CARE HOMES FOR OLDER PEOPLE
Claremont Parkway Nursing & Residential Home Holdenby Kettering Northants NN15 6XE Lead Inspector
Stephanie Vaughan Unannounced Inspection 6th June 2006 12.20p X10015.doc Version 1.40 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 DS0000066165.V298606.R01.S.doc Version 5.2 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 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. DS0000066165.V298606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Claremont Parkway Nursing & Residential Home Address Holdenby Kettering Northants NN15 6XE 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) 01536 484494 01536 524262 Avery Healthcare Limited Vacant Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57), Physical disability (30), Terminally ill (30) of places DS0000066165.V298606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. To include up to four (4) service users with Dementia, excluding Mental Disorder, providing personal care To provide care for Physical Disability from the age of 35 years To provide care for the Terminally Ill from the age of 35 years The maximum number registered Fifty Seven (57) Date of last inspection 29th November 2005 Brief Description of the Service: Claremont Parkway is a large purpose built facility on the outskirts of Kettering. It has been extended to provide accommodation in 57 single rooms. It is Registered to provide both Personal Care and Nursing Care. Its location in the town makes it easily accessible by private or public transport, being close to the main A14 road. Local amenities in close proximity include a cinema, supermarket, gym, pubs and restaurants. The home is spacious and well equipped. All rooms have telephone facilities, ensuite wash and toilet facilities and TV points. There are pleasant grounds, easily accessed by wheelchair users. Fees at the present time are between £ 415 & £ 480 per week. DS0000066165.V298606.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Prior to the inspection a period of 3 hours was spent in preparation, which included a review of the service history, previous inspection reports and associated requirements and recommendations. The Commission have received no concerns or allegations about this service since the last inspection. A review of comments received from residents and their representatives was also conducted and used to inform the inspection process. The issues raised on these comment cards are addressed within the body of the report. This unannounced inspection was conducted over a period of seven hours during which the inspector made observations and spoke to several residents, their representatives. Case tracking is the method used during inspection where a sample of four residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. Several members of staff were spoken to and a sample of staff files was viewed. A limited tour of the premises was conducted which involved viewing the communal areas and the private accommodation of the residents selected for case tracking purposes. The building is accessible for people who use wheelchairs. The focus of inspections for the current year is on outcomes for residents, taking into account issues such as diversity and equality. The residents within the home are all currently of Western European origin and no residents were identified with a specific disability or sexual orientation. 11 requirements were made at the last inspection and 9 of these have been met. 5 Recommendations were made and all of these have been met. What the service does well:
Admissions to the home are managed well and residents and their relatives are given the right information to help them make up their minds if the home is going to be right for them. Residents know what services are available, the cost and any extra services, including charges. DS0000066165.V298606.R01.S.doc Version 5.2 Page 6 Staff from the home visit residents before admission, to make sure that they will be able to look after them if they choose to live there. Each resident has a plan of care developed which tells staff how the resident should be cared for, these are generally done well and show that the resident or their relative is involved in the planning and review of care. These also contain good information about the residents chosen religion and what help they need from the staff to be able to carry on with their faith. Staff were seen to speak nicely to residents and to make sure that their privacy was respected. Residents are able to have their visitors come to the home, see them in private and have their own belongings brought into the home. There is a good level of entertainment in the home, which is organised by a named member of staff; some of the activities are led by visiting entertainers. Residents are able to choose if the want to join in with activities and they are enjoyed by the older residents. The food in the home is good, residents are able to choose from a menu, other foods are provided if the do not like what is on the menu. The food is well presented, the portions are good and a balanced diet is provided. The dining facilities are very nice having proper tablecloths, decorations and salt and pepper. Management have good systems in place to help people make their concerns known and try to put things right whenever possible. The building provides a very nice setting for residents to live in and is generally safe and clean. The management are doing their best to make sure that there are enough staff who have the right skills and training to look after the residents living in the home and that the way that they work is safe for the residents. Management of the home is generally good, the manager is seeking registration with the Commission and is developing systems to make sure that residents are consulted about their satisfaction with the home and that other systems are monitored regularly to make sure that they are safe. The Certificate of Registration is displayed and is up to date and accurate, having only recently been issued What has improved since the last inspection?
Residents plans of care now have assessments and consent for the use of bed rails and also contain information about the residents views on the way they wish to be cared for in their daily routines or if their health gets worse, on dying and in death.
DS0000066165.V298606.R01.S.doc Version 5.2 Page 7 Residents looked well looked after and were helped into comfortable positions and to move regularly. Medicines are being given safely and the right records are being kept. 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. DS0000066165.V298606.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection DS0000066165.V298606.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1,2 & 3 Standard 6 is not applicable The quality in this outcome area is good; this judgement has been made using available evidence including a visit to the service Admission processes ensure that residents’ are able to make informed choices and their needs and expectations are met. EVIDENCE: Requirements were made at the last inspection regarding residents’ access to information on admission. The Service Users Guide has now been revised and reissued. This was seen to be in place in each of the resident’s private accommodation. The service users guide contains information about the services and facilities that the home provides. Residents and their representatives were able to confirm that they had good information prior to making a decision as to whether the home was able to meet their needs and expectations. DS0000066165.V298606.R01.S.doc Version 5.2 Page 10 Each resident case tracked had an appropriate contract on file which specified their terms and condition of residency, the contracts were signed by the residents or their representative as appropriate. At the present time fees range between £415 and £480 per week. New admissions were seen to have a comprehensive pre admission assessment conducted by a senior nurse prior to admission, which identified whether the home was able to meet the needs of residents. Appropriate individual plans of care had been developed from the preadmission assessment documentation. New residents and their representatives confirmed satisfaction with the admission processes. DS0000066165.V298606.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7, 8,9, 10 & 11 The quality in this outcome area is adequate, this judgement has been made using available evidence including a visit to the service Improvements have been made to the individual plans of care; however further improvements are required to ensure the ongoing well being of residents. EVIDENCE: A new format has been recently introduced, which provides the baseline for comprehensive individual plans of care. In general information was well documented particularly for new residents and included details about their personal preference relating to food and routines. Although for some pre existing residents some important information had been omitted, such as a record of regular weight, blood pressure and regular review. However all records indicated an improved level of involving the residents and or their representatives in the development and review of the individual plans of care. The next step in the development of individual plans of care is to improve the level of specific detailed instruction to staff for example, the management of
DS0000066165.V298606.R01.S.doc Version 5.2 Page 12 Percutaneous Endoscopic Gastrostomy Feeding tubes, to prevent the tube from becoming embedded, to ensure that assessments for nutrition and pressure are accurately recorded and the appropriate level of intervention is both recorded and provided. In addition, the management of individualised oral care and where a resident suffers from epilepsy to provide detailed instruction as to the action that is to be taken in the event of a fit. Residents have access to a wide range of specialist health advice including dieticians, physiotherapists and speech and language specialists. A previous requirement to obtain the guidance of the speech and language therapist in the management of residents requiring Percutaneous Endoscopic Gastrostomy Feeding support has been met. A previous requirement regarding residents having appropriate referrals to general practitioners has not been met. One residents daily records indicated that they had been ‘very low’ on several occasions, however there was no indication of a referral to the general practitioner or guidance from another health professional such as the Community Psychiatric Nurse had been sought. In addition there was no evidence that a specific care plan had been developed to address the residents emotional needs. Individual plans of care now contain risk assessments for the use of bedrails with documented consent, however these need to be further developed in line with the guidance issued by the National Institute for Clinical Excellence and the Health and Safety Executive. A further requirement was made at the last inspection for residents to have risk assessments for the prevention of falls and this has not yet been achieved. However this non-compliance with requirements does not appear to have so far an adverse effect on the outcomes for residents since the incidence of falls in the home remain within an acceptable limit. The requirement is therefore carried forward. Residents appeared well presented and comfortably positioned, being well supported and assisted to move regularly. A requirement was made at the previous inspection for medication to be safety stored and administered at all times. Medication systems were reviewed and found to be in order, with the exception of one minor recording error, which was corrected at the time of the inspection. This requirement has therefore been met. Staff were noted to relate well to residents, being mindful of their privacy and dignity and personal preferences regarding the care by persons of the same gender was respected. DS0000066165.V298606.R01.S.doc Version 5.2 Page 13 Following a requirement made at the last inspection and the implementation of the new care plan format the individual plans of care now contain information regarding the residents’ wishes relating to terminal care and death. DS0000066165.V298606.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 12, 13, 14 7 15 The quality in this outcome area is good; this judgement has been made using available evidence including a visit to the service Daily life and social activity is generally managed well to meet the needs of the elderly. However further improvement is recommended to ensure younger residents have access to activities appropriate to their age group and interests. EVIDENCE: Individual plans of care evidenced residents’ preferences regarding individual routines, including times of rising and retiring to bed, frequency of bathing and food choices. One of the comment cards indicated that routines were not flexible however through discussion with this resident it was established that her initial concerns had now been addressed to her satisfaction. Residents have access to a good level and range of communal activities, involving external entertainers and are able to choose whether or not they wish to participate. One resident had attended 15 events within a period of one month. However the home also caters for some younger adults above the age of 35. Discussion with a resident from within this group indicated that they
DS0000066165.V298606.R01.S.doc Version 5.2 Page 15 would prefer access to more individualised activities based on their age group and specific interests. Individual plans of care now contain a good level of information about the resident’s personal religious observances and arrangements to access these. Visitors were seen to come and go freely, residents were able to receive their chosen visitors in privacy if they so wished Resident’s private accommodation evidenced personalisation of their rooms and staff spoken to confirmed access to advocacy for any resident who may not have the support of relatives or friends. Teatime service was viewed and seen to comprise of various sandwiches, cake and tea with an alternative of jacket potatoes with cheese and beans. Meals appeared well presented and of adequate proportion and were served in the communal dining rooms or on trays in residents rooms. Residents requiring assistance were sensitively supported. The facilities within the dining room were pleasantly laid out with double tablecloths, mats, condiments and table decorations. Although menus were not reviewed the provision of fresh fruit within the dining room and discussion with residents and staff indicated that residents were able to access a balanced diet. Mealtimes appeared to be reasonably flexible to meet the individual and collective needs. Residents and their representatives confirmed satisfaction with the food and access to special diets. DS0000066165.V298606.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 16 & 18 The quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to the service Complaints procedures are managed well and are accessible to residents and their representatives. Residents are protected from abuse by the recruitment practices and the training of staff directly employed by the home. However the current systems fails to protect residents from potential abuse by people who work in the home and who are not directly employed there. EVIDENCE: The Commission have received no concerns or allegations about this service since the last inspection. There is a clear and appropriate complaints policy included within the Service Users Guide, which is provided in each of the residents’ rooms. In addition the policy along with complaints forms are accessible in the main entrance. The complaints file was reviewed as apart of the case tracking process and provided evidence that complaints were managed well and inline with the homes policy. Through discussion with Staff and a review of staff files it was established that the management have good recruitment practices that include obtaining Criminal Records Bureau Clearances and appropriate references prior to new staff commencing employment. Staff were able to confirm that they had had recent training in the protection of vulnerable adults and had an understanding of the action that would need to be taken in the event of an abusive situation.
DS0000066165.V298606.R01.S.doc Version 5.2 Page 17 However one of the younger residents was noted to have an individual session with an external entertainer. On further enquiry it was established that the new management have no records to demonstrate whether the entertainer has appropriate clearances that pertain to his work in this home or any other. DS0000066165.V298606.R01.S.doc Version 5.2 Page 18 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 the following standard(s): 19 & 26 The quality in this outcome area is good; this judgement has been made using available evidence including a visit to the service The home meets the needs of residents and is well maintained, clean and hygienic throughout EVIDENCE: A limited tour of the premises was conducted and was seen to be suitable for the stated purpose. The home is well maintained, clean and hygienic throughout. Residents and their representatives confirmed satisfaction with their individual accommodation and the communal areas. The building is accessible for people who use wheelchairs. DS0000066165.V298606.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in this outcome area is good; this judgement has been made using available evidence including a visit to the service Management respond well to the changing needs of residents and ensure appropriate staffing levels, recruitment and training. EVIDENCE: Staffing levels are calculated according to the residents assessed level of dependency and in line with the guidance issued by the Residential Forum. Existing staffing levels comprise 9 carers, on the morning shift, 6 on the evening shift and three on the night shift. All shifts include at least 1 registered nurse. At the busiest time this provides a ratio of 1:6. Nearly all of the comment cards received from residents and residents commented on an apparent shortage of staff and this was also confirmed in discussion with residents and staff. However senior staff confirmed that the management are mindful of the needs of the residents and the impact of the layout of the building. The existing levels have recently been revised and the management are currently recruiting more staff to increase staffing levels by one on each shift. Staff interviews are being held in the same week as the inspection; in the interim agency staff are being used to cover any shortfalls. DS0000066165.V298606.R01.S.doc Version 5.2 Page 20 The management are currently developing a Named Nurse / Key worker system to ensure that residents are cared for by staff that they know well and that have a good level of understanding of their needs and preferences. Adequate levels of domestic and catering staff support care staff. Care staff confirmed that the management encouraged them to undertake appropriate training for National Vocational Qualifications. Some of the care staff were able to confirm that they had achieved NVQ level 2 & 3, more recently appointed staff had already expressed an interest in undertaking the training. The recruitment of staff employed directly by the home is managed well. Staff files evidenced appropriate recruitment practices, employment history, references and Criminal Records Bureau Clearances. Staff files provided evidence of staff training, however it was not possible to identify whether this was consistent for all staff as only one file contained all of the appropriate certificates and there was no other evidence to as to whether the remaining staff had received all of the mandatory training. Discussion with staff confirmed that some of the training such as the Protection Of Vulnerable Adults, First Aid and Health and Safety had been conducted and that further training was planned, such as Movement and Handling, Infection Control and the Safe Administration of Medication. On further enquiry it was evidenced that staff have appropriate induction training and staff training records are currently being reviewed and computerised to ensure effective management. DS0000066165.V298606.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35, 36, & 38 The quality in this outcome area is adequate, this judgement has been made using available evidence including a visit to the service. Management of the home is generally good, however some recommendations are made to ensure the ongoing safety of residents. EVIDENCE: The manager of the home is a appropriately qualified, competent and experienced, has been in post for approximately six months. She has now completed her probationary period and is in the process of seeking Registration with the Commission. The Certificate of Registration is displayed, is up to date and accurate, having only recently been issued. Quality Assurance systems are currently being developed and a residents’ satisfaction survey is being developed for regular use. In addition a
DS0000066165.V298606.R01.S.doc Version 5.2 Page 22 comprehensive internal audit system is being developed for use in all areas and systems within the home. Management continue to hold regular residents meetings, have a staff member with responsibility for representing residents’ views, conduct of frequent medication and care plan audits. The manager continues to maintain contact with residents by an active and visible presence within the home and staff confirmed this. All existing residents have their own personal arrangements for managing their finances, which is usually supported by their relatives. Currently no money is held for residents within the home. Files held within the office evidenced that staff have appropriate formal supervision, at present this is conducted on a three monthly basis, i.e. 4 times per year. Senior staff were advised that the National Minimum Standards specify that this should be conducted at least six times per year. Health and safety appears to be managed well, with staff having access to appropriate training The home has had a recent inspection by the Fire Officer, which was satisfactory. As a consequence the Fire Risk Assessments are currently being reviewed and a return visit by the Fire Officer is anticipated. Many residents prefer their bedroom doors to be left open during the day and these are not fitted with automatic closing devices. The Commission has sought guidance form the Fire Officer regarding this and is advised that the home has adequate systems in place to compensate for this fact. One of the comment cards received from a residents representative expressed concern over the security at the front entrance. Our investigations identified that the building is secured from 9 o’clock at night, when the main entrance is locked, up until that time the door is only secured by a standard door handle, which would allow anyone to gain entrance to the premises. DS0000066165.V298606.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 2 DS0000066165.V298606.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 13 (4b&c) Requirement All residents must have appropriate risk assessments for the prevention of falls Requirement made 06/12/05 Individual plans of care must be developed to ensure that specific and detailed instruction is provided to staff regarding the management and prevention of life threatening complications Residents must have appropriate referrals to the general practitioner Requirement made 06/12/05 Individual plans of care must be developed to ensure that residents emotional needs are addressed All people working in the home, including the self employed and volunteers must have appropriate Criminal Records Bureau Clearances A risk assessment must be conducted to assess the risks associated with the daytime security of the main entrance. Timescale for action 01/08/06 2. OP8 12 01/08/06 3. OP8 13 (1) 01/08/06 4 OP8 12 01/08/06 5 OP16 19 01/08/06 6 OP38 13.4 c 01/08/06 DS0000066165.V298606.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP12 OP36 OP38 Good Practice Recommendations All risk assessments should be based on current best practice and be accurately completed Activities for younger adults should be reviewed to take into account their age group and specific interests. Staff should receive formal supervision at least six times a year. Guidance should be sought from the local crime prevention officer regarding the daytime security at the main entrance DS0000066165.V298606.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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