Inspection on 22/11/07 for Cascade Care Ltd (Cascade III)

This inspection was carried out on 22nd November 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cascade Care Ltd (Cascade III) 30/07/06

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Cascade Care Ltd (Cascade III) Cascade III 74 Linthorpe Road London N16 5RF Lead Inspector Robert Sobotka Unannounced Inspection 22nd November 2007 10:45 Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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 Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cascade Care Ltd (Cascade III) Address Cascade III 74 Linthorpe Road London N16 5RF 020 8800 8530 020 8221 7981 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) Cascade Care Ltd Vacant Post Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 30th July 2006 Date of last inspection Brief Description of the Service: Cascade III is a registered care home, which provides care, support and accommodation for a maximum of five male service users within a community setting, who have mental health needs. The premises are situated in Linthorpe Road, which is situated in Stamford Hill, N16, within a walking distance from Stamford Hill Train Station. Access to buses and underground trains (Victoria Line) from Seven Sisters and Piccadilly Line from Manor House Station are approximately 10 minutes away from the home and the 235 bus stop is two minutes away. Further buses with routes to Tottenham, London Bridge, Aldgate and Euston are also within walking distance. The property is a large Victorian terraced house, which consists of five single bedrooms, a large communal lounge with cable TV and a music centre, separate laundry facilities with a dryer, bathroom and WC, separate WC, large dining room, fully equipped kitchen and a large garden at the rear of the house. The premises are not suitable for those with complex mobility needs and are not wheelchair accessible. At the time of this inspection, there were 3 service users accommodated in the home and 2 places were vacant. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and was unannounced. As part of this visit, the inspector spoke to three of the service users living in the home, as well as two of the care staff. As the new home manager was on sickness leave at the time of this visit, the inspector dealt with the Clinical Services Manager and a manager of a sister project owned by Cascade Care Ltd. Prior to this inspection visit, the home manager was asked to complete an Annual Quality Assurance Assessment. This document has not been returned to the Commission at the time of this inspection and a statutory requirement has been issued within this report to ensure that the home manager/organisation returns a completed AQAA to the Commission within the set timescale. As part of the visit, the inspector spoke with some of the people who use the service and care staff working in the home. He also conducted a tour of the premises and viewed various records. The aim of this unannounced inspection was to check the home’s compliance with the National Minimum Standards for Care Homes for Adults (18-65) and The Care Homes Regulations 2001. The inspector would like to thank service users and staff who co-operated and contributed to the inspection. What the service does well: What has improved since the last inspection? The home’s Adult Protection Policy has been further developed/updated to include information on the Protection of Vulnerable Adults List and what action should be taken if abuse is suspected. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 6 The home’s Statement of Purpose has been updated and that the statement that the home provides services to “men who have past and present history of drug dependence or alcohol abuse” has been removed. The responsible individual has ensured that all policies and procedures listed in Appendix 2 of the National Minimum Standards are up-to-date and kept under review. The mandatory training has been booked for all staff and will be taking place in early December 2007. The responsible person has ensured that records of the food provided for service users are kept and that they are sufficient in detail to enable any person inspecting the record of determine whether the diet is satisfactory, in relation to nutrition or otherwise, and any special diets prepared for individual service users. 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. The summary of this inspection report can be made available in other formats on request. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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 Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given sufficient information they need to make an informed choice about where to live. Appropriate admission systems were in place. The home was meeting the needs of those accommodated there. Prospective service users have an opportunity to “test drive” the home, prior to moving in. EVIDENCE: Since the last inspection the home’s statement of purpose has been updated and that the statement that the home provides services to “men who have past and present history of drug dependence or alcohol abuse” has been removed. At the time of this visit the home did not have a registered manager in place, however the organisation was in the process of submitting an application to the Commission for the manager to be registered as fit to manager a residential home for people with mental health issues. There have been two new admissions to the home since the last inspection. The inspector viewed a care plan of the most recently admitted service user. His file contained a comprehensive assessment. There was also evidence that appropriate and relevant information had been obtained from the placing authority. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 9 Following a discussion with a service user, staff working in the home and review of the documentation, the inspector was satisfied that the home was meeting the needs of the current service user group. There was evidence that service users are offered to visit the home and have overnight stays in the home, before they make a decision to move to the home on a full time basis. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had an appropriate care planning process in place. Those using the service are encouraged to take part in decision-making about the care they needed. Confidentiality is maintained. EVIDENCE: As part of this visit, the inspector checked care plans of all three service users. Documents viewed were well maintained and were reviewed on a regular basis. Minutes from the Care Planning Approach meetings were also in place. There was evidence that service users are encouraged to participate in their care planning process and their views were taken into account. Since the last inspection service users’ care plans have been reviewed on a monthly basis to reflect any changes of service users’ needs. The inspector was informed that the organisation was in the process of implementing a new care planning system. A copy of a blank care plan was showed to the inspector on the day of this visit. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 11 The home operates a keyworking system. Each person had a designated keyworker, who was responsible for coordinating care of their keyclient. Keyworking sessions were also organised, during which any individual goals, progress and areas that needed further support were discussed. Regular service users’ meetings were also held, during which service users could make any comments and suggestions as to how the home should be run. Appropriate risk assessments were in place and there was evidence that service users were encouraged to take responsible risks as part of an independent lifestyle in line with their individual risk assessments. Confidentiality was being maintained. All confidential information was kept in the office, which was locked when not in use. Staff working in the home shared information about the service users with the inspector on a need-to-know basis. Service users were aware that they had access to their files should they wish to view them. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who live in the home were encouraged to lead active lifestyles within the local community and develop and maintain friendships and family links. Service users enjoyed food offered in the home and improvements have been noted in relation to records of food offered to service users. EVIDENCE: Documentation viewed confirmed that staff working in the home encourage and support service users to become a part of the local community and to attend local college courses and day centres. They are also offered assistance in seeking paid and/or voluntary employment. Those who lived in the home were offered a holiday to Butlins and one of the service users chose to go on it. Service users are allowed to receive visitors in the home. They were encouraged to maintain family contact and to have appropriate relationships. Care plans of the service users evidenced that those who live in the home are encouraged and supported to maintain appropriate family contacts and develop Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 13 appropriate friendships. The service users who spoke with the inspector confirmed this. There were appropriate food supplies in the home. Some of the meals offered to the people who used the service were prepared some staff and also prepared by the service users themselves. Fridge freezer temperatures were taken and recorded daily. Food was appropriately stored and the inspector was satisfied that records of food offered to the service users have been improved and were sufficient in detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition or otherwise, and any special diets prepared for service users, as previously required. The inspector was invited to have a meal with the service users. Food offered was attractively presented, nutritionally balanced and tasty. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was appropriately meeting the physical and emotional needs of the service users, however medication systems required improvement. EVIDENCE: At the time of this inspection, none of the service users required support with personal care. There was evidence in the care plans viewed that verbal prompts to service users were sometimes required. Care plans viewed showed that those who live in the service received appropriate care from the healthcare professionals. Those who use the service received regular psychiatric reviews. Each person was registered with the General Practitioner and any other healthcare professional who would be beneficial to meeting their needs. As part of this visit, the inspector checked the home’s medication systems. It was noted that medication administration record (MAR) sheets contained several gaps and there was no indication as to whether this medication had been administered and if not, what was the reason for not administering medication. The inspector was concerned to find out that one of the service Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 15 user’s MAR sheets indicated that his medication was out of stock. This practice is unacceptable and it is the home’s responsibility to ensure that there are adequate supplies of any prescribed medication available in the home. One of the service users was prescribed PRN (“as required”) medication. The medication box stated that “one or two tablets should be given”, however there were no guidelines in place for staff to instruct them as to when one or two tablets should be offered to the service and thus allowing the correct dosage to be given as necessary. It is required that the responsible person makes arrangements for the recording, handling and safekeeping, safe administration and disposal of medicines into the care home, in order to ensure that appropriate and safe medication systems are in place. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a good complaints system in place and any concerns are dealt with without delay. Those living in the home were generally protected from abuse, neglect and self-harm, however better systems must be introduced to ensure appropriate money management systems on behalf of the service users living in the home. EVIDENCE: The inspector viewed the complaints record. There have been four complaints since the last inspection. There was evidence that they were appropriately investigated and dealt with and resolved within reasonable timescale. Those who lived in the home were also given opportunities to raise their concerns about the way the home is run, during resident’s meetings and their keyworking sessions. Two of the service users who spoke to the inspector said that they felt comfortable raising any concerns with the manager or a member of staff. Service users manage their own finances, however support and guidance is offered to those who may require help in managing their finances, due to the risk of substance abuse or money mismanagement. During the review of service users’ care plans, the inspector came across a letter from a high street bank that included details of a joint bank account opened between one of the service user’s and his keyworker. Although this is not a common practice in the home, the account was set up by the service user’s keyworker with good intentions, because the service user has shown a history of mismanaging his finances. During this inspection, the organisation was able to demonstrate that Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 17 this account had not been used and that the previous manager had pointed out to the keyworker that this practice was unacceptable and must stop. Even though the account has not been used, it had not been closed at the time of this inspection. In order to protect service users from financial abuse, the responsible person must ensure that the joint account between one of the service users and his keyworker is closed. A confirmation letter from the bank to evidence this must therefore be forwarded to the Commission. Records of accidents/incidents were also reviewed during this visit. These showed that appropriate action is taken following any incident/accident to prevent further incidents from reoccurring. The home’s Adult Protection Policy has been updated to include information on the Protection of Vulnerable Adults List and what action should be taken should abuse be suspected, as previously required. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a homely, comfortable and safe environment. EVIDENCE: The premises are situated in Linthorpe Road, which is situated in Stamford Hill, N16, within a walking distance from Stamford Hill Train Station. Access to buses and underground trains (Victoria Line) from Seven Sisters and Piccadilly Line from Manor House Station are approximately 10 minutes away from the home and the 235 bus stop is two minutes away. Further buses with routes to Tottenham, London Bridge, Aldgate and Euston are also within walking distance. The property is a large Victorian terraced house, which consists of five single bedrooms, a large communal lounge with cable TV and a music centre, separate laundry facilities with a dryer, bathroom and WC, separate WC, large dining room, fully equipped kitchen and a large garden at the rear of the house. The premises are not suitable for those with complex mobility needs and are not wheelchair accessible. At the time of this inspection, the premises were well maintained. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 19 Service users who spoke with the inspector said that they were happy with the home’s communal areas and their bedrooms. The inspector was informed that a new carpet was laid in communal areas, new wooden flooring was laid in the communal lounge, a new sink has been installed in one of the service user’s bedroom and a ceiling was replaced in the home’s kitchen following a leaking sink. New furniture has been ordered for one of the service user’s bedrooms and there were plans to purchase some music equipment for another service user. The premises were found to be clean and hygienic at the time of the inspection. Appropriate laundry facilities were in place. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service are supported by staff who are committed to providing good quality of care. EVIDENCE: The inspector viewed duty rosters, which showed that there were sufficient numbers of staff on duty. There are two members on each shift, including nights. Night staff remain awake throughout the night. Staff who spoke with the inspector stated that they felt that staffing levels were sufficient. The majority of staff either have obtained the NVQ qualification or were in the process of obtaining one. It was identified during the last inspection visit that some of the mandatory training for staff was overdue. During this inspection visit, the inspector was presented with a confirmation letter, which evidenced that mandatory training has been arranged for care staff and would be taking place in early December 2007. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 21 As part of this visit, the inspector checked staff personnel files and he was satisfied that appropriate pre-employment checks have been undertaken before employing any member of staff in the home. There was also evidence that each member of staff received induction. Staff were appropriately supervised. Supervision records were also checked and the inspector was satisfied that staff received regular supervision. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As the newly appointed home manager was on sickness leave during this inspection visit, the inspector was unable to assess Standard 37. This standard will be assessed during the next inspection visit. Staff and the service users who spoke with the inspector gave him a positive feedback about the manager and his managerial skills. They felt that the manager was fair and approachable. Regular visits from the registered provider (Regulation 26 visits) were taking place and reports from these were being forwarded to the Commission. Prior to this inspection visit, the home manager was asked to complete an Annual Quality Assurance Assessment. This document has not been returned to the Commission at the time of this inspection. The responsible Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 23 person/manager must ensure that a completed Annual Quality Assurance Assessment is returned to the Commission. Appropriate health and safety checks were in place. The home was adequately insured for its purpose. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X X X 2 X X 3 X Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA20 Regulation 13(2) Requirement Timescale for action 21/12/07 2. YA23 20(3) 3. YA39 24(2) It is required that the responsible person makes arrangements for the recording, handling and safekeeping, safe administration and disposal of medicines into the care home, in order to ensure that appropriate and safe medication systems are in place. In order to protect service users 31/12/07 from financial abuse, the responsible person must ensure that the joint account between one of the service users and his keyworker is closed. A confirmation letter from the bank to evidence this must be forwarded to the Commission. The responsible person/manager 15/01/08 must ensure that a completed Annual Quality Assurance Assessment is returned to the Commission. Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cascade Care Ltd (Cascade III) DS0000067296.V355333.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!