Inspection on 24/11/05 for Carlingford Road, 181

This inspection was carried out on 24th November 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 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 17/05/05

Carlingford Road, 181 16/09/04

Carlingford Road, 181 20/05/04

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 Carlingford Road, 181 181 Carlingford Road South Tottenham London N15 3ET Lead Inspector Caroline Mitchell Unannounced Inspection 22nd November 2005 09:00 Carlingford Road, 181 DS0000060630.V259093.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 Carlingford Road, 181 DS0000060630.V259093.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. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlingford Road, 181 Address 181 Carlingford Road South Tottenham London N15 3ET 020 8693 6088 020 8299 4818 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) Choice Support Mr John Philip Parsonage Care Home 4 Category(ies) of Learning disability (0) registration, with number of places Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 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 Sanctuary Housing Association provides the housing management. 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 it’s 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. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took around five hours to complete. During this time the inspector spoke to the acting manager, who aided the inspector throughout the inspection, and briefly to two other members of staff. The inspector was shown around the home and a number of written records were also examined. Due to the nature of the disability of the service users it is difficult to elicit their opinions. However, the inspector was able to speak to two service users and spend some time with them. They appeared relaxed and well cared for. What the service does well: What has improved since the last inspection? What they could do better: The main concerns for the registered provider are to recruit a permanent manager to the home to ensure that there is consistency and focus, particularly in terms of record keeping about service users. 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. It is also necessary to contact the placing authority to ensure that service users have proper placement reviews, as these are outstanding. Please contact the provider for advice of actions taken in response to this Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carlingford Road, 181 DS0000060630.V259093.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 Carlingford Road, 181 DS0000060630.V259093.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): 1&2 The information needed to make an informed choice about where they live, is available to prospective service users. Service users’ aspirations and needs are properly assessed. EVIDENCE: 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. A copy of the statement of purpose had 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, and was reviewed briefly at this inspection. 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. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 & 10 Service users’ needs and goals are reflected in their individual plans. They are encouraged to make decisions about their lives and supported to take risks as part of an independent lifestyle. Generally, service users can be confident that information about them is handled appropriately, and that their confidences are kept. EVIDENCE: 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. The individual risk assessments include guidance on how individuals are supported in activities in the community and at home. The inspector found that the risk assessments have been further improved and reflect the areas of risks in individual service users’ lives. One service user has poor eyesight and the risk assessments that are in place have been improved to properly reflect the effect of this disability. The plans and risk assessments are kept separately from other general written information about service users and are accessible to staff, although a note about the general monitoring records is made under standard 19 of this report. The inspector is aware that a person centred planning approach is to be introduced in the home, but that this has not yet been achieved. The inspector noted that some of the service users have not Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 10 had multi-disciplinary placement reviews for more than a year and a requirement is made in respect of this. The inspector noted that an individual procedure was in place for each service user, to be flowed in the event that they should become missing. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Service users are subject to some restrictions to their personal freedom, these restrictions are in the interests of their safety and are reviewed regularly. EVIDENCE: All service users attend specialist day services in the daytime. One service user has presented a number of challenging behaviours and records reflect that, with advice from appropriate professionals and with consistency of staffing, these have reduced significantly over the past months. As a result this service user is now able to visit their family more often, and has become more settled in their day placement. There are a number of restrictions placed upon this service user in relation to their challenging behaviour and the inspector noted that these are properly documented, having been agreed with a psychologist and there are appropriate risk assessments in place. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 12 Each service user has a schedule of activities, setting out the individual activities that they are to undertake each week and include social, leisure and skills based activities, both in the home, and in the local community. The records for each service user indicated that they were being supported to engage in a range of activities that reflect their interests and needs. One service user told the inspector that they were looking forward to Christmas and were going to visit their advocate during the Christmas period. The acting manager told the inspector that three of the service users have very regular contact with their families, and that the forth service user, having no family contact, has a long standing friend who acts as their advocate. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Service users receive personal support to suit their needs and preferences and their health needs are met generally. However, written records are disorganised, which could result in some risk to their wellbeing in this area. The arrangements for the administration of medication in the home are acceptable. Service users can be confident that their ageing, illness or death would be handled sensitively and appropriately in the home. EVIDENCE: Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 14 The inspector noted that there was detailed guidance for staff regarding the support each service user required and preferred as part of the assessment and individual planning records. The way in which the day-to-day records were presented enabled the acting manager to monitor the kind of support that had been provided to each person on a daily basis, and the emphasis was on encouraging service users to do as many of their own personal care tasks as possible. It was evident that service users’ healthcare needs were being addressed to some extent 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. However, whereas the service user plans and risk assessments are clear and accessible, the inspector noted that the files of general information regarding each service user do need to be re-organised as they were untidy and over full. Consequently information was not easily accessible, particularly in relation to medical treatment and appointments, making monitoring health related issues difficult. At one service user’s review an identified task was for them to receive support from a speech and language therapist. It had been recommended that another service user have a blood test. In each case it was difficult to monitor how these issues had been followed through. A requirement is made in respect of this. The inspector saw the records of the monitoring undertaken by staff in relation to medication prescribed and administered to service users. The supply of medication that is received from the pharmacist is checked to ensure that it is correct. The record of medication that has been administered is also checked regularly to ensure that there are no mistakes or omissions. Consent for staff to administer medication was included in service users’ records. The temperature that medication is stored at is monitored by staff and a record kept. This reflected that it was generally stable at around 22°c. As it is difficult to gain the opinions of the service users, due to the nature of their disabilities, the home has sought the wishes of the service users’ families regarding how things should be handled in the event of a service users’ death or serious illness. This is documented as part of each individual’s written records. There was also evidence that the home had sought advice from the service users’ GP regarding their taking part in sporting activities, such as trampolining, where there were other medical considerations such as epilepsy. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 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, and the acting manager explained that the service user’s relative who had previously expressed concern regarding the night-time staffing arrangements appears to be reassured and there has been no incidents at night to cause concern. 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. No adult protection issues have arisen since the last inspection. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 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 house is quite a spacious Victorian family home and quite homely in general. The service users’ bedrooms are personalised to reflect their backgrounds and personalities. At the previous inspection the inspector noted that the physical environment of the home is deteriorating. This remains the case and must be addressed by the registered persons as a matter of priority. However, the majority of the requirements made at the previous inspection remain outstanding. The acting manager explained that there remain issues with Choice Support and the housing managers, Sanctuary Housing, regarding budgeting for this work to be carried out. The inspector later discussed these issues with management staff from Choice support and is aware that efforts are being made to resolve these issues. Each of the necessary repairs and improvements are restated as part of this report. On a positive note, the outside of the house has been painted, and staff in the home has addressed a number of the smaller issues that were noted at the Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 17 previous inspection, such as washing the curtains. In addition the hallway and landings have been painted and staff do a health and safety check of the property on a weekly basis and any issues identified through this process a more addressed in a more timely manner. A requirement remains outstanding for the registered person to provide a washing machine that has a sluice cycle programme and this requirement is restated. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 & 36 The service users are supported by sufficient numbers of staff. Service users are generally protected by the home’s recruitment practices although some work is still necessary in relation to staff files. To further protect service users’ best interests, some staff need training in first aid. Staff benefit from a reasonable level of supervision support. EVIDENCE: The inspector found that there were sufficient numbers of staff rota’d to be on duty during the day time hours. The acting manager explained that a change in staffing arrangements, from two staff on duty at night, to one staff member sleeping-in, in operation for over six months at the time of this inspection, was working well and without serious incident or concern. The inspector reviewed the monitoring records in relation to this, and these reflected that some, periodic sleeplessness of one service user had decreased in frequency and the other service users has settled well to this arrangement. In house risk assessments had been undertaken in order to predict and minimise any risks. It was, however unclear as to whether the placing authority had been consulted regarding this change in support, and some service users’ placement reviews, undertaken prior to the change, stated that they were provided with waking support on a twenty four hour basis. The requirement is made that service users have placement reviews under standard 6 of this report and a recommendation is made that these reviews include clarification of the support that is currently being provided. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 19 The inspector reviewed the records kept regarding the staff employed in the home. The majority of the required information was available, indicating that staff had been through a thorough vetting process, prior to being employed in the home. However, some records did not include a recent photograph of the staff member or a copy of their current job description. It was also difficult to be sure of the actual date that each staff member commenced work in the home and one staff member’s written records were not available. A requirement is restated in respect of these issues. At the previous inspection a requirement was made for a first aider to be on duty on each shilft. Although some staff have had first aid training, this has not been wholly achieved, and this requirement is restated. The acting manager provided evidence to the inspector that appropriate one to one staff supervision and support is being provided to staff. She was being supported in this task by another manager in the organisation. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42 There is a need to recruit a full time permanent manager in order to safeguard the best interests of the service users. There is room for improvement in some areas of the record keeping in the home. There is a business planning system 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 and bathrooms. EVIDENCE: The previous registered manager has left and a long-standing senior staff member is temporarily acting as manager until a permanent manager can be recruited. Although she is doing a reasonable job of running the home on a day-to-day basis, she has other commitments that are taking increasing amounts of her time, and doesn’t intend to apply for the permanent post. A requirement is made in relation to this. At the previous inspection a requirement was made for the registered person to produce a business plan and the inspector was able to confirm that this has Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 21 been addressed. Environmental risk assessments are in place and the staff team keep good written records of the health and safety checks that they undertake, which are thorough and regular. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 2 2 X 2 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 2 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carlingford Road, 181 Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 2 X X X X 3 X DS0000060630.V259093.R01.S.doc Version 5.0 Page 23 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 19 Regulation 17 The registered person ensure that the service users’ written records are re-organised order to ensure that ensure that information is readily available to staff. 2. 6 14, 15 The registered person must contact the placing authority and request that multi-agency placement reviews are undertaken for the service users who have not had one in more than one year. 3. 26 23 The registered person must ensure that in R’s bedroom A suitable lockable facility is provided. The cracks in the plaster around the door are repaired. The room is redecorated throughout. The previous timescale of 30/09/05 was not met. 30/05/06 28/02/06 Requirement Timescale for action 28/02/06 Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 24 4. 26 23 The registered person must ensure that in D’s bedroom A suitable lockable facility is provided. The room is redecorated throughout. The previous timescale of 30/09/05 was not met. The registered person must ensure that in V’s bedroom The cracks on the ceiling are repaired and redecorated. The room is redecorated throughout. The carpet is steam cleaned. The vanity unit is repaired or replaced. The previous timescale of 30/09/05 was not met. 30/05/06 5. 26 23 30/05/06 6. 26 23 The registered person must ensure that in C’s bedroom The room is redecorated throughout. The previous timescale of 30/09/05 was not met. 30/05/06 7. 28 23 The registered person must ensure that in the hallway, stairs and landing All carpeted areas are refitted with new floor coverings. The previous timescale of 30/09/05 was not met. 30/05/06 8. 27 23 The registered person must ensure that in the bathroom on the first floor The leak behind the toilet is repaired. The room is redecorated throughout. The previous timescale of 30/05/06 Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 25 30/09/05 was not met. 9. 27 23 The registered person must ensure that in the bathroom on the ground floor The flooring is replaced. The previous timescale of 30/09/05 was not met. 10. 24 23 The registered person must ensure that in the kitchen/dining area The floor covering is replaced Fridge handle is replaced or repaired. The room is redecorated throughout. The kitchen units and work surfaces are replaced. The hob and oven are replaced. The Venetian blinds are replaced. The previous timescale of 30/09/05 was not met. 11. 33 17(2) The registered person must ensure all care staff personnel records are kept in the home at all times. They must contain all information as set out in the National Minimum Standards and as required by regulation. The previous timescale of 30/08/05 was not met. 12 35 13 (4)(c) The registered person must have on each shift a qualified first aider. This requirement was not inspected. The previous timescale of 30/08/05 was not met. 13 30 23(2)(k) The registered person must have in place a washing machine that Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 26 30/05/06 30/05/06 30/03/06 30/03/06 30/09/06 has a sluice cycle programme. The previous timescale of 30/09/05 was not met. 14 37 8 The registered persons must ensure that a full time, permanent manager is recruited and applies to be registered by the Commission. 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 33 Good Practice Recommendations It is recommended that the registered person ensures that the service users’ pending placement reviews include discussion with the placing authority regarding the current levels of support that are provided to service users at night. Carlingford Road, 181 DS0000060630.V259093.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Southgate Area Office 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 Carlingford Road, 181 DS0000060630.V259093.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. 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