Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 09/09/05 for Chestnut Road

Also see our care home review for Chestnut Road for more information

This inspection was carried out on 9th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There are members of staff that are interested and that have developed good relationships with service users. A service user spoken to said her key worker was good and that, "she knew how to support her". A member of staff spoken to demonstrated a good knowledge of the difficulties experienced by people with learning disabilities. She had completed psychology studies and spoke of the importance of developing relationships with service users. She managed appropriately a service user that displayed challenging behaviour and displayed good interaction with other service users. The accommodation is comfortable with pleasantly furnished bedrooms and communal lounges.

What has improved since the last inspection?

Assessments have been completed by Occupational Therapists from the health team. Aids and adaptations have been provided that enable more independence for individuals.

What the care home could do better:

Although the staff team have worked hard there have been occasions when a small number of staff have let down the team. For example, a member of staff did not follow care procedures which came to light after the death of a service user. The care worker was not implicated in the death but had not provided night care as planned and required. The manager has been successful in making improvements at the home. This inspection has highlighted the need for further improvements to the following areas. To continue the development of care planning documentation which staff follow. To continue with the consultation of service users relating to activities. To audit staff recruitment information in order to identify that applicants for work have all been thoroughly checked at the recruitment stage. More work is needed to develop the complaints arrangements in order for service users to be able to make complaints. Work to address this is already planned.

CARE HOME ADULTS 18-65 Chestnut Road 44 Chestnut Road West Norwood London SE27 9LF Lead Inspector Mary Magee Unannounced Inspection 9th September 2005 10:00 Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chestnut Road Address 44 Chestnut Road West Norwood London SE27 9LF 020 8761 3689 020 8761 9457 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Caretech Community Services Limited Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 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. 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. 12th April 2005 2. Date of last inspection Brief Description of the Service: 44 Chestnut Road is one of a number of residential 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. There is a wheelchair accessible large garden with 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 DS0000055761.V249962.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours and was the second unannounced inspection of the year. The manager was not on duty. The inspector met with the regional operational manager, three members of staff and eight service users. A senior physiotherapist from the Community Learning Disabilities Team was at the home. Comments received from three relatives by telephone are also included. The service has been operating for a little over twelve months. There is no current registered manager and the service has been managed throughout 2005 by an experienced Caretech manager who has worked in and been registered as the manager of other care homes. A new manager has been appointed and Caretech have advised that they are considering how best to provide long term management at the home. A manager must be appointed and an application be made to CSCI for the manager to be registered. Concerns about care provision had been raised by the Community Learning Disability Team (CLDT) before the inspection and copied to CSCI. A written response to the concerns from Caretech was also copied to CSCI. Caretech advised CSCI, at a meeting held after the inspection, that some improvements had been made. In addition, clarification had been requested from the CLDT on a number of areas. Caretech also advised that since the original concerns had been raised they had received positive written feedback from the CLDT in matters relating to the individual care provided to some of the service users. What the service does well: What has improved since the last inspection? Assessments have been completed by Occupational Therapists from the health team. Aids and adaptations have been provided that enable more independence for individuals. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 123 Assessments of needs are completed for all service users before admission. Staff have received training on how to support people with complex physical disabilities. EVIDENCE: A new service users’ guide has been developed and is available. It includes photographs of individuals’ bedrooms. A copy of this was available on each service user’s file. Service users have their needs fully assessed by a senior member of staff. before they move to the home The home reported having had trouble in acquiring sufficient information from previous placements. The Community Learning Disability Team (CLDT) has worked closely with service users at the home. They have provided training for staff and given them training on how to support people with complex physical disabilities. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 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 the following standard(s): 679 There have been improvements in care planning arrangements but care is not always delivered according to the agreed individual care plans. EVIDENCE: Day and night time logs and monitoring sheets of individual’s progress were viewed. Care arrangements are not always delivered according to the individual care plans agreed. For example, for one service user that experienced frequent episodes of challenging behaviour there was insufficient information recorded in her notes focusing on positive behaviour techniques or how to manage her aggression. A care worker showed the inspector a scratch she had sustained from the service user earlier in the day. At a recent review for a service user it was recorded that a behaviour chart be maintained to analyse any particular patterns of behaviour. The behaviour charts had not been maintained consistently by staff. Record keeping is not always accurate and, as identified at the previous inspection, the information sheets are restrictive and do not give a good indication of a service user’s condition or of the actual care given. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 10 Risk assessments are current and held on service user files. Guidelines on transferring people safely developed by professionals from the health team have been supplied. The CLDT have raised concerns about the care provided. These concerns cover the view that staff at the home were not following assessments and guidance, that care plans do not outline all the information needed such as communicating with service users and that not all staff demonstrated an awareness of supporting individuals with complex needs with staff not always following the guidance, for example at mealtimes. In addition, the Health Care Team felt that staff were not assisting service users with complex physical disabilities with safe manual handling practices. Caretech have advised CSCI that since the inspection they have addressed a number of the points raised by the CLDT, that they have asked for more information in order to follow up and they have advised that some issues raised had already either been acted upon or that they have now received positive feedback on from the CLDT. In addition, a core team to support service users with assistance to eat is being developed. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 16 17 There have been improvements in the activities available to service users. Some relatives feel that more proactive work on activities can be done by staff particularly at weekends. Work to consult with service users about activities needs to continue. Meals are nutritious and wholesome. EVIDENCE: Generally there have been improvements to opportunities available to service users. More service users now participate in external activities. Some attend college, recreational activities and have trips out in the minibus. Concerns were raised by a relative and the CLDT that not all service users enjoyed relevant activities. For example, a description was given of some service users being seated in front of a television when it was not their choice. Similarly, it was reported by relatives that not all service users were enabled to enjoy external weekend activities particularly on hot days. During the inspection staff were interacting and talking with service users on the ground floor. On the second floor, staff were unfamiliar with service users and demonstrated little knowledge of their special needs. Interaction observed Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 12 between the service users and staff member was not good. The inspection took place on the day of a funeral of one of the service users and the inspector acknowledges that regular senior members of staff were therefore not available for duty and that the funeral arrangements had had an impact on the atmosphere at the home. Other relatives spoke with said that improvements had taken place to the lifestyles of service users. The manager said that there had been developments in relation to the activities provided. These included having meals on a theme of “countries around the world”. The inspector accepts that improvements have been made. The requirement given in the last inspection report of 12 April 2005, to consult with services users and relatives about the programme of activities, is re-stated in order for this matter to be thoroughly addressed. The preparation of meals was in progress during the inspection. Meals prepared and served appeared nutritious and wholesome. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 There are policies and procedures in place that recognise and meet individual service user’s needs. Staff have received training in using specialist equipment. EVIDENCE: A high number of service users have complex physical disabilities. A range of equipment and aids has been supplied to promote independence and assist with safe moving handling and exercise. Staff have received training in using the equipment. More input into staff training needs is being provided by the manager and the CLDT. As described in the “Individual Needs and Choices” section above, there is ongoing communication between the CLDT and the home manager about the care arrangements at the home. Improvement work has taken place and more information requested by Caretech about possible further improvements. This includes the setting up of a core special team to assist service users with eating/swallowing difficulties. The inspector observed that staff completed body charts/maps when service users had any changes observed in skin conditions. Records showed that necessary consultation with GP took place following concerns regarding changes. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Staff have received training on safeguarding service users from abuse or neglect. The complaints procedure arrangements are adequate but can be developed to assist service users to make complaints where necessary. EVIDENCE: The complaints record book was inspected. No formal complaints had been received. However, there were records kept which demonstrated that numerous minor issues were raised and responded to promptly. More development work is required to the complaints system in formats so that service user views can effectively communicate their views. Following the inspection Caretech advised that they were to develop their complaint’s procedure in order to facilitate service users making complaints. Staff have received training on how to protect and safeguard vulnerable adults from abuse or neglect. There has been a recent adult protection incident. Caretech undertook an investigation of the matter and have provided a written report to CSCI and the relevant local authority. Recommendations arising from the investigation were made. Relevant staff disciplinary action and referrals to the Prevention of Vulnerable Adults list were made. The inspector was informed that a long standing adult protection issue was still being investigated by the police. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 27 29 30 The home is equipped with a range of specialist equipment to maximise service user’s independence. EVIDENCE: The home is comfortable and attractively furnished. A passenger lift serving all floors is available. Additional equipment has been supplied following Occupational Therapy individual assessments. Standing frames for service users so that they can have the necessary recommended exercise are available and were in use at inspection time. The inspector met with the physiotherapist who attended at the home and was working with service users on their exercise programme. New ceiling track hoists have been installed in bedrooms and bathrooms. Bedrooms are single occupancy. On the ground floor there are eight bedrooms with shared bathroom/shower facilities between two persons. On the first floor there are five single bedrooms with toilet facilities. There are two bathrooms with specialised bathing facilities. On the second floor are three single bedrooms with toilet facilities. There is one bathroom with equipment and shower facilities. An Occupational Therapy (OT) assessment has been completed following a requirement set at the previous inspection. The OT made no recommendations following the assessment. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 16 Each floor has a dining room and lounge area. There is also a small snoozelem on the ground floor with an overhead hoist for service users who may wish to experience a quiet time. Further improvements are required to one of the bathrooms on the first floor to ensure that service users with specialist needs can access this safely. The home was clean and hygienic. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 35 36 Some members of the staff team require further training to develop the competencies and skills to meet the needs of current service users. An audit of staff files is needed to ensure that full information about applicants for work is obtained at the recruitment stage. EVIDENCE: Three staff personnel files were viewed. Recent CRB disclosure numbers issued as well as POVA checks were recorded. Two references were available on each of the three files. The inspector did not view the actual CRB checks as these are held at the head office and will be viewed at the next inspection. The references for one staff member did not include a professional reference. Employment history was not available for another staff member. Photographs were not present on the staff files. A requirement was made at the previous inspection that an audit be completed of all staff files to determine if there were any omissions in information and for full and satisfactory information to be available for all staff employed at the home. This requirement has been restated. There were records of regular one to one supervision. Two staff files included information to suggest that staff were competent and suitably skilled to become senior support workers. From observations made of other records relating to performance and from direct observations made of one staff Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 18 member it was found that some senior staff members did not have the necessary skills and required further training. There is a training and development plan for the staff team and was assessed at the previous inspection. It is not however linked to staff competencies /weaknesses and has not addressed the areas of shortfalls in the staff team. The mother of a service user said, “a number of staff are kind and understood what service users like and need but that there were a few staff with no interest in the work”. She described a number of occasions at weekends when staff were seated in lounges and not interested in interacting with service users. Two other relatives spoken to felt some of staff employed were unsuitable. There are management night time and weekend checks. Staffing rotas indicated that sufficient numbers of support staff were on duty during the day. However, at night there were four members of staff on duty with two of these on the ground floor, where the needs of service users are more complex, and one staff member allocated to the first and second floor. These staffing levels must be reviewed and reflect the assessed needs and numbers of service users. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 41 42 The management arrangements are temporary and must be clarified with an application made for an experienced, competent manager to be registered with CSCI. Some staff require further training on leadership skills. Quality assurance arrangements have yielded positive findings about the service. EVIDENCE: The manager is experienced in running a service for people with learning disabilities. She has made significant improvements since she transferred to the home at the beginning of the year. She has been able to respond to many of the issues raised by the CLDT. However, this manager has been working at the home on a temporary basis. A new manager has been appointed and the organisation is deciding how best to move forward with the need to have a permant manager who is registered with CSCI. The past few months has been a time of considerable change for the service with the area manager also being subject to a change. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 20 The leadership and direction given when the manager is on duty communicates a clear sense of leadership. Professionals and relatives spoken to confirmed this. The manager was not on duty at the time of inspection. The inspector found that management arrangements in place that day relied on some inexperienced members of staff that did not have the necessary skills and that require further training. The manager later informed the inspector that staff members were at low ebb on the day because of the death of a service user. The inspector viewed the results of a quality audit completed by an independent consultant. There was evidence to suggest that feedback was actively sought from service users and that the views of family friends or stakeholders views were sought on how the home is achieving goals for service users. The results of the audit was positive. At the previous inspection, it was found that recording logs used were not suitable. No further action has been taken to respond to the requirement stated. Staff also confirmed with the inspector that these logs were too restrictive and prevented staff recording sufficient information. The records for maintaining a safe environment were not checked. These will be checked at a follow up visit within the next three months. Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 21 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 3 2 1 X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 2 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score 2 2 3 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chestnut Road Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 2 3 3 x 2 3 x DS0000055761.V249962.R01.S.doc Version 5.0 Page 22 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 YA6 Regulation 12(1) a, b, c Requirement The registered person must ensure that the home is conducted in a manner to promote and make proper provision for the health and welfare of service users. Agreed care arrangements following needs assessments must be responded to accordingly. The registered person must ensure that service users/relatives are consulted about programmes of activities to be arranged and that these take into account individuals’ needs and preferences. Previous timescale of 31/05/05 not met. The registered person must ensure that the complaints procedure is developed further and that it is appropriate to the needs of service users. The registered person must ensure that all members of staff employed understand and comply with codes of DS0000055761.V249962.R01.S.doc Timescale for action 01/01/06 2 YA14YA12 16 (2) n 01/02/06 3 YA22 22 (2) 01/02/06 4 YA31 18 (4) 01/01/06 Chestnut Road Version 5.0 Page 23 conduct expected. 5 YA37 The registered person must ensure that a competent experienced person is appointed to manage the home, application for registration to be made to CSCI when appointment is made. 19 (1) a, The registered person must b, c complete an audit of staff files to determine if there are any omissions in information, full and satisfactory information including professional references as well as photographs to be available for all staff employed at the home. Previous timescale of 30/06/05 not met. 18 (1) (c) The registered person must (i) ensure that senior staff receive leadership training. 17 (1) (20 The registered person must (3) develop daily log sheets in a 15 format that enables clear written records to be maintained. Previous timescale of 30/05/05 not met 8 (1) 01/01/06 6 YA34 01/01/06 7 8 YA35 YA41YA6 01/02/06 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA35 OP33 Good Practice Recommendations The registered person should ensure that the training and development plan is linked to staff competencies and identified weaknesses. The registered person should ensure that the needs of service users are reviewed and that staffing levels reflect these assessed needs, in particular at nighttimes. DS0000055761.V249962.R01.S.doc Version 5.0 Page 24 Chestnut Road Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Chestnut Road DS0000055761.V249962.R01.S.doc Version 5.0 Page 25 - 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!