CARE HOME ADULTS 18-65
Chiswick Care Ltd 11-13 Chiswick Road London N9 7AN Lead Inspector
Rebecca Bauers Unannounced Inspection 21st February 2006 10:10 Chiswick Care Ltd DS0000010618.V271190.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 Chiswick Care Ltd DS0000010618.V271190.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. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Chiswick Care Ltd Address 11-13 Chiswick Road London N9 7AN 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) 020 8803 8002 020 8887 6664 Mr Bhooneswur Krite Luchmun Mrs Reeta Luchman Reeta Luchmun Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. One specified service user who is over 65 years of age may remain accommodated in the home. This condition will remain until such time as the home can no longer meet his needs. 6th September 2005 Date of last inspection Brief Description of the Service: 11-13 Chiswick Road, London, N9 7AN is a care home owned and run by Chiswick Care Limited. The home is located in a residential area of North London with community resources and facilities within close proximity. The home has two bathrooms, a kitchen, a lounge and a large paved garden at the back of the building. Chiswick Care provides support and supervision for six adults with a learning disability and associated mental health problems. Each service user has a single bedroom. The home has obtained a variation to its registration with respect to one service user over 65 years of age. Service users are supported to access community-based facilities such as libraries, swimming pools, cinemas and shops. There is a range of leisure activities provided at the home. A vehicle has been recently purchased to facilitate activities and trips further a field for the service users. In addition to support during the day, the home has one member of staff who is awake at night to respond to the needs of the service users at night. Mrs Reeta Luchman is the registered manager of the home. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 21st of January 2006 as part of the annual inspection programme to identify progress with previous requirements. In addition, the standards of care were checked against the core standards. Most of the minimums standards have been met. The inspection took approximately five hours to complete. A partial tour of the home took place; three service users were spoken to both on an individual basis and in a group. Care records, quality assurance audits, staff records and health and safety records were examined. Several staff were spoken to. The registered manager was helpful and present throughout. Positive comments were given with regard to the care received and the caring, enthusiastic attitude of the staff team to meet the needs of the service users. Service users were very positive about living in the home. Further information was obtained through observation of service users and staff interaction. What the service does well:
Service users continue to benefit from fulfilling activities to enhance their lives and meet their aspirations all within the guidelines of measured risk. This is further promoted by the house vehicle, which enables spontaneity. Service users continue to benefit from the experience of multidisciplinary working to ensure that their personal care, social and emotional health needs are met. The home ensures that service users, relatives and other professional’s views are listened to and addressed to improve service provision. Service users benefit from a well-established staff team who understand their needs and are provided with the support and information to work with service users in a consistent way. The home now has an up-to-date recruitment policy and procedure in place, which is in line with current legislative checks. The home is well managed and all health and safety checks are carried out to ensure the health, welfare and safety of service users living in the home.
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 6 The home is warm friendly and comfortable for service users. Service users say that the staff are very helpful, caring and friendly. All service users said that they felt comfortable in the home and that enjoyed the food. What has improved since the last inspection? What they could do better:
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 7 Four of the requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the ‘timescale for action’ column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about the unmet requirements can be found in the relevant standard. A further requirement was made for the home to revised its adult protection procedures in line with the London borough of Enfield’s adult protection procedures. Recommendations were made concerned the need to get the review notes form the placing authority for reviews that occurred in 2005, for issues of diversity to be explored during key work sessions and for a training matrix to be developed to ensure that staff are always competently trained. Other identified areas for improvement highlighted by the registered manager included improving the monitoring of practices including documentation and further training in staff appraisals and IT. The registered manager intends to address these areas to improve service provision. 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. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 the following standard(s): 1,2,5 Service users feel confident that their individual needs are understood and that staff are able to meet them. All service users have an individual written contract or statement of the terms and conditions with the home. EVIDENCE: The home has an informative statement of purpose and service user guide in place to ensure that prospective service users have the information they need to make an informed decision about where to live. There has been no new admission since the last inspection. One service users has however moved onto independent living. Progress had been made following a requirement made at the last inspection for each service user to have an individual written contract or statement of terms and conditions with the home. All five service user files examined contained contracts. Thus ensuring service users have clarity with regard to the terms and conditions of their tenancy and the service that they can expect to receive. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 All service users now have detailed individual plans that reflect their individual assessed, changing and personal goals, these are being reviewed regularly. Appropriate risk assessments are in place. Decisions and support with regard to finances still need to be documented to protect service users. Service users have good relationships with staff. EVIDENCE: Detailed risk assessments are in place with specific actions identified to minimise risk and to promote service users independence. Unfortunately the restated requirement made for the financial arrangements, support and tuition provided by staff to individual service users to be documented in their individual plans had still not been progressed. This must be prioritised to ensure that service users are protected and supported by staff consistently in the management of their finances. Five service user files were examined all contained individual plans that had been reviewed in the last six months. The evaluation sheets that are in place and state that individual plans will be reviewed three monthly are now being utilised in the way they were intended and service users are having monthly
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 11 key work sessions that appear very effective in promoting person centred working. However the area of cultural needs often stated that the individual had ‘no specific cultural needs’. It is recommended that this area be explored more thoroughly by staff to ensure that the diverse needs of the service users are explored. Some training for staff around diversity issues may be of benefit. Service users confirmed their involvement in multidisciplinary reviews and felt positive about being enabled to express their wishes with regard to their lifestyles. However two of the service users placed by Enfield and who had reviews in June and December 2005 have still not yet received their review notes. The registered manager stated that she had been in contract with the L/D team to ask for the review notes but had not been successful. It is recommended that the registered manager write to the local authority requesting the notes so that individual plans can be revised in line with the review. Clear guidelines continue to be in place for managing challenging behaviour, monitoring charts are being utilised to identify triggers and to inform the consultant psychiatrist during frequent meetings. Service users have a community nurse visit every two weeks to discuss issues that they have and in addition provide information with regard to sexual health matters. Service users stated ‘ I am very happy living here’, quality assurance questionnaires returned in January 2006 supported these comments. Relatives have made equally positive comments with regard to the care provided, the attitude of staff, the atmosphere and the participation in reviews. ‘ I am delighted with the care received, we don’t have to worry if we go away’ ‘I would recommend the home to anybody.’ ‘The atmosphere is good and very friendly’ ‘The staff are professional, good communicators and very caring’ Service users feel that they have a positive influence in the running of the home both on a day to day level and in the future. Service users spoken to were very relaxed calm and demonstrated that they had good relationships with the staff on duty. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 the following standard(s): 11,12,13,14,15,16,17 Service users benefit from good access to the local community for college’s daycentres and work. Meaningful leisure activities and holidays are offered, facilitated and undertaken by service users. Service users benefit from regular contact with family and friends and personal relationships are promoted. There is a feeling of real equality within the home. Service users enjoy the food that they choose and cook. Service users would benefit from the issues of diversity being explored further. EVIDENCE: Service users continue to have access to local colleges; daycentres and some have jobs within the local community. Service users spoke of there weekend trip to Broxbourne and all the benefits of having a house vehicle that they can now go out in every day spontaneously and how they are able to plan future day trips. All preferred activities and actual activities carried out had been recorded. Service users continue to see family and friends regularly and some have developed close personal relationships, support around these relationships had been documented in the individual plans.
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 13 Staff were observed positively interacting with service users and engaging in meaningful conversations. There is a genuine feeling of fun in the home. Staff and service users were seen laughing and joking equally with each other. The home has clear and agreed rules on smoking in the home, which are adhered to and were observed on the day of the inspection. Service users have free access to the kitchen and take it in turns to cook for each other throughout the week. Menus are decided upon as a group and the shopping is done weekly by service users with some staff support. Culturally specific foods are purchased routinely and all meat is bought fresh and on a daily basis. Culture is a regular subject for discussion with the service user during their individual key work sessions this is good practice although there is much room for expanding the discussion around the issue of diversity and an individuals cultural needs and preferences. It may be helpful for staff to have some training around this topic to benefit the discussion. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20 Service users preferences for personal care are documented and adhered to by staff. Emotional and physical health needs are being met and service users are receiving education about there health needs. Service users are protected by the homes medication policies and procedures. EVIDENCE: Service users say that they continue to receive personal care in the way that they prefer and this had been documented in their individual plans. Service users emotional health needs continue to be met through multidisciplinary input from psychologists and psychiatrists. Regular health checks from GP’s, dentists and opticians are taking place and had been listed in the individual files. The outcomes of these appointments were case tracked and it was found that they are consistently being documented in the service users files to give a full picture of the individual. A requirement made for issues of sexuality to be detailed in the service user individual plans had been progressed. This issue had been documented and included the input received from other professionals with regard to education around sexual health and sexuality. This is good practice and it is essential to obtain a holistic view of the individual in a person centred way.
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 15 Staff are competent in following the homes medication policy and procedures to safeguard service users. Some service users have PRN rectal diazepam for which staff have been appropriately trained; there are clear agreed written guidelines in place. Other service users are prescribed PRN medication to help to manage challenging behaviour. There are now agreed guidelines in place to state when this should be administered to protect service users. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 the following standard(s): 22,23 Service users continue to benefit from good accessible systems within the home to ensure that their views are listened to and acted upon. The homes adult protection procedure needs amending to ensure correct reporting and to safeguard service users from potential abuse. EVIDENCE: The homes adult protection procedures need to include clear guidance and reporting procedures for staff to follow in the event of an allegation of abuse being made. This must be based on Enfield’s adult protection procedure. This was in place at the last inspection. Staff will need to have refresher training in this area of practice Risk assessments are in place for those service users who are deemed at risk of self–harm. Service users spoken to do feel that their views are listened to and acted upon. Service users said that they have opportunities to discuss issues during resident meetings and on a daily basis with staff. Service users file also contained completed quality assurance forms, which asked questions with regard to the service they receive from the care staff. There had been no complaints since the last inspection. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 the following standard(s): 24,25,30 Service users live in a homely, comfortable and safe environment. Planned decoration of the communal areas will make the home more homely for service users. The home continues to be clean and hygienic. EVIDENCE: Service users bedrooms seen were decorated to a good standard and had been personalised. One service users bedroom has required ongoing redecoration and had recently been decorated. He had recently moved bedrooms and was pleased with the new bedroom. All the service users will be having their bedroom redecorated in the next twelve months. A requirement made for the communal areas to be decorated had not yet been addressed although this work is planned to be carried out in the summer when the service users are on holiday. A requirement made at the last inspection for the cracked tiles in the upstairs toilet to be replaced had been completed. In addition, a service users bedroom door had been fitted with an automatic closing device because of the service users preference to keep the bedroom door open. The home is comfortable, homely, clean and hygienic.
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 18 Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Service users are supported by an effective and competent staff team who have clarity with regard to their roles and responsibilities. Service users benefit from a well supervised staff team who work consistently to support the service users. Service users are better protected by the homes recruitment procedures. EVIDENCE: A requirement made at the last inspection for the personnel records to contain proof of identity including a recent photograph, two written references a contract of employments and completed induction and foundation record had mostly been complied with. Four staff files were examined, two files were for two staff recruited in September 2005 all relevant checks had been carried out and completed Induction records were held on file. The new staff did not have contracts of employment in place, this must be rectified. The two other files seen were for staff employed more than eight years ago. There were no contracts or references on file. It is essential that character references are obtained for each of these individuals and held on their personal file. These documents must be held on file to ensure the safety of service users. Training records now demonstrate that staff have been booked on and will be attending all statutory training during March 2006 to ensure that the service users needs and welfare are being met by competent staff. Six staff have
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 20 completed NVQ level 2 and two staff are currently undertaking NVQ level 2 and one is doing NVQ level 3. Two staff are planning to do NVQ level 2 in care in the near future. The Registered manager has obtained NVQ level 4 in care and the RMA. The senior support worker left her post in January 2006 and the registered advised that she would be aiming to recruit to the post soon. Staff files continued to contain evidence of regular supervision to ensure continuity in care practice for service users. All staff have been given a copy of the general social care council’s code of conduct as per the recommendation made at the last inspection. The staff rota was seen and reflected the current staff on duty at the time of inspection. The rota ensured clarity of staff on duty and the responsible person on duty. The home has a shift plan in place. Staff stated that the shifts were more organised and tasks are delegated equally. Staff personnel files had been reorganised to ease access to information following a recommendation made at the last inspection. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 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): 38,39,40,42 Service users benefit from an open management style. Service users are confident that their views underpin all self-monitoring and the health and safety of service users is well protected. Fire risk assessments are in place although emergency plans are not in place. EVIDENCE: The registered manager has completed the registered managers award and assessors course and is near to completing NVQ level 4 in care. Staff stated that the registered manager is approachable and supportive. A restated requirement made for the results from a quality assurance survey to be summarised had not been progressed. This must be rectified. It must be noted however that since this requirement another batch of questionnaires have been sent out to external stakeholders, relatives and service users. Comments remain positive and it would be of benefit for the result to be summarised. A requirement made for the actions listed in the homes workplace risk assessment to be addressed had not been acted upon to safeguard service
Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 22 users and staff. A fire risk assessment has been developed but the emergency plan still needs to be developed. A requirement made for staff to receive fire training and first aid has been progressed and training had been booked for March 2006 to ensure the safety of service users in the event of a fire and if first aid needed to be carried out. It is recommended that a training matrix is developed to enable easy identification of training needs and refresher training needed. All health, safety and welfare checks to safeguard service users had been completed and recorded. This included regular fire drills. Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 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 3 2 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Chiswick Care Ltd Score 3 4 4 x Standard No 37 38 39 40 41 42 43 Score X 3 3 3 X 2 x DS0000010618.V271190.R01.S.doc Version 5.0 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 YA7 Regulation Requirement Timescale for action 2. YA34 3. YA36 17(1)(a)Sch The registered person must 3(3)(q) ensure that the financial arrangements, support and 01/04/06 tuition provided by staff to individual service users are documented in their care plan and reviewed six monthly. This requirement is restated from the last two inspections. Timescale was 31/10/05. 7,9,19 The registered person must ensure that four staff files contain the following documents: 01/04/06 Terms and conditions of employment and written character references for the two staff members who have been employed for more that eight years. This requirement is amended and restated from the last two inspections. Timescale was 01/10/05 24(2) The registered person must ensure that the results from both quality assurance surveys 01/04/06 involving service users and family members are summarised and made available to interested parties
DS0000010618.V271190.R01.S.doc Version 5.0 Page 25 Chiswick Care Ltd 4. YA42 23(4) 13(4)(c) 5 YA23 13(6) including prospective service users, CSCI, placing authorities. This requirement is restated from the last two inspections. Timescale was 30/11/05 The registered person must ensure that the identified actions to minimise risks highlighted in the work place 01/04/06 risk assessment are addressed. The home must also have an emergency plan in place. This requirement is restated from the last inspection. Timescale was Timescale was 31/12/05 The registered person must 01/04/06 ensure that the adult protection procedures are revised to include clear reporting procedures which include informing the ‘host authority’ and the CSCI. 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 YA6 YA12 Good Practice Recommendations It is recommended that the registered person write to Enfield local authority L/D team to obtain the review notes for reviews carried out in June and December 2005. It is recommended that during key work sessions that further discussion takes place with regard to service users cultural needs in relation to diversity and how this is facilitated in the service that they receive. It is recommended that the registered person develop a training matrix for all staff so that all training received and required is easily identifiable. 3 YA41 Chiswick Care Ltd DS0000010618.V271190.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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