Inspection on 08/09/05 for Cherry Orchards Camphill Community Ltd

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherry Orchards Camphill... 24/09/07

Cherry Orchards Camphill... 01/11/06

Cherry Orchards Camphill... 18/01/06

Cherry Orchards Camphill... 08/12/04

Cherry Orchards Camphill... 26/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

Clouds House

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Cherry Orchards (Camphill Community Ltd) Canford Lane Westbury on Trym Bristol BS9 3PF Lead Inspector Peter Still Unannounced 8 September 2005 10.15 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. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 3 SERVICE INFORMATION Name of service Cherry Orchards (Camphill Community Ltd) Address Canford Lane Westbury on Trym Bristol BS9 3PF 0117 9503183 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) Cherry Orchards Community Ltd Mrs Hilda van Rooy CRH-PC Care Home 21 Category(ies) of MD Mental Disorder [21] registration, with number A Alcohol depend past/present [21] of places D Drug dependence past/present [21] LD Learning disability [21] Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 21 persons aged 18 - 64 years of age Date of last inspection 08/12/05 Brief Description of the Service: Cherry Orchard is a small therapeutic community, set in 18 acres of wooded landscape, yet within easy reach of local shops and amenities. The community comprises of 8-14 residents, 3 long term voluntary co-workers and their families and short term voluntary co-workers who stay 6-18 months. There is a gardener, secretary and part time therapists. The task of the volunteer coworkers is to help each resident to achieve the goals they have identified for themselves. This usually means supporting individuals to gain greater independence in the practical, emotional, social and spiritual aspects of their lives. There is an emphasis on helping individuals to establish and maintain mental health. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place from 10.15 to 14.30. Mr & Mrs Sands who are managers were present during the inspection. The inspector talked to two residents and three staff apart from the managers. The inspector was also invited to take part in the morning ‘Gathering’, where everyone meets to discuss the day and any issues. This was a helpful introduction for the inspector and later a resident talked about the importance of this time each day. The home tends to function with 12 residents and on the day of inspection there were 9 residents including 1 away. The atmosphere at the home was warm, relaxed and friendly, and it was clear that people were listened to and respected. Residents spoke of being content at the home and of the way it is helping them with their lives. The inspector looked around the home and extensive grounds and inspected a number of records. The residents, managers and staff were helpful on the day of the inspection and a lot of positive discussions, advice and suggestions took place throughout the inspection. What the service does well: The commitment, energy, yet gentle approach of staff creates an open and honest atmosphere where residents can work to change the things they wish to in their lives whilst feeling safe and supported. One resident said the home “could not be better”. Another said the most important aspect was being able to feel safe and also that routines are very important. All residents are helped to find the contribution, in what they do, that they can personally make to the Community and this demonstrates real ownership and of residents feeling and being a part of the Community. The careful admission process, with honesty from prospective residents and planned introduction, has a significant bearing on the future success for the resident. People make the choice go to the home and managers ensure they consider that they too would be able to work with an individual. Staff are supported with quality training to develop their skills. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 6 What has improved since the last inspection? What they could do better: The telephone number of the Commission and that of other agencies must be included in the home’s documentation and a review of needs to be undertaken. Staff need to be clear that they can approach the Commission CSCI, or other agencies at any time if they wish. Further guidance is needed concerning volunteers who come to work at the home from other countries, to ensure the current recruitment practice concerning the authority of references and criminal records checks conforms to requirements. Whilst the standards concerning protection from abuse, neglect and self-harm and risk taking are met, it is recommended that these standards should continue to hold a key priority for review, and reinforcement training, including support from external agencies. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 7 A co-worker suggested points for improvement, which could be considered, including: improved communication in general administration; co-workers need encouragement to take more initiative for themselves, to release the managers time; develop more links externally with residents being able to increase access to courses; provision of a separate and specific area for preserving food, which has developed so much and is causing a difficulty with space in the kitchen. 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. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 8 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 Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 Thorough assessment and documentation, with careful introduction ensure residents can achieve the best possible chance of positive change and development. A lack of full contact details of agencies may hinder residents who wish to make a communication. EVIDENCE: 3 care plans were inspected, providing comprehensive assessment processes and well planned introduction and trial period helping to ensure the prospective resident and the home can make the right decision as to suitability for admission. Whilst there is frequent movement of people using the service, for many, the placement may last for up to two years and the decision made by the individual is clearly understood to be a crucial step. Two residents talked about their admission process and of the huge commitment, which includes, for some, being too far away from family to enable regular visits and also of the significant loss financially, concerning benefits. Staff and residents talked about the importance of the careful preparation before admission and the way prospective residents are open and have an honesty about their needs which is fundamental in the resident knowing what their goals are and for staff to be able to support them. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 10 Admission is arranged with the full cooperation of the individual, and their ability to have a trial period is an important part of this. The inspector found that documentation concerning the home contained the address of the Commission but not the phone number and a requirement is made that all documentation be reviewed to ensure full contact details are included for all relevant agencies. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 11 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, 8, 9 The Cherry Orchards operates as a community where everyone has equal rights to be listened to and consulted and all aspects of these standards are encompassed to improve lives. EVIDENCE: The last inspection gave commendable praise to the home for the way they met these standards and evidence on the day of this inspection continues to confirm this. Comprehensive care plans are created directly with the resident and they are reviewed weekly, with three, co-worker’s, supporting the process. Residents make their own decisions about the way they wish to progress their care plans with support from co-workers. The community works on the basis of everyone participating in all aspects of life at the home. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 12 Evidence was seen that residents are supported in taking risks as part of an independent lifestyle and this standard is met. Both the resident and key worker had signed risk assessments and these included coping strategies to help reduce risks when difficulties arise. The joint ownership and full involvement of residents was seen to be commendable. Many risks can hold serious consequences for residents and it is vital that the openness of approach between residents and staff continues to be maintained and recorded and external supporting agencies are in agreement with approaches and any changes being made. Whilst good evidence was seen during the inspection concerning this standard and residents talked with were confident about the care they receive, it must remain a key priority for frequent recorded review, which includes the support of external agencies. It is vital too that ongoing reinforcement training continues to be given to all staff so that they are aware of the possible triggers and signs, which may indicate risks and of the steps to take. The home should be highly commended for their proactive decision to seek an external review of their work and consideration of what they could do better. The Mental Health Foundation has recently undertaken an in depth study of Cherry Orchards and their report is due soon. This demonstrates a willingness to include external agencies, which ensures the home is not insular. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 14, 16, 17 The ethos of the home provides excellent opportunity for residents to move their lives forward and to enjoy the varied responsibilities and activity. A healthy diet is a cornerstone of the community. EVIDENCE: Cherry Orchards has extensive grounds providing work opportunities in horticulture, care of animals and the day-to-day tasks within the two main residential buildings. Both residents and staff, talked enthusiastically about their involvement in activity both at the home and at other places. The farmers market is one important example. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 14 Residents enjoy visits to the local community and its amenities, which is close to the home. During the morning two residents walked into Westbury on Trym. Residents make use of the local swimming pool and sports centre. However, a resident told the inspector that they could do more if it were not for the small personal allowance they receive. This does present a problem for the home and it also has an effect on the level of physical activity, which can be important for some residents. A manager talked about the possibilities of creating a small gym at the home and this should be explored. The home does have table tennis and the outdoor environment already provides good opportunity for exercise. Evidence was also seen of individual programmes, which include variety and exercise. A resident talked about enjoying a recent trip to Avebury with a group of residents. A healthy diet is paramount at the home and high praise should be given for this vital aspect. Most vegetable food is home grown and a major job at the home concerns preserving surplice food for out of season use. Staff talked of proposals to relocate the preserving work to a specific area, away from the kitchen, since it can hinder work in the kitchen. If this goes ahead, it will be necessary to take guidance from Environmental Health. Resident’s said they enjoyed the food and on the day of inspection staff were having an in house training/cookery demonstration morning to reinforce and develop new skills. Nutritional content is recorded and good menus maintained, including individual needs. The lunch prepared on the day was nutritious, full of colour and was very appealing. A pastry being taken out of the oven had a wonderful aroma and was clearly beautifully cooked and with a good glaze. Cherry Orchards (Camphill Community Ltd) Version 1.40 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Page 15 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, 20 Residents are supported to make the decisions about their personal and health care needs and the homes ethos, policy and procedures help to ensure residents can overcome difficulties and be safe. EVIDENCE: A resident told the inspector that the way the home is run, provides a feeling of being safe and that this is paramount; residents are treated with dignity and respect and “ if I have something to say, I am listened to”. A resident said that where there are difficulties, staff try to find ways to help. These thoughtful points provide good evidence of the way the Community works to support residents personal and healthcare needs. Staff should be commended for their commitment in achieving an atmosphere where residents can communicate the care and support they receive so positively. Residents have locks to their bedrooms, which are the private place or refuge for them. Co-workers live alongside residents and share the same facilities. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 16 Where residents have needed to attend the accident and emergency department, detailed reports are sent to the Commission. Residents often choose to administer and control their own medication and do so in discussion with managers at the home. Records are maintained and on the day of inspection had been correctly recorded. Since the last inspection, the Commissions pharmacy inspector has visited to provide further support. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The complaints process in this home is supported by policies and procedures, which are available to residents and there is evidence that resident’s views are listened to and acted upon. EVIDENCE: The open and honest philosophy within the home creates a commendable atmosphere, where residents voice their issues and are listened to. Issues are discussed within the group or through the weekly reviews with key workers, or at any time when a matter is urgent. A resident, in talking about this, said that the way views are listened to and acted upon is one of the most helpful aspects at the home. Residents and staff talked about being clear with the steps to take if they had a concern regarding abuse, or neglect. However they were not clear that they could approach the Commission at any time and reinforcement is needed to ensure residents and staff, know they can also approach any other agency at any time if they wish. Inspection of records showed that the address of the Commission is provided for residents but unfortunately the telephone number was missing and it will be required that all documents are reviewed to ensure that telephone numbers are clearly added to the details of all agencies. Training records provided evidence that staff have received external training concerned with adult protection as well as in house training. This is commendable and it will be recommended that this be regularly reviewed and reinforced for all staff. The complaints book was inspected and none were recorded. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 The unique community environment provides a comfortable place, which residents have chosen to live in. The extent and variety of the facilities, buildings, gardens and land provides space and places of special importance, which have a very positive impact on residents. EVIDENCE: Residents and staff were clearly ‘at home’ at the Cherry Orchards and talked about their enjoyment of the facilities, which are extensive. There is such a lot of space and the range of buildings make it possible for people to enjoy the life of the community and also at times to find places on their own which can be of great help as residents work through positive changes in their lives. The inspector was told about a special place that had been used by a resident as a sanctuary, when things became impossible and how valuable this was. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 19 The managers should be highly commended for the magnificent new garden, which has been professionally designed. It is extensive and includes a large and beautiful water feature. This relaxing new area provides many places to sit with different views, and good use of colour, the sound of water or scented areas. It is subtly lit through the night and can be used at any time. The community living at the home all work together to keep the home clean, as it was found to be on the day of inspection. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 The current recruitment policy is unsatisfactory and may place residents at risk. Resident’s benefit from well trained and supervised staff. EVIDENCE: One staff file was read and included appropriate recruitment documentation. Records were seen to provide evidence that staff have clarity of roles and responsibility. The home currently has three managers that hold the Registered Manager’s Award and a fourth is to undertake this qualification. A training programme provides a variety of training for staff, important to the operation of the home and staff hold specific responsibilities. One member of staff talked about their task concerning fire precautions. Staff said they receive weekly supervision. 50 of the permanent staff will have achieved NVQ level 4, which is commendable and staff should be praised for their hard work and commitment to training. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 21 Recruitment practice for volunteers from other countries includes birth certificate and two references and this was inspected on one staff file but the inspector was not shown the CRB (Criminal Records Bureau) document or equivalent. The inspector was told that these are sought once the member of staff arrives and that until the CRB check has arrived and found satisfactory, the member of staff does not work on their own with residents. Bearing in mind the size of the facilities, this may prove difficult, which may put residents at risk. Background checks should be undertaken by overseas recruitment agencies, a personal declaration must be received as evidence if no CRB equivalent is available to ensure acceptance of an overseas employee and people should not be allowed to take up employment from overseas without checks first being completed and time should be allowed for this. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 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 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) 39, 42 Residents have freedom to express their views, which are listened to and acted upon, ensuring their welfare and personal goals are protected and supported. EVIDENCE: Mr & Mrs Sands, as managers, provide leadership within the home and are supported by other managers and volunteer co-workers. Two residents said they were listened to and respected, and this was supported by discussions with one member of staff. Negotiation and discussion of issues takes place at the ‘Gathering’ and at the meetings with the resident’s key workers. Since the last inspection, a member of staff has undertaken a key responsibility concerning health and safety. The member of staff has had training and a certificate to confirm this was seen. The member of staff has also produced a written health and safety review since the last inspection. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 23 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 2 4 4 4 x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 4 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x 3 Standard No 11 12 13 14 15 16 17 4 x 3 3 x 4 x Standard No 31 32 33 34 35 36 Score x x x 1 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherry Orchards (Camphill Community Ltd) Score 4 4 3 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x 3 x Version 1.40 Page 24 D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc NO 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 1 Regulation 5. 1.f Requirement Timescale for action 16/12/05 2. 22 13.6 3. 34 19 All documentation to be reviewed to ensure the telephone number of the Commission and other agencies is included The manager shall ensure that 16/12/05 all residents and staff are clear that they may contact the Commission and or other agencies at any time if they have a concern. The provider must not start new 16/12/05 workers until satisfied that there has been no criminal activity in their home country and not until the POVA check has been received. They must then work only under supervision until a full and satisfactory CRB check has been received. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 25 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 23 Good Practice Recommendations Whilst the inspector considers this standard to be met, the protection of residents from abuse, neglect and self-harm should be kept under close review and support from external agencies and reinforcement training should continue to take a high priority. Managers should take note of the helpful comments made by staff. Whilst the inspector considers this standard to be met, the recording and monitoring of risk taking should be kept under close review, which includes external agency support. 2. 3. 37 9 & 11 4. Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire 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. Extracts may not be used or reproduced without the express permission of CSCI Cherry Orchards (Camphill Community Ltd) D56_S26530_CherryOrchards_V248395_080905_Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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