Inspection on 12/04/05 for Chestnut Road

This inspection was carried out on 12th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Chestnut Road 25/01/08

Chestnut Road 27/05/06

Chestnut Road 09/09/05

Chestnut Road 23/11/04

Chestnut Road 07/09/04

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

CARE HOME ADULTS 18-65 Chestnut Road 44, Chestnut Road West Norwood London SE27 9LF Lead Inspector Mary Magee Unannounced 12/04/05 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. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Chestnut Road Address 44, Chestnut Road West Norwood London SE27 9LF 0208 761 3689 0208 761 9457 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) Caretech Community Services Ltd CRH Care Home 16 Category(ies) of LD Learning Disability registration, with number of places Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 Where windows in bedrooms do not allow a view from a sitting position as specified in Minimum Standards it must be recorded on file that the service user or a representative has been made aware of this prior to admission and that they are satisfied with this arrangement. 2 If service users are unable to reach light switches in bedrooms, they must be provided with an alternative means of allowing them to turn lights on and off. Date of last inspection 23/11/04 Brief Description of the Service: 44 Chestnut Road is one of a number of residentail homes owned and managed by Caretech. It provides care and accommodation for sixteen younger adults with learning disabilities, some also have physical disabilities. It is divided into three separate units, the ground floor has eight bedrooms and is suitable for people with learning and physical disabilities, the first floor has five bedrooms, and the second floor has three bedrooms. All units have appropriate numbers of bathroom and shower facilities and have their own kitchens and communal areas. A passenger lift is provided. At the rear of the premises is a wheelchair accessible large garden that consists of a lawn and a paved area. The home is located close to the main shopping area and public transport links. There is limited parking available on the driveway and on the roadside. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.30am. It took place over seven hours throughout the morning and late afternoon. During this period the inspector spoke with three members of staff separately, the manager and five residents. The communal areas and five bedrooms were viewed. A selection of records was viewed that included care files and those of staff members. The inspector spoke with the relatives of four residents by telephone to gain their views as well as professionals from the Learning Disability Team. What the service does well: What has improved since the last inspection? At the two previous inspections there were serious shortfalls identified. The attitude and professional approach of the team at the home has greatly improved since the last inspection. The new management has given excellent leadership and support to guide the team in the right direction. Additional training has been given in the protection of vulnerable adults. People are cared for in a safe manner. Staff are supervised regularly and consistently and areas of any poor practice are identified and addressed. Care planning and risk assessments have been kept reviewed and updated. The procedures for administering medication are followed. Residents are supported to lead more meaningful lives with many participating in numerous activities outside the home Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 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 Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 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) 1 3 4 Progress has been made in the way people are looked after. Occupational therapists and speech and language therapists have worked alongside residents and provided guidance support and training to ensure that staff are competent in meeting the specific and complex needs of residents. EVIDENCE: A new statement of purpose has been produced for the home. The service users’ guide was under development; a copy of the draft was viewed. It was in picture format. The interaction observed between staff and residents was appropriate, it was evident that staff were familiar with the mode of communication for residents that were non-verbal and responded accordingly. Residents were relaxed and related well indicating that relationships had been established with staff. Staff have received training in areas that are relevant to the specific needs of residents, they had developed the necessary skills and appeared competent in their roles. Referrals have been made to specialist teams in the learning disability service; the home was awaiting appointments from occupational therapists in response to a small number of other referrals made. Regular visits have been made to these residents by the occupational therapists, speech and language therapists. These professionals have worked closely with staff at the home in ensuring that they develop the necessary skills. Staff are interested and follow guidelines in supporting individuals with various disabilities including feeding difficulties, one resident that users a Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 9 wheelchair was supported to use a walking aid that enabled him improve his balance. On the ground floor a number of residents are from specific minority communities, the staff mix reflected this. Staff spoken to had a good knowledge of individuals needs. On the three care files were copies of needs assessments. The manager was visiting a prospective resident to complete an assessment of need during the morning. She spoke to the inspector of her findings following the assessment and that the home would be unsuitable to meet this persons needs. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 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 standard(s) 6 7 8 Progress has been made in improving care planning arrangements at the home. These improvements provide for the delivery of services that meet all aspects of health personal and social care needs of residents. More consistency and continuity have been established in the way care is delivered. The daily recording logs are restrictive and prevent the recording of a clear picture for residents. EVIDENCE: The home has worked hard in ensuring that care plans have been developed for residents. The care plans are detailed and comprehensive and ensure that health and social care needs are recognised and planned for. Care plans had been recently reviewed and updated. Records were available showing that the services required were delivered. Day and night time records were good, handover periods were recorded that addressed each residents welfare. Two of the staff spoken to said that handover periods were included in the shift patterns. They also said that this had helped to retain a consistent approach. Residents had talk time books, these recorded special times when the support worker sat with a resident and discussed what they would like to take part in. Weekly activity records indicated that participation had taken place in the activities that residents had indicated they wished to do. The daily log sheets used for recording day/nightime for individual residents are restrictive and are not suitable for recording all the information required, examples where boxes Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 11 were ticked instead of writing were used. This prevents one getting an accurate picture of how staff had supported individuals. Some of the comments used by staff did not reflect the particular mode of communication for those that were non-verbal. On one resident’s file there was an agreement in writing that the resident wished for staff to open his mail. Risk assessments were available on all the files viewed. They had been recently reviewed and updated following re assessments of need. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 12 13 15 17 Staff provide a supportive environment that enables people to lead valued and fulfilling lifestyles. Access is facilitated to many educational and leisure activities but further consideration must be given to developing opportunities according to individual capacities preferences and that are peer appropriate. EVIDENCE: More facilities and opportunity for stimulation has been provided for residents. On the day a number of residents attended college and day centres and returned late in the afternoon. One support worker returning from collecting residents from college spoke about how much the residents enjoyed going out. One young resident spoken to said that he enjoyed going out with staff in the minibus in his free time. Specialists from the Learning disability team have contributed to developing the services required by those with complex needs. They have also provided staff with guidance and support to the staff team. One resident spoken to said that arrangements had been made for him to do voluntary work at a college, he was looking forward to doing something worthwhile. Another resident was attending a college he attended prior to Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 13 moving to the home. Transport is supplied by the home to enable him to do this every week. The inspector viewed programmes of weekly activities. These had been developed for each individual resident. Some of these were not totally planned according to individual needs. Three members of the same family had weekly activity plans that were similar and did not take into account their individuality. Daily logs and handover books contained details of leisure activities enjoyed by residents in the recent months. The home has three vehicles that are used for group trips and to transport individuals to college/day centre and to leisure activities. One relative spoken to said that her sister had enjoyed life at the home and was happy with all the facilities especially the outings. She had looked after her at home until her health deteriorated and appreciated all the efforts made by staff at the home in helping her sister to settle in well in her new environment. She felt that the placement met her sister’s needs. Three family members spoken to over the telephone felt that staff at the home enabled them to retain the family links. Food served on the day of inspection was appealing and enjoyed by residents. A relative told the inspector that despite repeated reminders to staff not to serve certain processed food to her sister her request had been ignored. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 Residents receive personal support in a way that maximises their privacy and dignity and enables them to take control over their lives. EVIDENCE: The majority of residents have been assessed by occupational therapists, aids and equipment have been provided in response to recommendations to maximise independence. Ceiling track hoists were supplied in a number of bedrooms on the ground floor to enable those with severe disabilities to be moved safely. Referrals had been made for other service users to the OT but these were on the waiting list. Staff were observed to be competent and gentle in the way that they supported individuals. One young resident unable to verbalise was seen to communicate effectively with his support worker. When spoken to the support worker demonstrated a good understanding of the individual’s needs and that particularly related to the specialist guidelines supplied by the speech and language therapists and from his mother. Another support worker had made a referral regarding the neck support on the wheelchair for a resident, he had identified that it was uncomfortable. More consistency and continuity has been established in the key working system. Residents have now been allocated regular key workers. Individual records set out preferences such as likes dislikes and methods of communication where residents were non-verbal. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 15 An effective partnership has been established with professionals outside of the home. Guidelines and training supplied by professionals was demonstrated in the workplace. Staff were following guidelines on how to feed people safely that had swallowing disorders. Support workers spoken to had developed confidence and felt competent in their role. The inspector found that improvements had been made in the way that healthcare needs were monitored. There were records of GP consultations, visits by the district nurse. One resident has experienced chest infections frequently, records indicated that staff were vigilant and took prompt action when they noticed changes in his condition. A number of staff had received training on the administration of rectal Diazepan. Medication charts showed no omissions. The home is currently negotiating with another pharmacy to supply prescribed medication to the home in blister packs. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff are knowledgeable on adult protection procedures that ensure residents are safeguarded from abuse or neglect. The local authority had not completed an investigation under the Vulnerable Adults Procedures into injuries received by a resident. EVIDENCE: All staff at the home have received training in Adult protection policies. From discussions with two of them the inspector received feedback that indicated their competencies and knowledge on the procedures to follow if there was any suspicion of neglect or abuse. Records were maintained of any incidents including changes to individual conditions. The inspector has received promptly records of all notifiable incidents at the home. An investigation under the Vulnerable Adults Procedure was still in progress at the time of inspection. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 17 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 25 26 29 30 The home is clean and comfortable. Residents are provided with a range of specialist equipment to maximise their independence, ongoing assessments are required to ensure that all the facilities are appropriate to their needs. EVIDENCE: The home is divided into three units, the ground floor accommodates eight residents, the first floor has five residents and the second floor provides for three residents that are sisters. All bedrooms are single occupancy. A number of bedrooms have windows that are placed at high levels. The manager reported on the progress made following requirements made at the previous inspection. Occupational therapists have undertaken assessments on the environment. Ceiling track hoists have been provided in ground floor bedrooms and bathrooms where required, other recommendations made by the OT have been addressed. Other areas of the environment require further assessments. The second floor has a shower room as well as a bathroom, a special bath seat is provided for bathing. The shower room provided is not level with the floor and not easily accessible to all three residents on the floor and requires an OT assessment. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 18 The home was clean and hygienic. The arrangement for the security on the second floor is that a keypad is used. Spacious well-furnished lounges are available on each floor Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 19 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) 32 33 34 35 36 The staff team are well supervised and supported since the appointment of the manager. They show a positive and professional approach in looking after people with learning disabilities but further improvements are required in developing communication skills. EVIDENCE: Records were maintained of regular and consistent supervision provided to staff including one to one supervision. Staff had been issued with the codes of practice set by the GSCC. Areas where individual staff attitudes were not appropriate were addressed in supervision with action plans in place. Two members of staff spoke of the difference made to their role by the training and the support provided to them in recent months. Staff morale had improved with staff expressing a desire to learn and develop more in their role. They said that they valued the input and training from the specialist team. They now felt competent in providing for individuals with challenging needs and learning disabilities and were interested in further developing more expertise. The inspector received positive feedback from members of the MD team that had provided training to staff. Their observations were that staff attitude had become receptive to training and their interaction with residents had been positive. A large number of staff files viewed (8)contained all the essential information. A few omissions were observed however on two files, a POVA check had not been returned with the CRB for one staff member, references Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 20 were not available from a previous employer on another file. The omissions related particularly to staff that had worked previously at other Caretech homes. The home has an induction programme. A new member of staff told the inspector about her induction programme, it covered all the areas necessary including LDAF. Areas of training delivered to staff in previous six months included autistic spectrum disorder, approaches to and interaction with learning disability group as well as mandatory training. Staffing rotas indicated that sufficient numbers of suitably trained staff were on duty. In the previous three months it had been agreed that one to one staffing was provided for one resident while an investigation was undertaken regarding unexplained bruising and injury. Although the investigation had not been completed it had been agreed by the funding authority that two members of staff were on duty in the second floor unit and that the one to one staffing would discontinue. Three relatives spoken to said that they felt that staff were doing an excellent job. One relative commented on observations she made on weekend visits over a period of time. She had found that on some occasions residents on the ground floor were not always interacting with staff but sitting on front of the television. A few areas where communication was not always effective were found on written records, appointments for LA reviews had been agreed but these had not been recorded in the appointments book. Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 21 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) 38 40 41 42 Residents and staff benefit from a much improved home. The management style promotes and fosters an environment where people feel valued. EVIDENCE: The appointment of an experienced manager with strong leadership skills has given staff and residents clear direction. Her style of management is open and positive; she constantly strives for making live better for all the residents. She is vigilant and addresses any shortfalls in staff approach or skills. Staff spoken to said that she had given them inspiration and encouragement to develop their skills and that she was very supportive. The interaction observed between residents and the manager demonstrated that she had a good understanding of their needs and knew when residents were anxious or unhappy. She has helped restore morale to the staff team. More emphasis has been placed on ensuring that staff understand and adhere to the policies and procedures of the home. Record keeping has improved; individual records were up to date. The health and safety and welfare of residents are promoted. New guidelines as well as training on caring for people with swallowing disorders have been Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 22 provided for staff, equipment for the safe moving and handling of people have been supplied. Staff have received mandatory training including food and hygiene and moving and handling safely. Recent risk assessments had been completed for safe working practices. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Chestnut Road Score 2 2 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 2 3 3 3 Standard No G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Score Version 1.20 Page 23 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 2 3 x 3 x 2 31 32 33 34 35 36 3 2 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 3 3 x Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 24 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 The registered provider must ensure that a service users’ guide is developed for the home and made available to all service users, and that this guide contains the information as specified in standard 1.1. Timescale for action 31/05/200 Subject of a previous requiremen t. Timescale extended to enable completion of this 31/05/200 5 31/05/200 5 2. 6 15 3. 12 16 (2) n 4. 17 16 (2) i 5. 27 23 (2)j j 6. 32 3 The registered provider must develop daily log sheets in a format that enables clear written records to be maintained. Residents/relatives must be consulted about programmes of activities to be arranged and that these take into account individuals needs and preferences Residents must be offered a choice of suitable meals that take into account their dietary needs and preferences An OT assessment must be completed on 2nd floor shower room to determine if a more accessible shower is required Staff must have their communication skills developed and dedicate time particularly at 31/05/200 5 31/05/200 5 31/05/200 5 Page 25 Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 7. 34 4 (a) (b) weekends to listening and communicating with residents, All communication with professinals regarding appointments must be recorded in writing. An audit must be completed of 30/06/200 staff files to determine if there 5 are any omissions in information, full and satisfactory information to be available for all staff employed at the home 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 17 Good Practice Recommendations Staff should ensure that more emphasis is placed on the promotion of healthy eating, Chestnut Road G52 S55761 Chestnut Rd V221187 12 04 05 Stage 0.doc Version 1.20 Page 26 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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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