the placement with Outward senior management, the care manager and family, and endorses this action. The inspector was satisfied in conversation with the manager that he would comprehensively assess the needs of any prospective service user and would not offer a placement to an individual whose needs could not be met by the project. The manager agreed that in order to take a decision regarding moving into the home a prospective service user would need to test drive it. He felt this would be impossible whilst the inappropriately placed service user is living there. The inspector viewed tenancy agreements on files. The rent figure changes from time to time and the document has to be read in conjunction with a sheet updating the rent. This is acceptable but the rent figure should therefore be kept out of the document completely and a direction to the current sheet inserted instead. The manager agreed that the contracts are somewhat dense, old fashioned and out of date and need to be updated to a more accessible format. The inspector advises the manager and organisation to do this in conjunction with the requirements of regulation. The manager must ensure that each individual service user has a written contract or statement of terms and conditions with the home. This is a requirement. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8. The home consults with service users about the running of the home but must hold regular tenants meetings. EVIDENCE: The inspector was satisfied that service users are verbally consulted about the running of the home. They also have an opportunity to attend monthly service user participation meetings. Tenants meetings should be held fortnightly but it was noted from the records that months sometimes pass without meetings in the downstairs flat. The manager explained that this is because the meeting is only held when the mother of one individual is able to attend. The manager must ensure that the tenants meeting is held regularly even if it is only for one service user. This is a requirement. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 standard(s) 11 and 14. The home supports service users with a range of activities which offer opportunities for personal development, leisure and recreation. EVIDENCE: The manager stated that service users have many opportunities for personal development and engage in appropriate community leisure activities. One service user attends a day centre for four days of the week. Service users also attend a social club on Monday evenings, Gateway club weekly and a once a month social group which meets at the weekends. The service users from both flats sometimes get together to do things. The organisation has an annual barbecue and so does the home. Service users have holidays planned, one service user is returning to her country of origin for a week. The inspector viewed the programmes of service users and noted that they include domestic responsibilities which promotes independence. One service user is provided with the services of an interpreter for appointments and meetings as English is her second language. She also attends a club where her first language is spoken. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 12 The previous inspection identified a shortfall in the programme of a service user in that if he chose not to attend his day centre there was little provided in the way of alternative. The manager advised that an contingency programme has now been devised for the service user as he still chooses not to attend his day centre for a significant proportion of the time. A new worker is starting who will either escort the service user to his day centre or work with him in the home and community. it was recommended at the last inspection that two small refrigerators, should be purchased for service users in the upstairs flat, to store snacks in their rooms. These are now in place. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 standard(s) 20 The arrangements for the administration of medication are sound. EVIDENCE: The manager stated that the keys to the medication cupboard are now kept with the main bunch and handed over at each shift change to the staff member in charge. The manager further stated that the home is adopting a new system with Boots, from 18th August 2005, for the administration of medication. There is a book for recording incoming medication, a cross reference as it is also recorded on the MAR sheet), and a book for recording medication returned to the pharmacy. There will be three monthly medication audits and annual staff training. Previously medication was prescribed three months at a time. It will now be prescribed for only 28 days at a time. The medications will now be dispensed in bubble packs. There will be a direction to any liquid medicines which will be measured and administered by syringe. The practice of countersigning the measurement of liquid medications has been resumed. Prescribed lotions for skin, for the two downstairs service users are stored in individual locked cupboards in their bathroom. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 14 The manger advised that the home is working towards the three service users who live upstairs having their medications stored in their bedrooms (in locked cupboards) to enhance their independence. As recommended at the last inspection a sample of staff signatures has been inserted into the medications folder. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 standard(s) 22. The home has a complaints policy. It also has a guide to complaining which requires some amendment, and a Quick Guide to How to Complain. EVIDENCE: The manager stated that he had amended the complaints policy as required in the last inspection report. Unfortunately he was unable to evidence this and the requirement is therefore restated. The complaints policy and guide to complaining must be amended with the correct contact details for the Commission for Social Care Inspection (CSCI) and advised that the commission can be contacted directly. This is a restated requirement. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 standard(s) 24,25,26 and 29. The environment in the home is generally comfortable and safe but needs some redecorating and refurbishment. Most bedrooms suit the needs of their occupants and promote their independence. Aids are in place to enable service users. EVIDENCE: The inspector made a tour of most parts of the premises. The home is generally comfortable and safe. The manager acknowledges however that a redecorating and refurbishment programme is needed for the home including a new floor in the kitchen and redecoration of the downstairs sittingroom and hallways. The inspector and manager had a discussion about the level of damage the downstairs flat sustains from one service user. As previously stated the manager believes this service user to be inappropriately placed in the home, The inspector chatted with two service users in their rooms. The rooms reflected personal choice and supported independence. One service user is keen on sewing and keeps a sewing machine in her room. The inspector was Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 17 unable to view the two bedrooms in the downstairs flat as their occupants were out, but the manager stated that they are very bare. This is appropriate for one service user but not for the other service user who frequently has his possessions damaged by his flat mate. The flat mate also invades the space of this service user and mistreats his room. The inspector felt that there are issues of the quality of life for both service users in the downstairs flat and was assured by the manager that these will be considered at the aforementioned placement review meeting. The manager advised that the home will be getting a pictoral information communication system (PICS) board to support communication with one service user. One service user has tried a number of different bath chairs and work is ongoing with the Occupational Therapist to identify one which suits her needs. Handrails are provided in the downstairs bathroom for one service user. Taps in the downstairs cloakroom have been changed to avoid flooding by one individual. They have however been mishandled and are not a success. The home continues to address the problem. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34, 35 and 36. Staff are increasingly clear about their roles and responsibilities and service users are supported by a team growing in effectiveness. Service users are generally protected by safe recruitment. Staff training has improved and staff are feeling better supported. Supervision is regular and frequent and staff appraisal is in place. EVIDENCE: The manager advised that he has mooted a team building day for the staff. He feels that staff morale is improving and this was borne out in the discussion the inspector had with a staff member. The staff member interviewed advised that during the time when the home had several temporary managers the staff felt unsupported. Since the new manager has started she feels that the home is more organised and she can access policies and procedures when she needs them. The staff member said that the staff need support to support the clients and she feels that they are now getting this. The previous inspection identified a lack of Criminal Records Bureau and POVA checks for three members of staff. The inspector viewed paperwork which Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 19 gave CRB reference numbers for two of the members of staff. She was assured that the other check has been returned and is satisfactory. The manager must ensure that documentation is made available to confirm the outstanding CRB check. This is a requirement. At the last inspection training was an issue for the staff who told the inspector that they felt they did not receive adequate training. The manager advised that the home has decided not to pursue accreditation for autism. However, all staff have however core training which is provided in house. The inspector viewed records of staff training which evidenced staff undertaking training on various topics during 2005. Three staff are working towards NVQ level 3. The deputy manager has level 2 and LDAF. A member of staff advised that since the new manager has started she feels that the situation with NVQs is in hand, and although there are problems in accessing an assessor the process is being driven and the staff will be able to achieve their NVQ levels. Whilst acknowledging the above evidence that training is now being actively pursued the inspector hopes to see more evidence of staff training having taken place at the next inspection. The manager must ensure that staff (including bank staff) receive adequate training. This is a restated requirement. The inspector viewed evidence of regular and frequent supervision. The manager stated that he has made a point of talking to staff individually and getting to know them and their views regarding the service. The manager stated that he approaches appraisal by dividing it into quarterly sessions over the year. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,40 and 42. The home appears well run and quality monitored but the manager is not registered. Service users are protected by policies and procedures. Safety and welfare are promoted but can be further improved. EVIDENCE: The inspector learnt that the manger has not actually registered with the CSCI, although he has been in post for three months. The inspector was also surprised to learn that the manager is working towards NVQ level 4. Prior to the manager starting she had been advised by a senior manager in the organisation that the incoming manager had this qualification already. This information was contained in the last inspection report which was sent to the organisation in draft form for correction of any factual error. This error was not corrected. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 21 The manager advised that he has considerable experience in managing supported living accommodation and in undertaking assessments of needs with adults. The inspector felt, having spent some time with the manager and observed the work he has done in getting to grips with the service that he is competent to manage it. He will however be interviewed by the central registration team in the course of processing his application to be registered manager of the service. The manager must apply to the CSCI for registration as manager of the service without further delay. This is a requirement. The inspector saw evidence of person in charge visits taking place on a more regular basis. There were visits in April, May and June. The report of the visit in July was not yet to hand. The deputy manager has worked in the service for some time and has a good historical knowledge. The inspector observed that the new manager is working closely with the deputy manager and has acquainted himself with the location of policies and procedures and other key documents. He has also engaged with electronic communication with the organisation and is updating and storing documents electronically. As previously stated under standard 22 the complaints policy requires amendment. The manager must ensure that the complaints policy is amended. This is a restated requirement. The previous inspection made a requirement for fire equipment check and electrical wiring certificate to be made available for inspection. The inspection report dated May 2005, by an outside contractor, for the fire protection systems was viewed. The manager advised that he feels magnetic door closers for bedrooms would improve fire safety in the home. The manager must ensure that magnetic door closers are put in place on all bedroom doors, to ensure fire protection. This is a requirement. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 22 Gas and boiler inspection report dated May 2005 was viewed. The electrical wiring certificate is a 5 year check and a copy was still not available for inspection. The manager must make available for inspection the electrical wiring certificate. This is a restated requirement. Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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 2 x 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 2 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x 3 x Standard No 11 12 13 14 15 16 17 3 x x 3 x x x Standard No 31 32 33 34 35 36 Score 3 x 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Buxton Street (131-133) Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x 2 x 2 x G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 24 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 1 Regulation 5 Requirement Timescale for action 01 October 2005 2. 22 22 (7) The service user guide must be expanded to include all the necessary information to comply with the regulations (previous timescales of 1st September 2004 and 1st December 2004, 1st August 2005 not met). The complaints policy and guide 01 October to complaining must be amended 2005 with the correct contact details for the Commission for Social Care Inspection (CSCI) and advised that the commission can be contacted directly (previous timescale of 01 August 2005 not met). The manager must ensure that documentation is made available to confirm the outstanding CRB check. The manager must ensure that staff (including bank staff) receive adequate training (previous timescale of 01 July 2005 not met). The manager must apply to the CSCI and obtain registration as manager of the service without further delay. The manager must ensure that 01 September 2005. 01 December 2005 01 December 2005 01 October Page 25 3. 34 19 4. 35 18 5. 37 8 6. 40 22 Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 7. 42 23 the complaints policy is amended - as per standard 22. The manager must make available for inspection the electrical wiring certificate (previous timescale of 01 July 2005 not met). The manager must ensure that magnetic door closers are put in place on all bedroom doors, to ensure fire protection. The manager must ensure that tenants meetings are held regularly even if it is only for one service user. The manager must ensure that each individual service user has a written contract or statement of terms and conditions with the home. 2005 01 September 2005 8. 42 23 01 October 2005 9. 8 12 01 September 2005 01 December 2005 10. 5 5 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 Good Practice Recommendations Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 4th Floor, 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 Buxton Street (131-133) G57 G06 S10293 Buxton Street V243100 020805 Stage 4.doc Version 1.40 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. 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!