Inspection on 01/09/05 for Chase House

This inspection was carried out on 1st September 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

Chase House 11/03/08

Chase House 12/02/07

Chase House 01/03/06

Chase House 09/03/05

Chase House 22/09/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Chase House 95 Chase Road Brownhills, Walsall West Midlands WS8 6JE Lead Inspector Maggie Bennett Announced 1 September 2005 st The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chase Home Address 95 Chase Road, Brownhills Walsall West Midlands WS8 6JE 01543 252063 01543 300399 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Angela Lane Mr Danny Page 4 4 Category(ies) of LD _ Learning Disability (4) registration, with number of places Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th March 2005 Brief Description of the Service: Chase House provides care for four people with autism. The home is designed to meet the continued education needs of service users through their development into adulthood. Chase House offers structured activities and full use is made of community based provision. The property is set back from the main road on the outskirts of Brownhills. All bedrooms are single, each service user having been involved in choosing the decor and furniture. The garden area is small, with a patio and lawned area. There is a drive to the front of the property with very limited parking. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Chase House was carried out on a weekday between the hours of 8.30 a.m. and 4.00 p.m. Prior to the inspection a Questionnaire was completed by the Registered Manager. Anonymous questionnaires were also sent to service users and their relatives, one of which was returned to the Commission. During the course of the day, the care plans of all service users were seen and their care and support was “tracked” through cross reference to other documents. It was not possible to speak with individual service users, as none are able to verbalise, but all indicated through their behaviour that there was an excellent rapport between them and the carers. Service users appeared cheerful and relaxed. Discussion took place with care staff and the manager of the home. A tour was made of the premises and various documents were seen in order to check that appropriate health and safety procedures are followed at the home. Three of the seven statutory requirements made at the last inspection have been met and there are plans to meet the remaining requirements by the end of the year. Two further statutory requirements were made at this inspection. What the service does well: All the service users have lived together at Chase House since 1999 and this is very much their home. There is a very homely atmosphere, one member of staff describing the service users and carers as “one big happy family”. Staff clearly enjoy their work and are happy to “go the extra mile” for the benefit of service users. One person in their anonymous questionnaire said: “…..are very pleased with the care and attention……..at Chase House. The staff always greet you with a smile and are very easy to talk to.” There are excellent systems in place to ensure that service users’ needs are met. Records clearly demonstrate that service users are assisted to make decisions about their lives and to be as independent as possible. Any risks to service users are also assessed and action is taken to minimise risk. A wide range of appropriate activities are provided, which assist the service users to develop their personal skills and confidence. Food is of good quality and all nutritional needs are attended to. Care is taken to ensure that the healthcare needs of service users are met. The manager is well respected and is proactive in accessing appropriate training and specialist advice. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 There are sound assessment procedures in place, which ensure that service users’ needs are met. The home is attentive to the specialist needs of individuals, obtaining relevant staff training and professional advice. EVIDENCE: No new service users have been admitted to Chase House since 1999. There is evidence that all service users received the benefit of a full assessment before moving to the home. All service users have individual care plans, which include risk assessments. The home is able to demonstrate through its records and care plans that they are able to meet the assessed needs of the service users. Staff receive relevant training and various methods of communication are used to suit individual service users. This includes Makaton. The home has the services of a Speech Therapist, who is carrying out training with staff. The specific cultural needs of one service user are clearly documented and upheld. Respite care is not provided at Chase House. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 There are clear care planning systems in place to ensure that service users’ needs are met and goals pursued. Service users are assisted to make decisions about their lives. Systems are in place to minimise risk to individuals, whilst supporting them to be as independent as possible. EVIDENCE: Each service user has an individual care plan. “My Life” books are also being introduced, which will operate alongside the care plans. These books are compiled with the service user and are in formats which are accessible to the individuals. When completed the books will be retained by the service users and kept in their own rooms. Care plans are comprehensive and include management guidelines for the individual needs of service users. These include specialist requirements and procedures to manage any aggressive or harmful behaviour. Each plan includes a risk assessment. The day of each service user is clearly recorded. A keyworker system is in operation. Care plans are reviewed on a six monthly basis. It is recommended that care plans are updated following reviews. One care plan had remained unchanged since 1999. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 10 There is evidence from care plans that staff assist service users to make decisions, using a variety of methods. This can include the use of signs, symbols and photographs. Where individual choices are made, these are recorded in the Day Book for each service user. None of the current service users manage their own financial affairs. Where the registered person acts as appointee, appropriate records are kept. At the time of the inspection individual bank accounts were being set up for each service user. Any limitations on choice to prevent harm are clearly documented in the individual’s Management Guidelines. Risks to service users were assessed prior to their admission and risk assessments are regularly reviewed and updated. Required action to minimise risk is documented in the Management Guidelines. The home has a Missing Person Procedure. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 17. A wide range of appropriate activities are provided, which assist service users to develop their personal skills and confidence. A healthy diet is provided and the particular needs of individuals are attended to. EVIDENCE: Service users are able to take part in a range of activities organised by the home to help them develop their skills and confidence. There is a daily curriculum, which includes music and movement, horse riding and personal skills training. One to one cooking sessions are held, as well as assistance with domestic skills. Service users also attend numerous activities organised at Ferndale Day Centre. All daily activities are clearly recorded. Menus seen indicate that service users are offered a variety of nutritious foods. Attention is given to the particular cultural and dietary needs of individuals. Care plans seen showed that halal meat is purchased for one service user. Where there was concern about a service user’s weight loss, clear records had been maintained and risk factors identified. The food taken by each individual is recorded on a daily basis. Service users are able to assist with food preparation under supervision. The kitchen is domestic in style and was clean Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 12 and in good order at the time of the inspection. Fridge and freezer temperatures are taken daily and core temperatures are taken of all cooked meats. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Personal support is received in private. Healthcare needs are clearly documented and specialist support and advice is obtained which ensure that these needs are met. Medication administration procedures are clear and protect service users from any mishandling. EVIDENCE: All personal support to given to service users in private. Staff have taken part in moving and handling training. As there are few male members of staff, it is not always possible for male service users to be given intimate care by a person of the same gender. Times for getting up and going to bed are flexible and evidence of this was seen in service users’ care plans. Service users are assisted to choose their own clothes. Additional specialist support is provided by the speech therapist and dietician. There is a key worker system in place and care plans describe the individuals’ preferred routines, likes and dislikes. The healthcare needs of individuals are clearly documented in their care plans. All care plans contain a Health Plan checklist. All service users regularly attend either the Well Woman or Well Man Clinic. Where possible, service users visit healthcare facilities in the community. Training is provided on healthcare issues and epilepsy training for staff was to take place the day following the inspection. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 14 None of the current service users manage their own medication. All medicines are kept securely and appropriate records are maintained of all medicines received, administered and leaving the home. Medication and accompanying administration sheets were seen at the inspection and there were no discrepancies. Satisfactory arrangements are in place for the administration of medication when service users are away from the home. It is recommended that the home speak with the prescribing G.P. and Pharmacist to request that specific times are stated on medication and administration sheets. It was noted that “as directed” had been used in some cases. All staff who administer medication have received accredited training and staff have also taken part in monitored dosage training provided by Boots. The Pharmacist carries out a regular audit of the medication and the Registered Manager carries out a monthly audit of staff performance with regard to medication administration. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 There are clear procedures in place to protect service users from abuse or neglect. EVIDENCE: The home have clear procedures in place for responding to any suspicion or evidence of abuse or neglect. These issues are also covered in NVQ and LDAF training. In addition, the registered manager goes through the procedures at supervision sessions. No allegations of abuse have been made at the home. The registered manager is aware of his responsibilities under the POVA guidance. The home have guidance in place for dealing with physical and verbal aggression by a service user. Specialist training in physical restraint has been arranged through BILD and will take place in December 2005. Until this training has taken place it is the home’s policy that physical restraint is not used. The financial records of all service users are clearly recorded and independently checked by an Accountant on a three monthly basis. The home is advised that all those items listed in Standard 26.2 must be provided by the home and that the purchase of any of these items is not the responsibility of the service user. Where service users (or their representatives) wish to purchase items of furniture which are above and beyond those listed in the Standards, a clear agreement must be reached with all concerned (social workers and parents where appropriate) and this must be recorded. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 30 Chase House is homely and comfortable and provides a safe environment for the service users. All service users have single rooms, which have been personalised to suit their individual wishes. The home is clean and there are systems in place to prevent infection. EVIDENCE: Chase House is an older, detached property, which has been modernised and refurbished over the years. It is domestic in style and has a homely and comfortable atmosphere. All service users have their own single room and there is a large lounge/dining room on the ground floor. There is a bathroom and toilet on the first floor and a shower room with toilet on the ground floor. A number of improvements to the environment have been made since the last inspection. All bedrooms have been re-decorated and service users have been involved in choosing the materials. All radiators are now covered. The front drive has been renewed. The roof to the art room (in the garden) has been replaced and it is hoped to get this facility operating again in the near future. There are plans to re-decorate the hall and provide new floor covering, to replace the floor covering in the first floor bathroom and to provide new carpets in two bedrooms. The home received a visit from the Environmental Health Officer in August 2005. The home is requested to seek advice from the Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 17 Fire Officer with regard to the exit arrangements from the back garden in the event of a fire. All service users have their own rooms, which have recently been re-decorated to their personal taste. All the required items of furniture are included in the rooms (unless risk assessments and personal preferences indicate otherwise). As stated in Standard 23 above, where service users or their representatives wish to purchase items above and beyond those provided, a clear agreement must be reached with the service user’s representatives and this must be recorded. Among works to be carried out in the near future are the provision of wash hand basins. In order to minimise disruption to service users, this work will be carried out when they are on holiday. Service users are also to be provided with suitable locks and keys to their bedroom doors. The laundry is domestic in style and all dirty washing is taken to the laundry via the garden. The washing machine has a sluicing facility. There are policies and procedures in place for the control of infection. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35 and 36. Staff are clear about their roles and responsibilities and promote the aims of the home. There is an effective staff team, which has the service users’ interests at heart. Although recruitment procedures are generally good, new staff must not be employed without the receipt of satisfactory checks. There are good opportunities for relevant training and a good record of supervision, with clear benefits for service users. EVIDENCE: Staff spoken to during the inspection were enthusiastic and committed. They were clearly knowledgeable about the needs of the service users and the main aims of the home. One staff member said that the best things about working at Chase were observing the development of the service users and the benefits of “one to one” working. There is a key worker system in operation and all staff have clear job descriptions. There are good opportunities for training. Currently 2 care staff hold the NVQ3 qualification and 1 is in the process of obtaining this, 5 care staff hold the NVQ2 qualification and 1 is currently undertaking the qualification. The registered manager is about to complete the Registered Managers’ Award and NVQ4. Staff rotas seen at the inspection showed that there are 2 members of staff on all day time shifts and 1 waking member of staff on duty at night. The registered manager’s hours are supernumerary. There is a stable staff group Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 19 with low rates of turnover. Specialist services, such as speech therapy and dietician, are obtained. Staff meetings take place at regular intervals and are recorded. All staff are able to communicate with the service users, using a variety of methods. Staff receive training in Makaton. There are good recruitment procedures in place at the home. It was, however, found that one member of staff had commenced at the home without a Criminal Records Bureau check and Protection of Vulnerable Adults check having been received. If, in the interests of the health and safety of the service users, it is felt necessary to employ a new member of staff before the receipt of the CRB check, a satisfactory POVA First check must be obtained. The home must also carry out a risk assessment and ensure that the person does not work without supervision until the CRB check is received. All other staff files seen contained the required documentation. Some files, however, did not contain a photograph of the member of staff. All prospective members of staff are invited to spend time with the service users prior to their interview. Staff receive statements of terms and conditions and all appointments are subject to a 3 month probationary period. Particular emphasis is placed on appropriate staff training. Two care staff have completed LDAF training and the remainder are to undertake this in the near future. Staff are also trained in understanding Autism and in the use of Makaton and risk assessments. Training planned for the future includes Adult Protection, the management of continence and Equal Opportunities. All new staff receive induction training. Staff meetings are held on a regular basis. There was evidence from files seen that staff receive regular, formal supervision sessions, these being recorded, signed and dated. Staff also have annual appraisals. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 There are clear policies and procedures in place to protect the health and safety of service users and staff. EVIDENCE: Staff files seen showed that staff receive regular training in moving and handling, fire safety, first aid and food hygiene. The fire alarm and fire fighting equipment is tested regularly and maintained and there are regular fire drills. The home has a Fire Safety Risk Assessment. There are certificates in place to verify the regular maintenance of the boiler and electrical system. The electrical equipment is regularly tested. Water temperatures at outlets accessible to service users are tested to ensure they do not exceed 43 degrees. The water is tested for legionella. All hazardous substances are kept securely. Accidents are correctly recorded and reported. The home has a clear written statement of the policy, organisation and arrangements for maintaining safe working practices, which has recently been updated. All staff receive induction on safe working practice topics. Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 21 Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 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 x 3 4 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 4 x x x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chase House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 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 23 Regulation 13(6) Requirement Timescale for action 31/12/05 2. 23 and 26 16(2)(c) 3. 26 12(4)(a) 4. 34 19 Staff must receive training in physical restraint from an accredited trainer. (Previous timescale of 31/05/05 not met). This training has been arranged for December 2005. 01/09/05 The purchase of those items of furniture listed in Standard 26.2 is the responsibility of the Registered Individual. Where service users (or their representatives) wish to purchase items of furniture above and beyond those listed in the Standards, a clear agreement must be reached with all concerned and be recorded. All service users must have a 31/12/05 key (or suitable locking device) to their own bedroom, unless a risk assessment demonstrates otherwise. (Previous timescale of 31/05/05). (This work is to commence in the near future). New staff must not commence 01/09/05 until a satisfactory Criminal Records Bureau check has been received. If, in the interests of the health and safety of the service users, it is felt necessary to employ a new member of staff Version 1.40 Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Page 24 before the receipt of the CRB check, a satisfactory POVA First check must be obtained. The home must also carry out a risk assessment and ensure that the person does not work without supervision until the CRB check is received. 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. 2. Refer to Standard 6 20 Good Practice Recommendations It is recommended that care plans are updated following each six monthly review. If the plan is unchanged, there should be an up to date statement verifying this. It is recommended that the home speak with the prescribing G.P. and Pharmacist to request that specific times are stated on medication and administration sheets, rather than as directed and as required. It is recommended that the home seek advice from the Fire Officer with regard to the exit arrangements from the back garden in the event of a fire. 3. 24 Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 25 Commission for Social Care Inspection Halesowen Local Office - West Point Ground Floor, Mucklow Office Park Mucklow Hill, Halesowen West Midlands 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 Chase House E55_V241118_Chase House_S20846_010905_Stg4.doc Version 1.40 Page 26 - 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!