Inspection on 25/01/06 for Chandos House

This inspection was carried out on 25th January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chandos House 03/07/07

Chandos House 26/07/06

Chandos House 20/09/05

Chandos House 21/03/05

Chandos House 21/01/05

Chandos House 03/03/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Chandos House 36 Chandos Road Redland Bristol BS6 6PF Lead Inspector Sandra Gibson Unannounced Inspection 25th January 2006 09:30 Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chandos House Address 36 Chandos Road Redland Bristol BS6 6PF 0117 9243071 0117 9243071 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) Ms Joyce M Dickinson Mr James Dickinson Care Home 10 Category(ies) of Past or present alcohol dependence (10), Past or registration, with number present drug dependence (10) of places Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Chandos House is operated by Mrs J Dickinson and is registered by the Commission for Social Care Inspection to provide secondary care residential treatment for up to ten males, aged 18 - 65 years who are recovering from drug and alcohol dependency. The management team are committed to the twelve-step programme and aim to provide a holistic environment, which combines the use of counselling with alternative therapies. Residents are expected to participate in an activities programme that includes group and individual therapy sessions, as well as focusing on life skills. Chandos House is not intended to be a home for life and an average stay lasts no longer than six months. The service is not staffed during the evening or at the weekends. Arrangements for support in an emergency are in place. The home is accommodated in a large Victorian house, which comprises four stories. It is situated in a residential area, close to local amenities and major transport routes. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place midweek between the hours of 11:15am and 16:00pm Evidence was gathered from: talking to a group of service users, talking to the owner/responsible individual, talking to the manager, talking to the business development manager, talking to a volunteer, looking at the premises, and examining records, policies and procedures. What the service does well: What has improved since the last inspection? The complaints procedure has been improved since the last inspection with the result that residents have the detailed information they need to make a complaint. The systems in place to promote the health safety and welfare of residents and staff has improved since the last inspection. Please see below for details of other improvements. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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): 1,2,3,4,5 Information about the Chandos House Treatment Centre provided to prospective residents and their representatives has improved considerably since the last inspection. However, further development is required to ensure that all prospective residents have clear detailed information so that they are able to make an informed decision about whether the treatment centre can meet their individual care needs. The admission procedure is not wholly satisfactory as it does not ensure that a person’s needs have been fully assessed prior to moving into the treatment centre. Without this information there is no assurance that an individual’s needs can be met. EVIDENCE: There is now an up to date statement of purpose in place in this home and the service users guide is currently in draft form. The inspector saw a copy of the draft guide and observed that it benefited from the IT and photography skills of one member of staff. The information leaflet developed a number of years ago is currently given to prospective service users before they visit the treatment centre. It was understood that as soon as the service user guide is completed then this would be provided to all prospective residents. A couple of residents spoken to during the inspection said that they had heard about Chandos House through “word of mouth” and by a representative from their funding a their fund looking at the Commission for Social Care Inspection website. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 9 A sample of records was inspected and it was noted that many of the individual records included a detailed and comprehensive pre-admission assessment conducted by staff from Chandos House. However, it was noted that there was no needs assessment in place for several service users. The inspector was informed at the last inspection that this practice was relatively common, particularly with some London Boroughs who failed to send needs assessments despite numerous requests being made from the treatment centre. It was noted on this occasion that the situation had deteriorated rather than improved and that Bristol Social Services and Health was also included in the list of authorities who were frequently failing to send needs assessments. Potential residents complete an application form for admission to the home and are usually offered the opportunity to spend a day and overnight stay where practicable. This gives them the opportunity to meet the existing group of residents, have discussions with the staff and get a fuller understanding of the ethos of the home. One resident said that “I was given a choice of Rehab from my funder and I chose Chandos House because of people, environment and attitude” Another resident said “the reputation proceeds it” A third resident explained that he was visiting Chandos House that day as part of the admission process. The inspector heard how the visit had gone well and that “he was pleased with what he had seen. The support seems very good”. Records inspected confirmed that service users are provided with a written contract/statement of terms and conditions, which they are required to sign on admission. It was noted that this information contains house rules, their rights and obligations. All residents consulted confirmed this information. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected during this inspection. They were inspected at the last inspection conducted in September 2005 and were all found to be met. EVIDENCE: Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17 Chandos House provides residents with the opportunity to engage in a rehabilitation programme, which helps them, prepare for a lifestyle that is free from drug and alcohol dependency. Meals are well managed and provide daily variation, good nutrition, life skills and social contact for residents. EVIDENCE: All residents consulted during the inspection spoke highly of the quality of the programme. They said that the therapeutic programme was demanding but agreed it was well balanced. The programme continues to be underpinned by group work and regular one-to-one sessions. It aims to enable all residents to go to a monastic retreat at least once during their stay. It was noted that the last retreat had been held in October 2005. A couple of residents seen at the time of the inspection had been present at the retreat and spoke highly of the experience. One residents said “Chandos House is a good place it helps me look at myself and helps me maintain, be clean and sober” Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 12 Residents are encouraged to participate in team games at a local gym and are supported in accessing college courses and voluntary work with the support of their counsellor. During the inspection residents were seen going to the local gym to play team games such as badminton or squash, or returning from college where they confirmed that they have the opportunity get involved in a variety of courses. These include reading and writing skills, access to further education and learning a new language. In the first two weeks of the programme new residents can go out escorted by one of their peers. They also regularly participate in Alcoholics Anonymous and Narcotics Anonymous groups and other community projects including voluntary work. In agreement with counsellors and peers, residents’ families can visit as part of their recovery programme. The twelve-step programme and routine underpins the life of the home, but within this there is flexibility and a high degree of trust. There is an expectation of honesty about what people have been doing and how they are feeling which they share with other residents and their counsellors. There was evidence to confirm that staff use risk assessments where they feel it is necessary to do so. There are robust on-call arrangements when the home is not staffed during the evenings and at weekends. Residents said that they felt this encouraged selfresponsibility. Residents consulted confirmed the on call arrangements. One resident said that the telephone was programmed for automatic redial to the manager and that the call was free. The inspector heard if anybody relapsed a member of staff would ring to check everybody was ok and also that if there were any problems night they could ring the on call person for support. The kitchen is well equipped to meet the needs of those accommodated. The meals are planned and prepared by residents. All residents consulted with spoke highly of the catering arrangements and the high standard of food they ate. The main communal meal is in the evening and is seen as a time for all service users to get together and support each other about the day’s events. However, the inspector took the opportunity to participate in a communal lunch as all residents and the manager were at home that day. The light meal had been prepared by one of the residents and was hot and nutritious. A resident said “we take it in turns to clean, cook and tidy up. We learn how to be self sufficient at Chandos House”. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 Residents’ physical care and emotional health needs are fully met and support and counselling is delivered in a way that meets the individuals’ assessed needs. The medication administration system in place has improved considerably since the last inspection but further improvement is needed to ensure that residents and residents are protected fully from risk of harm EVIDENCE: The home continues to have a positive relationship with the local GP who is willing to accept service users accommodated at Chandos House as temporary residents on his GP list. It was noted that contact with appropriate health professionals was made as required and detailed records were maintained about this contact. Residents confirmed that they had been informed that staff at Chandos House reserve the right to request a urine sample from any resident suspected of using alcohol or drugs. Residents who are subject to a drug testing and treatment order are required to provide a sample at intervals specified by the court. It was noted that staff members carry out these tests sensitively. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 14 The inspector was informed that very little medication is managed within the home unless a resident has a medical condition or requires homely remedies. There is lockable storage facility in place. However, it was observed that medication security needs to be improved for a sample of medication currently held in the home. All medication brought into the home is signed in and held securely by the staff team. It was noted that a new medication administration record is used following a requirement made at the last inspection. Residents and staff now sign for any medication administered by staff as recommended at the last inspection. A sample check of medication held was carried out and the records were noted to be up to date and accurate. It was also noted following a recommendation at the last inspection that any homely remedies held for staff is now held separately from any held for residents. . Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 The complaints procedure has been improved since the last inspection with the result that residents have the detailed information they need to make a complaint. EVIDENCE: Residents confirmed that they are familiar with the complaints procedure. It is explained to them on admission. They also sign to say they have received this information. The gaps in the information seen at the last inspection have now been filled. This information includes details of the Commission for Social Care Inspection and the response time for dealing with a complaint. The complaints information is now found in the in the statement of purpose and will be included in the service users guide which is in the process of being developed (as discussed in section one of this report). There have been no complaints received by the Manager of Chandos House or The Commission for Social Care inspection since the last inspection. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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): 24,27,28,30 Chandos House continues to provide a clean, comfortable, safe home. EVIDENCE: The environment is well maintained and suited to residents’ needs. However there is currently no lift or accessible toilet facilities for disabled persons. The home has four levels with the lower ground floor accommodating the lounge/kitchen diner. Residents were seen using this area and looked comfortable and relaxed. Chandos House is decorated and furnished to a good standard which creates a comfortable homely atmosphere. All residents spoken with said that they valued this environmental standard and it helped them to “feel valued”. Communal rooms are tastefully furnished and attractively decorated. There is an attractive garden area as well as a conservatory for service users. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 17 There are four shared rooms and two single rooms available in the home. The shared room is part of a programme of support when residents move into the home. As residents progress through the treatment/rehabilitation programme they move into a single room in preparation for leaving the treatment centre. One shared room was seen during this inspection. It looked homely and adequately equipped. It had been personalised with the two residents’ personal possessions. The toilet and bathroom facilities are sufficient to meet the needs of the residents. The home smelled fresh and the rooms were cleaned to a reasonable standard. One of the two domestic assistants was seen during the inspection and it was observed how support is provided to residents. The residents explained how they are encouraged to do cleaning and laundry themselves but domestic assistants support them with these tasks. The house-cleaning day is held on a Thursday each week when all residents are expected to participate. The owner and responsible individual explained that the structural work that was taking place on the building at the last inspection is now complete. Six new windows have now been installed and there is one outstanding window to be fitted. Staff confirmed that there had been minimal disruption to residents’ daily lives. It was noted that there is a programme of maintenance work and redecoration is in place. The inspector was informed that three new showers had been installed, redecoration had taken place and new carpets fitted since the last inspection. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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): 31,32,33,34,35,36 The experienced, effective staff team is currently under pressure due to a staff shortage. This situation needs to be urgently reviewed to ensure that resident’s rights and interests are safeguarded. The staff recruitment procedure is not satisfactory. It needs to be urgently improved to ensure that all residents are protected at all times. EVIDENCE: The home has a manager/counsellor, a full time counsellor, a business development manager and a volunteer. Residents are usually provided with at least 1-hour 1:1 counselling per week, more if they wish and access to staff at any time during the day. However it was noted that there was currently pressure on the counselling service as the full time counsellor is on long-term leave of absence. Consequently there is only one trained counsellor who is also the registered manager and has the responsibility to fulfil both roles with the support of the business manager and a volunteer. It was noted that there were no immediate plans for the return of this second full time counsellor but discussions were taking place about filling this post temporarily. As previously stated the home is not staffed at night or at weekends but there are robust support systems in place in the event of an emergency. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 19 Both the counsellor and manager have diplomas in counselling and considerable experience in the field. They have regular professional independent counselling supervision, paid for by Chandos House. The business development manager, who has considerable experience in Social Care including management, explained that his role is to support the manager and counsellor with the administration of the home and reviewing all policies and procedures. All residents consulted confirmed that they were aware of the roles and responsibilities of each member of staff. The inspector viewed two staff files including a volunteer and it was noted that the majority of recruitment checks had been completed. This included two written references, proof of identification, work experience, declaration of a criminal conviction and a Criminal Bureau check/ Protection of Vulnerable Adult Check (CRB/POVA). However, it was observed that the CRB/POVA checks had been completed through the previous employer and not through Chandos House. The inspector was informed that CRB/POVA checks had also not been completed for the two domestic staff employed by the home. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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): 37,38,39,40,41,42,43 Chandos House is kept under constant review and development by the management team, which ensures that the residents benefit from a well run home. The systems in place to promote the health safety and welfare of residents and staff has improved since the last inspection. EVIDENCE: The management of the home continues to work well with the support of the manager, counsellor, volunteer and business administrator. However, as discussed in the staffing section there has been pressure on the staff team in particular the manager / counsellor since the last inspection as a result of the full time counsellor being on leave of absence. The owner and responsible individual of the rehabilitation centre seen at the time of the inspection confirmed this situation. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 21 Staff and residents seen at the time inspection also confirmed this information, but added that they had no complaints about the management of Chandos House. All residents consulted once again said that they “felt safe” and “well looked after”. It was noted that as part of the quality assurance system residents complete a survey prior to leaving the home. A sample of this information was seen during this inspection. One resident said “ I feel I am being given the tools to live at Peace with myself and world. I am seeing how deep my disease has affect on others”. Samples of health and safety records were examined and it was noted that they were all up to date and accurate including the fire log. Fire safety training and drills including residents are now taking place on a regular basis as recommended by Avon Fire Brigade. The fire risk assessment is in place and has recently been reviewed as recommended at the last inspection. It was noted that the member of staff who is on leave of absence is the appointed first aider. It was noted that the business manager was due to attend first aid training on the 31/01/06 and Health and safety training on the 7/02/06. The manager is currently responsible for these areas. Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 2 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 3 3 3 3 Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 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 YA1 Regulation 5 Requirement An up to date service users guide must be in place and must be provided to all current and prospective service users This is an outstanding requirement from the previous inspection conducted in September 2005 Service users must only be admitted following the receipt of a full needs assessment from the authority responsible for funding an individuals assessment This is an outstanding requirement from the previous inspection conducted in September 2005 Medication storage must be improved following consultation with CSCI pharmacist A review of the current staff shortage must take place to ensure that residents receive the counselling support as outlined in the statement of purpose. Information about the action taken must be sent to the CSCI Timescale for action 31/05/06 2 YA2 14 30/04/06 3 4 YA20 YA33 13 18 30/04/06 30/04/06 Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 24 5 YA34 19 All staff / volunteers working employed by Chandos House must have a Criminal Record Bureau check and POVA check carried out through “CRB umbrella organisation”. This information must be received before a person is appointed in post. If a person is supplied by an agency. They must have an up to date a CRB/POA check completed by the agency and seen by the manager before the person starts work. POVA first can only be used in “exceptional circumstances” before a CRB is returned. A risk assessment must be completed and the person must be shadow worked at all times. 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 YA2 Good Practice Recommendations It is recommended that the manager formally writes to all Local Authorities where there is a problem in obtaining needs assessments prior to a individual being offered a placement in the rehabilitation centre. This letter should explain the legislation that Chandos needs to comply with in respect of the receipt of needs assessments. A copy should be sent to the CSCI for information Chandos House DS0000026580.V277980.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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