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Inspection on 10/06/05 for Chrissian Residential Home Limited

Also see our care home review for Chrissian Residential Home Limited for more information

This inspection was carried out on 10th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The service provides a homely environment within which service users are encouraged to maximise their independence. The day to day involvement of the owners in the running of the service, and the opportunities service users have for direct contact with them, is appreciated and service users regard them highly. Health needs, including the administration of medication, are demonstrated to be well responded to and well recorded.

What has improved since the last inspection?

The home had made good progress on all of the 11 requirements made at the last inspection. Documentation had improved. The home had a clear sense of what needs it can meet, and has presented this, with other information required in the Statement of Purpose and Service Users Guide. Employment practices have improved considerably since the last inspection.

What the care home could do better:

Service users care plans require some development. Staff training needs to improve. This is the one outstanding requirement from the last inspection, and progress has been delayed because of difficulties obtaining the required training packages. The home had been working on this but had yet to recruit staff onto NVQS and induction and foundation training.The owners are aware of that many new referrals they receive are for service users with a higher levels of needs than they have cared for to date. A business plan is required, which addresses the home`s future operation.

CARE HOMES FOR OLDER PEOPLE Chrissian Residential Home Limited 526-528 Woodbridge Road Ipswich Suffolk IP4 4PN Lead Inspector Mary Jeffries Announced 10 June 2005 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 Older People. 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. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Chrissian Residential Home Limitied Address 526-528 Woodbridge Road Ipswich Suffolk IP4 4PN 01473 718652 01473 718652 None Chrissian Residential Home Limited. Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Bibi Rookian Molabaccus Care Home 22 Category(ies) of OP Od Age (22) registration, with number of places Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10/02/05 Brief Description of the Service: Chrissian House is situated on a main road into Ipswich town centre. The home comprises two buildings joined together at ground and first floor level. There is a medium sized garden to the rear of the building, with patio area and a small amount of outdoor furniture and seating. The accommodation was developed in early 2002 to meet the standards at that time. The number of double rooms was reduced, and new rooms were created when the development was completed. The garden has had landscaping, and is attractively maintained. The home caters for those with low and medium needs only. The interior of the home is basic in decoration, with stair lifts to aid those with poor mobility. The home would not accept a service user who was a wheelchair user at the time of admission. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection took place during one day in June 2005. The Inspector met with the owners, one of whom is the Registered Manager, and also with a deputy manager who helped with the inspection. Other staff also assisted. Four service users were spoken with and their records were tracked. Another group of three service users were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Service users care plans require some development. Staff training needs to improve. This is the one outstanding requirement from the last inspection, and progress has been delayed because of difficulties obtaining the required training packages. The home had been working on this but had yet to recruit staff onto NVQS and induction and foundation training. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 6 The owners are aware of that many new referrals they receive are for service users with a higher levels of needs than they have cared for to date. A business plan is required, which addresses the home’s future operation. 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. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 The home has a clear understanding of the range of needs it can meet, and these are clearly set out in the Statement of Purpose and Service User Guide. EVIDENCE: An updated Statement of Purpose and Service User’s Guide were provided. These were clear documents and contained all necessary details. The Statement of Purpose contained details regarding the provision of door guards, which are charged for if a service user does not have an identified need for one. The Statement of Purpose sets out fully the admission procedure, and states explicitly that the home does not accept emergency admissions. A copy of the home’s contract with service users was provided. It did not include the number of the room to be occupied, but was otherwise comprehensive. Four service users tracked all had assessments on file. Since the last inspection, the home had developed and implemented a needs assessment tool, to demonstrate its consideration of its ability to meet the needs of service users admitted to the home. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 9 One of the four service users spoken to in depth had dissatisfactions, and expressed the view that the home was not suitable for them. They were of the stated opinion that they were younger than the other service users and that there was no suitable company. This service user, however, had recently had a Care Programme Approach review which addressed the appropriateness of the placement. The notes were not available at the time of the inspection. The home should continue to monitor this. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Service users can be confident that their health needs will be identified and appropriately responded to. They can expect to be well cared for, but may find that some staff are less sensitive than others. Service users emotional and social needs are given consideration by staff but are not clearly identified within care plans. EVIDENCE: One of the four service users tracked, all had daily care plans on file. One had a CPA care plan, but this did not include social needs. Care plans seen did not contain aims or goals of the care provided in all aspects of personal and social care needs and the action that needs to be taken by care staff to ensure identified needs are met. Evidence that plans, including risk assessments were regularly reviewed was on file. One of the service users was seen to have had three falls entered in the accident book during the month prior to the inspection. The service user had a personal risk assessment on file which included a falls risk assessment. care plan. Service users files showed referral to appropriate medical services for assessment and or treatment as required. Service users confirmed that Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 11 this took place. The manager had found that some referrals were taking longer than they used to, for example chiropody referrals, and had responded to this by arranging care staff training to cut toe nails. Staff and management spoken with had a good knowledge of service users needs. The afternoon medication round was observed and records checked for the seven service users occupying the annex. No errors were found in the recording. Practices were generally good, however in one case eye drops were administered to one service user at the dining table. Senior staff are trained in the administration of medicines by the manager, who is a nurse. Seven relatives responded to the pre inspection survey, all indicated that they were satisfied with the overall care provided by the home. Service users spoken with generally felt that their privacy was respected. One pointed out that the deputy manager knocked on the door before entering. They added that they couldn’t say enough for both deputy managers, and the way they treated them, with respect and care. Another service user said that some of the carers are alright, but some can be a “bit funny”. They gave an example of being told by carers – “ You’ve messed your bed up”. They went on to say that the manager and deputy have reassured them that it is the job of carers to deal with such problems, and that they are not to worry. One service user responded to the question – do staff treat you well ?” said “generally speaking they are very good.” Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Service users use of community resources and associations with family are well supported and encouraged. Service users who are more dependent may find that the activities programme is not as extensive as they would like. Service users have choice regarding their life styles, but may be able to exercise more choice with encouragement. EVIDENCE: Social activities were discussed with a group of three service users. One said that it was a little bit quiet, and recalled that they used to like games such as skittles that a carers who had now left used to arrange, but which did not currently happen. Another said “We don’t get enough exercise, I’d like 10 minutes a day. Seven relatives responded to the pre inspection survey, all indicated that they were made welcome in the home, at ant time, by staff and owners. Five could not confirm that they could see their relative in private. One service user spoken with said that they could have their visitors in their room, and that they don’t have to ask. Another service user said that they can see people on their rooms, but that people don’t generally do this. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 13 Service users advised that visitors are sometimes offered a cup of tea, but that they do not go out of their way to do this. Two visitors spoken with confirmed they were made welcome at the home. A service user confirmed that a church service is held at the home every Sunday. Service users are encouraged and assisted to use community resources, such as the local pub and the Caribbean centre, and the Bridge Club. This was confirmed by service users. A member of staff said that they thought “everybody feels it is home.” They had worked at the home for many years, and said that “ it is a lot more relaxed than it used to be. They (service users) can go to bed when they want to and there is a lot more choice in everything”. One service user who prefers to stay in their room for much of the time had meals taken up to them. Two service users confirmed that had a cup of tea in their rooms in the morning. The luncheon menu was displayed on the wall. One service user said “The food is always very good, always edible, I can’t complain about anything.” Meals were discussed with a group of three service users. One said that they would tell the manager if there was any food they did not like, also, if they do want something, “ she asks, we get it” .Two of the service users said that they thought it was a long time from tea time to breakfast, and said that a supper they had a savoury biscuit or a custard cream with their hot milky drink. They thought a bit of cheese would be nice. This was discussed with a member of staff who said that the service users only had to ask. A log book of meal choices taken was maintained for service users. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Proper procedures and practices were in place, and the home has a variety of different channels of communication open to service users. EVIDENCE: The home forwarded a copy of an amended complaints policy following the last inspection, when a requirement was made that their policy be amended to make clear that a complainant could contact the CSCI at any stage of a complaint. Service users views on how open the home is to hearing concerns varied. One service user said that if I start to get annoyed (with the staff) I tell them right quick” Another said that “ I do what I’m told, I’m not going to start quarrelling now.” They confirmed that they all have the opportunity to speak to the deputy manager on a daily basis, and that service user meetings are held. On this occasion employment practices were seen to fully comply with the regulations, with one minor exception, and so offered protection to service users. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 23,24,25,26 The home is a converted dwelling and the environment is domestic in nature. It is basic in decoration, but is clean and homely. Overall attention is paid to health and safety, however the home needs to be more proactive in identifying and responding to risks in the environment to ensure service users safety. EVIDENCE: The environment at Chrissian House continues to be maintained at a satisfactory level. On the day of this announced inspection, the home was clean throughout, with no unpleasant odours. Communal bathrooms had liquid soap, paper towels and waste paper bins. All areas were well ventilated and bright. The garden was well maintained. The size of individual rooms and communal space meets the National Minimum Standards. All of the rooms examined were furnished with the required furniture, and had been personalised by service users as they chose with personal possessions and individualised decoration. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 16 One service user’s room was seen to have an uncovered radiator. This was discussed with the deputy manager, who was advised that in the absence of a cover, individual radiators should be risk assessed. A risk assessment of hot water outlets had been forwarded following the last inspection. Signs advising that water is hot had been put up. One service user said that they were unhappy with their bed, and that it was uncomfortable and too hard. This was discussed with the manager, who advised that the service user had previously said they had wanted a double bed and they had been unable to provide that, but that this concern had not previously been presented. A wall lamp in this room was not accessible from the bed, and there was no other bedside lamp. A long standing recommendation to have the premises assessed by a suitably qualified person had not been met: the home had advised CSCI that they had encountered difficulty in obtaining a suitably qualified person, and therefore have arranged a course for the Assistant manager on O.T. Assessment and the environment with regards to care homes. This home had reviewed the arrangements regarding the provision of door guards. The home’s Statement of Purpose and Terms of Residency had been amended accordingly. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30 The home was adequately staffed on the day of the inspection. A low percentage of the care staff have National Vocational Qualifications. The impact of this is modified by the experience and long standing employment at the home of some staff, and the hands on approach of the management team. EVIDENCE: The owners are involved in running the home. One service user commented that the deputy manager “goes out of their way, they are in every day at quarter to nine, and comes round asking you how things are.” Minimum staffing levels are 3 members of staff by day, and 2 by night. Staffing levels are being maintained at satisfactory levels, and staff turnover is low. One service user said that “some are the same ones ever since I’ve been here, I like that I do.” Seven relatives responded to the pre inspection survey, six indicated that they thought there were always enough staff on duty, one thought that there was Some shortage when staff were taking their breaks. One service user said that everything gets behind occasionally, maybe a half hour wait” but commented “I think they have enough staff”. A group of three service users spoken to confirmed that their tablets were “a bit late sometimes.” A requirement was made at the last inspection that Criminal Records Bureau checks be undertaken in respect of two most recently employed members of staff. One of these had since left. A CRB was in place for the other member of staff. Evidence of a CRB check for the visiting hairdresser was seen. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 18 The staff files for three most recently recruited carers were inspected and found to be in order, including CRB checks achieved and references taken up before employment commenced, photographs and proof of identity, with one exception only. The form of proof of identity for one carer who is not a British national was not adequate. A requirement was also made that an enhanced level CRB check be made for a domestic worker for whom a standard check only was on file. Evidence of this having been done was seen. Of twenty care staff, excluding the manager, one is a nurse and 3 had NVQ 2 or above. Four staff were part way through their NVQ 2, one had started , and another 4 were waiting to register. This had been delayed due to difficulties training companies had been experiencing with Government funding. A requirement was made at the previous inspection that the Registered Person must ensure that ToPSS standard foundation and induction is undertaken by any staff new staff who have previously not received this within 6 months of commencing work at the home. This induction had not been provided for three new workers, due to difficulties with obtaining the training providers. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35, 36, 37, 38 The home is well regarded by service users and relatives and seen to operate in the best interests of the service users. An ethos of genuine caring is apparent throughout the management team, which is a family group. The homes documentation and recording in a number of areas had improved to an acceptable standard since the last inspection. EVIDENCE: A staff member advised that the home benefited from always being able to get hold of a member of the management team, advising that they would attend within 10 minutes if not on duty when needed. The home does not look after any service users monies. A book had been set up to record small purchases made on behalf of a few service users who have no next of kin had been set up. Receipts are given to service users, and all transactions recorded. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 20 The home had devised a questionnaire for service users, and collated the results in the Service User Guide. Prior to this inspection, it had been established that supervision sessions were occurring by monthly, but there were no written records. The inspector was advised that supervision involved observation and a short one to one. Standard supervision recording sheets had been produced and put into use for the supervisions that had occurred in April/May. Staff annual appraisals were seen to have been carried out. Evidence of the monitoring of fridge and freezer temperatures, and also of meat temperatures, was seen. A letter from the company accountant, dated 18th February 2005, including a balance sheet dated 31st October 2003. The letter confirms that the home operates in a profitable way, and has adequate financial resources to meet all of it’s immediate and medium term needs. The Responsible persons advised that they are mindful that referrals to the home have demonstrated a change in the needs of service users, who have been less physically and mentally active than in the past. The home does not currently have a business plan. Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 2 2 2 3 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 2 3 3 x 2 Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement Service users plans need to be developed to clearly show the aims or goals of the care provided in all aspects of health, personal and social care needs and the action that needs to be taken by care staff to ensure identified needs are met. An accesible bedside lamp must be provided. The suitablity of the service users bed in room 3 must be assessed. A window restrictor must be fitted to the window in room 6. Uncovered radiators must be risk assessed. An acceptable form of proof of identity must be on the employment file of a non British National. This must be a full passport or identity card issued by an EU Country, or a full passport or a document issued by the Home office establishing the individuals immigration status in the UK for non EU nationals. The Registered Person must ensure that foundation and induction is undertaken by any Timescale for action 31/11/05 2. 3. 4. 5. 6. 24 24 25 25 29 16( c) 16( c) 13(4) (a)(c) 13(4) (a)(c) 19 schedule 2 30/09/05 14/08/05 Immediate 30/09/05 Immediate 7. 30 18(1)(c) 30/09/05 and ongoing Page 23 Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 8. 30 18(1)(c) 9. 34 25 staff new staff who have previously not received this within 6 months of commencing work at the home. Sufficient staff must be registered on NVQ 2 courses to 50 staff with the relevant qualification A business and financial plan must be produced. 30/09/05 10/12/05 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. 3. 4. Refer to Standard 2 10 14 22 Good Practice Recommendations The agreement for Terms and Conditions of residence should include the number of the room to be occupied. Eye drops should not be administered in the dining room. Service users choice should be promoted by assisting them access options that are open to them. The Registered Person is advised to obtain an assessment of the premises and facilities from a suitably qualified person, including a qualified occupational therapist, with a specialist knowledge of the client group catered for, and provide evidence that the recommended disability equipment has been secured or provided and environmental adaptations made to meet the needs of service users. The recreational and activities programme should be revised in the light of the changing needs of service users. The home should review its environmental risk assessment. 5. 6. 12 25, 38 Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection St Vincents House Cutler Street Ipswich IP1 1UQ 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 Chrissian Residential Home Limited I54-I04 S58102 Chrissian V232572 050610 Stage 4.doc Version 1.30 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!