Inspection on 17/05/05 for Carlingford Road, 181

This inspection was carried out on 17th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Carlingford Road, 181 02/07/08

Carlingford Road, 181 14/11/07

Carlingford Road, 181 19/04/07

Carlingford Road, 181 03/10/06

Carlingford Road, 181 24/11/05

Carlingford Road, 181 16/09/04

Carlingford Road, 181 20/05/04

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Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 181 CARLINGFORD ROAD South Tottenham London N15 3ET Lead Inspector Caroline Mitchell Announced 17 May 2005 @ 09.30 am 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. 181 CARLINGFORD ROAD Version 1.10 Page 3 SERVICE INFORMATION Name of service 181 Carlingford Road Address South Tottenham, London, N15 3ET 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) 020 8693 6088 020 8299 4818 Mr Charan Singh and Mrs Margaret Badu of Choice Support Mr John Philip Parsonage PC - Care Home only 4 beds Category(ies) of LD - Learning Disability registration, with number of places 181 CARLINGFORD ROAD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 September 2004 Brief Description of the Service: 181 Carlingford Road is a residential home that is registered to provide personal care to up to four service users who are over the age of eighteen and who have a learning disability. Service users can be of either gender. The home is situated in a residential area of Tottenham North London, with good public transport links and close to Wood Green shopping and leisure facilities. The home is a converted mid-terrace house, arranged over three storeys, with four bedrooms, a garden, lounge and kitchen/diner. The accommodation is suitable for the needs of the service users but is not suitable for those requiring assistance with mobility or who use mobility aids. On the 1st April 2004 the management of the home was transferred from Care Providers Haringey Adult Independent Living Association (HAIL) to Choice Support and the housing management is provided by Sanctuary Housing Association. Choice Support is a charity organisation that has been in business for 20 years supporting people with learning disabilities in the community. The head office is based in Westminster in Central London. The homes provide 24 hour care and its stated aim is to provide the service users with a secure, relaxed and homely environment in which their care, well being and comfort is of the prime importance. 181 CARLINGFORD ROAD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on an announced basis and took around seven hours to complete. The registered manager was present and aided the inspector throughout the visit and conducted a tour of the building with the inspector. The inspector also had the opportunity to speak in some depth with one staff member and briefly with three others. The inspector also referred to the information provided by the registered manager in the pre-inspection questionnaire and the feed back from service users’ relatives and social care professional via a small number of written feed back questionnaires. All service users living in the home have done so for a number of years, one service user has live in the home since it was opened. During the inspection the four service users returned from their day services and the inspector had the opportunity to spend about an hour getting to know them. Due to the nature of their disability, and their communication difficulties it is difficult to gain their opinions about life in the home. However, the inspector observed that they were relaxed and comfortable, in each other’s company and with the staff and there was a lot of laughter between staff and service users. What the service does well: What has improved since the last inspection? What they could do better: 181 CARLINGFORD ROAD Version 1.10 Page 6 The main concern for the registered provider is that the state of the house is deteriorating and there is a need to ensure that the maintenance issues are addressed in the home as a matter of priority. A number of requirements are made and restated under standards 26, 27 and 28. The washing machine also needs to be replaced with a machine with a sluice cycle. A recommendation is made regarding the home seeking support from an occupational therapist regarding any specialist equipment that might help promote the independence of one service user who has a visual impairment. It is also necessary to review the night-time staffing arrangements to ensure the safety and well being of the service users. A business plan needs to be put in place for the home, that includes the plans that the registered provider has to meet staff training needs and for redecoration and maintenance of the home for at least the next twelve months, including reasonable resources and timescales. Staff need to be reminded of the home’s policies and procedure regarding the administration of medication and the service user plans and risk assessments for two service users need to be expanded to properly reflect their particular needs. A number of requirements from the previous inspection were not reviewed and are restated in that they are to inspected at the next inspection. These are in relation to the recruitment, support and records held regarding staff employed in the home. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 181 CARLINGFORD ROAD Version 1.10 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 181 CARLINGFORD ROAD Version 1.10 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, 2, & 3 Prospective users have the information they need to make an informed choice about where they live, and can be confident that their aspirations and needs will be properly assessed, and that the home will meet these. EVIDENCE: A copy of the home and organisation statement of purpose has been submitted to the lead inspector prior to this inspection. This included a list of weekly placement fees for each service user. The service users guide is individualized, is in accessible language, including symbols, and is suitable for people with learning disabilities. Each service user has lived at Carlingford Road for several years. One user has lived in the home since it opened and a number of users came from longterm hospital and from their homes after living with their families for many years. It was evident on each file examined that each person had a full assessment undertaken prior to moving into the home. The home supports four service users with learning difficulties with challenging behaviour. The statement of purpose sets out how the home supports the service users both in the home and the in community. 181 CARLINGFORD ROAD Version 1.10 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 standard(s) 6, 9 & 10 There is a clear and consistent care planning system in place that is satisfactory overall. Service users needs and goals are reflected in their individual plan. They are encouraged to make decisions about their lives and supported to take risks as part of an independent lifestyle. However, one service user’s plan and risk assessment is not detailed enough, which potentially places the service users at risk of accidents. Service users can be confident that information about them is handled appropriately, and that their confidences are kept. EVIDENCE: 181 CARLINGFORD ROAD Version 1.10 Page 10 The inspector saw the written records for all four service users and found that each person had a service user plan, which is of an acceptable standard. At the previous inspection, it was required that the registered person ensures that risk assessments were developed regarding all activities, tasks and situations which service users take part in or are exposed to which involve risk. The requirement made was to ensure that all individual risk assessments include guidance on how individuals are supported in activities in the community and at the home. The inspector found that the risk assessments have been improved and reflect most of the areas of risks in individual service users’ life. However, the inspector noted that one service user has poor eyesight and that this contributes to the risks in this person’s life. The service user plan and risk assessments that are in place for this service user do not properly reflect the effect of this particular disability, and a requirement is made in respect of this. The home has in place a confidentially policy which makes reference to the Data Protection Act 1998. However, the organisation is a charity and is exempt from the Act. 181 CARLINGFORD ROAD Version 1.10 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, 13, 15, & 16 The home provides opportunities for personal development and service users do take part in a good range of social and leisure activities, both in the home and in their local community. Service users’ families have involvement in their lives. Service users’ rights are recognised, although one service user’s plan and risk assessments need to be expanded in order to protect his best interests in this respect. EVIDENCE: It was evident that each service users is given the opportunity to develop their own personal skills and abilities. Each individual plan is developed with this in mind and is reviewed regularly. Service users’ individual user guides are a good example of this as they are completed in a pictorial style to suit each individual service user and this clearly illustrates their likes and dislikes. 181 CARLINGFORD ROAD Version 1.10 Page 12 It was evident from the daily logs that all service users have access to the local community and participate in various activities at the day centre, and these activities are supported by the home. Each service user has a timetable of events in their plans. The home ensures all service users participate in community life on a day-to-day basis. Generally, where specific restrictions are placed upon the service users’ freedom, these were documented, reviewed and discussed as part of service users’ reviews. However, the inspector found that one service user had no water supply to his bedroom vanity unit. The registered manager explained that this was due to particular behavioural issues. This was not properly reflected in the service user’s plan or risk assessments and a requirement is made in respect of this. The inspector found that service users are supported to maintain their family links and develop new friendships. It was evident from care plans that individuals have regular contact with family and friends outside of the home. One user has no family but has a befriender whom acts as the user’s next of kin. During the latter part of the inspection the care staff on duty were preparing the evening meal. Staff and users were all in the kitchen listening to music and chatting. The atmosphere was pleasant and relaxed. 181 CARLINGFORD ROAD Version 1.10 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) 19, 20, & 21 Service users are well supported with regard to their physical and emotional health needs. The arrangements that are in place in the home for the storage and administration of medication have been improved. However, staff do need to be reminded of the policy regarding the safe administration of medication in order to safeguard the service users. Service users can be confident that their ageing, illness or death would be handled sensitively and appropriately in the home. EVIDENCE: 181 CARLINGFORD ROAD Version 1.10 Page 14 The inspector saw evidence that service users’ physical and emotional health needs are met. It was evident that service users’ healthcare needs were being addressed by the home and, in addition to being registered with a local GP, the specialist consultant in learning disabilities sees all the service users at least annually. It was evident at this inspection that the medication procedures and documentation had improved. Copies of all staff who have undertaken the medication training were listed with signatures. All PRN medication had guidance notes for individual care staff to follow when administering these. However, during the inspection a tablet was found on the floor in one service user’s bedroom and a requirement is made in respect of this. It was evident that the home has worked together with the user and their families to produce a plan of action regarding individual wishes in the event of their death or a serious illness. One file was examined and the user’s family signed it on their behalf and it included the service user’s religious beliefs and what type of ceremony they would like. 181 CARLINGFORD ROAD Version 1.10 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 & 23 Service users and their representatives can feel their views are listened to and will be acted on, and that service users are protected from abuse, neglect and self-harm. EVIDENCE: The home’s complaint policy and procedure was in place, which is titled ‘How to complain’, and is in pictorial style for the service users. Since the previous inspection there have been no formal recorded complaints, although one service user’s relative has expressed concern regarding the night-time staffing arrangements. This issue is addressed under Standard 33 of this report. The home has a comprehensive adult protection policy and procedures in place. There is evidence to show that the home has provided relevant training to all staff. The staff who were spoken to demonstrated that they were clear about what to do if they suspected that a service user was being abused. They were able to describe different forms of abuse and the action that they would take. 181 CARLINGFORD ROAD Version 1.10 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, 27, 28, 29 & 30 The home provides an environment that service users can regard as their home and their bedrooms are personalised to reflect this. However, the standard of the repair and décor is poor, and is becoming a less comfortable environment for service users to live in. EVIDENCE: The home has four bedrooms, which are individualised to meet personal styles and tastes. All the rooms are in need of redecoration and repair. However, each bedroom does reflect individual’s identity and cultural preference. There are two bathrooms, one with a shower unit. 181 CARLINGFORD ROAD Version 1.10 Page 17 At the time of the inspection there were decorators working in the home, decorating the stairs and landing. There was also some re-tiling being undertaken in the downstairs bathroom. However, the inspector was concerned to note that the majority of the previous requirements regarding up-grading the decoration in the home had not been achieved. Several new requirements are made, in this report as the decorative state of the home has deteriorated further. The registered manager explained that the schedule of refurbishment of the building included external decoration of the home and that this is planned for September of this year. The following maintenance issues must be addressed as a matter of priority: 181 CARLINGFORD ROAD Version 1.10 Page 18 R bedroom 1. There is no lockable storage or drawer in this bedroom. A suitable lockable facility must be provided. This requirement is restated. 2. The cracks in the plaster around the door must be repaired. 3. The room must be redecorated throughout. D bedroom 4. There is no lockable storage or drawer in this bedroom. A suitable lockable facility must be provided. This requirement is restated. 5. The wardrobe door is broken and must be repaired. 6. The room must be redecorated throughout. V bedroom 7. There are cracks on the ceiling, these must be repaired or redecorated. This requirement is restated. 8. The window frame and ledge paintwork is peeling and must be cleaned and redecorated. This requirement is restated. 9. The curtains on the wardrobe are dirty and must be washed. 10. The room must be redecorated throughout. 11. The carpet is dirty and must be steam cleaned. 12. The vanity unit must be repaired or replaced. C bedroom 13. The room must be redecorated throughout. Hallway and stairs 14. All carpeted areas must be refitted with new floor coverings. This requirement is restated. Bathroom on first floor 15. The bathroom must be redecorated. This requirement is restated. 16. The leak behind the toilet must be repaired 17. The room must be redecorated throughout. Bathroom ground floor 18. The flooring must be replaced, as it is uneven and dangerous. This requirement is restated. Kitchen/dining 19. Floor covering must be replaced – This requirement is restated. 20. Fridge handle broken and must be replaced or repaired – This requirement is restated. 21. The kitchen must be redecorated. This requirement is restated. 22. The kitchen units and work surfaces are broken and water damaged and must be replaced. 23. The hob and oven are in poor repair and must be replaced. 24. The Venetian blinds are in poor repair and must be replaced. 181 CARLINGFORD ROAD Version 1.10 Page 19 Outside of the building 25. The paint peeling off of the outside of the building. The whole area must be redecorated. This requirement is restated. In addition, it is necessary that the registered person request a visit from the environmental health officer and a requirement is made in respect of this under Standard 42. It was required at the previous inspection that the home has in place a washing machine with a sluice cycle. However, it was evident that the old washing machine was still in place. This requirement must be addressed as a matter of priority. No specialist equipment is provided in the home as none of the service users are physically disabled. One service user is visually impaired and it is recommended that the registered person seek support from an occupational therapist regarding any specialist equipment that might be acquired to help promote this particular service user’s independence. 181 CARLINGFORD ROAD Version 1.10 Page 20 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) 33 The service users are supported by sufficient numbers of staff during the daytime. However, it is necessary to conduct a formal review of the night-time staffing arrangements in order to ensure the safety and well being of the service users. EVIDENCE: The inspector found that there were sufficient numbers of staff rota’d to be on duty during the day time hours. The registered manager explained that a recent change in staffing arrangements, from two staff sleeping–in at night to one staff member. He said that this is still under review, and showed the inspector the written monitoring records that relate to this. One service user’s relative has expressed concern about this issue, in terms of the safety of service users at night. A previous requirement under Standard 33 is revised and restated in this report, to include the need for a formal review of the night-time staffing arrangements and the consequent risks to be undertaken. Compliance with a number of previous requirements was not assessed at this inspection. They relate to staff personnel records, evidence of training undertaken by care staff, supervision records and job descriptions. These requirements are restated and will be reviewed at the next inspection. 181 CARLINGFORD ROAD Version 1.10 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 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) 40, 41, 42 & 43 The policies and procedures and the record keeping in the home safeguard the service users’ best interests. . While service users’ interests are looked after, work is needed to ensure a business planning system is in place. Service users can be reasonably confident that the home protects their physical safety and security through a proactive approach to health and safety, although there are some areas for improvement in relation to the kitchen. EVIDENCE: The inspector saw those service users’ best interests are protected by the home’s policies and procedures. It was evident that all policies and procedures were in place as set out in Appendix 2 of the NMS for Adults. The record keeping was of a good standard. The inspector reviewed the records of the money kept on behalf of service users and these were in good order; a running balance is kept illustrating all money received and spent, and receipts are kept as proof of expenditure. 181 CARLINGFORD ROAD Version 1.10 Page 22 At the previous inspection it was required that the registered person must produce a business plan, as required under Standar 43. Such a plan must be kept in the home and be available for the inspector. No business plan is yet in place with regard to the home and any future improvement such as training and maintenance of the building. Therefore this requirement is restated in this report. Due to the deterioration in the state of the kitchen generally, a requirement s made for the registered person to request a visit from the local environmental health officer. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 181 CARLINGFORD ROAD Score 2 x x Standard No 24 25 26 27 28 29 30 Version 1.10 Score 2 2 2 2 2 2 2 Page 23 9 10 LIFESTYLES 2 3 Score STAFFING Standard No 11 12 13 14 15 16 17 3 x 3 x 3 2 x Standard No 31 32 33 34 35 36 Score 2 x 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 3 Standard No 37 38 39 40 41 42 43 Score x x x 3 3 2 2 181 CARLINGFORD ROAD Version 1.10 Page 24 yes 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 Requirement Timescale for action 30/08/05 2. 16 3. 24 4. 31 13(4)(a-c) The registered person ensure that the risk assessments for one service user is developed in order to reflect the impact of the service users visual impairment. 13(4)(a-c) The registered person ensure 30/08/05 that the practice of preventing one service user access to running water in his bedroom is reviewed, with input from all relevant stakeholders, and that the outcome is properly documented as part of this service users plan and risk assessments. 23(4)(a) The registered person must 30/09/05 ensure that all the environmental deficiencies identified under Standards 24 to 29 of this report are appropriately addressed. An action plan with regards to the works programme is to be submitted to the CSCI with proposed timescales. The previous timescale of 30/2/05 was not met. This requirement is restated. 17 (2) The registered person must 30/08/05 ensure all care staff personnel records are kept in the home at all times. They must contain all Version 1.10 Page 25 181 CARLINGFORD ROAD 5. 33 18(1)(a) 6. 34 18(1)(a) 7. 35 13(4)(c) 8. 36 18(2) 9. 20 13 (2) information as set out in the National Minimum Standards and as required by regulation. This requirement was not inspected. The registered person must ensure that a formal review of the nighttime staffing arrangements in the home is undertsaken in order to ensure that the home has an effective staff team with sufficient numbers and complementary skills to provide continuity in support service users’ of assessed needs at all times.This requirement is revised and restated. The registered person must operate a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users, and evidence this through the maintenance of appropriate documentation in the home and make available for inspection as required by regulation.This requirement was not inspected. The registered person must have on each shift a qualified first aider. This requirement was not inspected. The registered manager must ensure that individual staff supervision meetings are carried out at least six times a year with a senior/manager, in addition to regular contact on day-to-day practice, and that records must be mentioned in accordance with the requirements of the standard.This requirement was not inspected. The resgistered person must ensure that all staff are reminded of the guidance that is in place regarding the safe and proper administation of Version 1.10 30/10/05 30/08/05 30/08/05 30/08/05 30/08/05 181 CARLINGFORD ROAD Page 26 medication to service users. 10. 43 25 The registered person must 30/09/05 produce a business plan, which must be kept in the home and be available for the inspector.This requirement is restated. The registered person must 30/08/05 request an inspection visit from the local environmental health officer. The registered person must have 30/09/05 in place a washing machine that has a sluice cycle programme.This requirement is restated. 11. 42 23 (5) 12. 30 23(2)(k) 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 6, 9 Good Practice Recommendations It is recommended that the registered person seek support from an occupational therapist regarding any specialist equipment that might be aquired to help promote the independence of the service user who is visually impaired. 181 CARLINGFORD ROAD Version 1.10 Page 27 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 181 CARLINGFORD ROAD Version 1.10 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. 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