Inspection on 07/09/06 for Clearview

This inspection was carried out on 7th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clearview 14/08/07

Clearview 17/01/06

Clearview 12/09/05

Clearview 18/01/05

Clearview 25/08/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Clearview 48 Lipson Road Lipson Plymouth Devon PL4 8RG Lead Inspector Helen Tworkowski Unannounced Inspection 7 September 2006 09:45 th Clearview DS0000003465.V290572.R01.S.doc Version 5.2 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 Clearview DS0000003465.V290572.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 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. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clearview Address 48 Lipson Road Lipson Plymouth Devon PL4 8RG 01752 256980 NONE clearviewpl4@btopenworld.com 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) Mr Jeffery John Nicholson Mrs Amanda Jane Nicholson Mrs Amanda Jane Nicholson Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7), Physical disability (7), of places Physical disability over 65 years of age (7) Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning disabled adults some of whom may have a physical disability Date of last inspection 17th January 2006 Brief Description of the Service: Clearview is a home that currently accommodates six people with varying degrees of Learning Disability and Challenging Behaviours. The service users have complex care needs and require a high level of support. Mr Jeffery Nicholson and Mrs Amanda Nicholson own the home. Mrs Nicholson is also the Registered Manager. Clearview is situated in the Lipson area of Plymouth within easy access to local amenities, including shops and parks. The home is a large terraced property, which has a large lounge, adjoining dining room and domestic style kitchen and utility room. Service users are accommodated in single bedrooms, three with en-suite facilities. There is a patio area at the rear of the premises. Service users are supported partake in a range of opportunities inside and outside the home. No details of fees were provided by the Care Home, however these should be available on enquiry. Additional charges are made for: hair dressing, chiropody, toiletries, holiday spending and tobacco. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included two site visits that took place on 7/9/06 between 9.45 and 3 pm and on 13/9/06 between 12 noon and 5pm. The site visit included a tour of the premises; time was spent in discussion with Service Users, staff and manager and deputy manager. The Inspector ate lunch with the Service Users on the second day. Records inspected during these visits included those relating to service users, to staff, to medication and to health and safety. Information was also obtained from a Pre Inspection Questionnaire that was competed by the Registered Provider, staff surveys (ten sent out, four returned) and from Service User surveys. The Inspector spoke with one relative who regularly visits Clearview, and with a behavioural advisor who has contact with the service. Feedback was sought from Social Services but none was received. What the service does well: What has improved since the last inspection? Information regarding training records had improved since the last inspection. This means that it was more easy to identify who has had training, and who has not. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users can be confident their needs will be known prior to a move to the home and they will be given clear information about what they can expect at Clearview. EVIDENCE: One person has moved to Clearview since the last inspection. Assessments had been carried out be a range of professionals before the person had moved. This information was very detailed and comprehensive. Staff at Clearview therefore were aware of the individual’s needs prior to a move and had received additional training. The deputy manager confirmed that the individual had had the opportunity to visit prior to a move and had done so. This had given the prospective Service User and existing Service Users a chance to get to know each other. The deputy manager said that a new Service User or their representative is given information about the home prior to a move. A copy of a written Service User Guide and Statement of Purpose were available on site. The deputy manager said that each Service User has their own Service User Guide, especially adapted to their needs and skills. One of these documents was Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 9 looked at during this inspection. It contained clear information about what an individual might expect. It used symbols and pictures- and was well thought out and adapted to the individual. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 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, and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service User needs are known to staff however documents that should help ensure there is consistency lack detail. EVIDENCE: The Service User Plans for two people who live at Clearview were looked at during this inspection. These documents should explain in detail how the needs of each person are to be met. This is particularly important if a Service User has complex needs. The two Plans looked at both lacked detail, and one had been written after the person had moved to Clearview. This meant that there was no Service User Plan when he or she first moved. For one person the Plan described various health conditions that would have an impact on their day-to-day lives and the way that staff supported the person. However whilst the health conditions were noted as a diagnosis, the health needs were not addressed through the Service User Plan, for example in relation to diet and exercise. It was recommended at the last inspection that Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 11 more detail be included in these documents including information about how the person’s finances are to be managed. This has not been carried out. From discussions with the deputy manager he had an excellent understanding of each individuals needs and how they were to be met. However this level of understanding was not included in the Service User Plan. Information that had been provided by specialist support services as to how to manage particular behaviours was not reflected in the Service User Plans. Service User Plans are one of the tools for ensuring that an agreed consistent approach is taken with individuals. This is of great importance when an individual has behaviours that challenge services. The lack of consistency in practice could be seen in that the deputy manager had thought that there was agreement around an individual’s nighttime routine. The daily notes showed that staff were not following this agreement. There were risk assessments on the file, however these did not reflect the actual risks that Service Users were exposed to. One risk assessment referred to a document that did not exist. The use of door alarm was noted on one risk assessment but there was no reference to the use of the alarm in the Service User Plan, nor was there a note of any multi-disciplinary agreement. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 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): 12, 13, 15, 16, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users receive a good level of support and are encouraged and to participate in a range of activities at home and in the community. Service Users are supported to maintain contact with relatives. EVIDENCE: The Inspector spent time with Service Users talking about life at Clearview. Service Users are able to choose where they eat their meals, one person prefers to eat in his own room and had been provided with a table and chair, though Service Users are encouraged to eat together in the dining room if they are able to do this. On the second day of inspection two Service Users had been making cakes, something that they enjoyed doing. The Inspector was told that Service Users are involved in choosing the main meal and have a choice of sandwiches at lunchtime. There is a picnic table in the garden, where meals can be eaten outside. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 13 Service User bedrooms reflect their interests and hobbies. One person has a large collection of videos that he enjoys; another person closely follows a football team and has decorated a room to reflect this. The staff told the Inspector that Service Users were no longer able to use Plymouth Social Services Day Centres, and they were working to find a range of alternative activities and clubs to ensure that each person. During the time the Inspector spent at Clearview- some Service Users were out at various activities, others stayed at home. One relative spoken with said that she would like to see more activities however acknowledged that her relative preferred to spend time watching TV. The four Service User surveys that were returned all confirm that Service Users feel that they have there are always activities arranged by the home in which they can take part. The Inspector was told that Service Users are supported to maintain contact with their relatives, either visiting or being visited. A number of Service Users are able to maintain very close contact with their relatives. A holiday is planned in the next month, and Service Users spoken with said they were looking forward to this, and to other important occasions in their lives such as birthdays. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 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, and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service Users are generally provided with a good level of support, including support to manage challenging behaviour. The system that is used for the administration of medication is not robust, and could be more prone to error than other systems. EVIDENCE: All four Service Users who completed surveys replied that they always received the care and support needed, that staff always listened and acted on what was said, and that staff are always available when needed. The Inspector spoke with one Service User, in depth, about the care and support he received. The person was satisfied with the care offered and that “the staff treat me well”. The Inspector spoke with a member of staff about her role as a key worker, and was told that this included buying clothes for the Service User. The Service User does not go on these shopping trips, because the worker is unable to Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 15 drive. As has already been noted in this report Service Users are each paying a charge for transport to be provided at Clearview. Service Users must be given the opportunity to be involved in choosing the clothes they buy for themselves. It was noted the section on Individual Needs and Choices in this report that Health Care needs were not fully identified and recorded in the Service User Plan. Where individuals have challenging behaviour, there is guidance on how to manage these behaviours. Clearview receives support from Behavioural Services to assist with managing individuals with particular behaviours. Feed back from the Behavioural Support Service was very positive: staff are open to new guidance and follow the advice that has been given. The bulk of medication is kept in a lockable medicine cupboard. A potting up system is used. This system involves one member of staff transferring a 6-day supply of medication into containers that are used to administer the tablets. This system is generally considered to be more prone to error, than systems that involve administration from the dispensed containers or from a Monitored Device System, prepared by the Pharmacist. The Home’s Policy provides guidance on administration but does not refer to the system of “potting up” that is used and relates to systems of direct administration or using a Monitored Dose system. Medication is administered in relation to epileptic seizures. There is good clear guidance about under what circumstances this medication must be administered. There is a record of staff that have been trained to administer this medication. Medication is also prescribed in relation to difficult behaviours. This medication is to be given “as required”, however there was no guidance on when this medication was required. Staff told the inspector that this medication was given as a last resort. Guidance should be drawn up on when such medication is to be given, it should be agreed with the relevant professionals. This ensures that such medication is given at an appropriate time and that there is consistency between staff. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 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 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service Users and their representatives are able to raise concerns about the service, if they should wish to. There are good system in place for protecting service users from abuse, however the systems in place to manage service users monies are not appropriate. EVIDENCE: Clearview has a complaints procedure that has been provided in a symbol format, this is included in the Service User Guide. Each individual has a copy of this document. The Inspector discussed with the deputy manager how this document could be developed in to a similar format to the other documents that are accessible to Service Users. The deputy manager said that no specific complaints had been raised, though concerns expressed by relatives had been recorded and were being considered by Social Services. The Commission has received no complaints or concerns regarding Clearview since the last inspection. There was evidence of plans for staff training in relation to the Protection of Vulnerable Adults, and records of staff training indicated that some staff had already received this training. The deputy manager explained that they had recently set up accounts for the existing Service Users, though no statements were available. The Inspector discussed with the deputy Manager the need to have a readily auditable Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 17 system, and that money that belongs to the individual service user could be seen being paid into their account- such as Income Support and Disability Living Allowance. Also, all money that is withdrawn must be accounted for. The Inspector discussed with the Registered Manager this issue of Disability Living Allowance- Mobility Allowance. This benefit belongs to the Service User, and is paid to the Service User because of difficulties with their mobility. It does not belong to the Care Home. The Registered Manager said that the home provides two minibuses that Service Users use and that the Service Users mobility allowance helps fund. If the Clearview wishes to make a charge for optional services provided, such as the use of the minibus, then this must be clear in the contract. If the charge for the use of the minibus is not optional, then it is part of the “fee”, and needs to be referred to the contracting organisation (usually social services). Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector looked around the entire home during this inspection. The house was found to be clean and tidy. It was generally in very good decorative order. The dining room and sitting room are large and airy and domestic in character. The deputy manager said that the hallway was awaiting redecoration as this area had taken some wear and tear. Service User bedrooms were decorated to reflect their individual tastes and preferences. There were window restrictors on all windows above the ground floor. The Inspector was told that during the hot weather Service Users had been provided with fans to help them keep cool. The Inspector was told that the temperature of hot water in baths and showers is temperature regulated so that no one is at risk of scalding himself or herself. The water temperature in one showerhead was checked. It was noted that there is a freezer in the laundry room; this could be of concern in relation to health and hygiene. The deputy Manager said that the Environmental Health Officer had not raised this issue on visits. It is recommended that the advice of the Environmental Health Officer is sought. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 19 There is a well-maintained patio area to the rear of the house. This is not overlooked and has views over Plymouth. The pots and containers are well maintained, and the deputy manager said that this area had been well used over the summer. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems for the recruitment of staff, to ensure that the right people are recruited. Staff are well trained and receive good support to enable them to carry out their roles. There are sufficient staff to enable Service Users to lead active lives. EVIDENCE: The staff file of a member of staff who had recently most been recruited to the home, was looked at during this inspection. The file was well organised and there was clear evidence of a thorough recruitment procedure including taking two references and obtaining a Criminal Records Bureau check. There was also a record of induction, supervision and support and of on going training. The deputy manager was able to produce a staff team training plan, showing what training staff had receive, and so where there were gaps. The deputy manager confirmed that three staff were usually rostered on between 8am and 8pm. During the night one member of staff remained awake, whilst the second member of staff slept, but was on call in an emergency. This was considered to be sufficient for the needs of the service users. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 21 Staff spoken with said that they felt well supported, that there was a good team of staff, who worked well together. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users benefit from a well managed home. EVIDENCE: Mrs Nicholson is the joint provider and Registered Manager. Mrs Nicholson has completed the Registered Managers Award, has a nursing qualification and many years experience in working with people with a Learning Disability. Discussions with staff showed that staff feel well supported in their work, and that there are monthly staff meetings, appraisals and staff supervision. There was an open and supportive atmosphere, which is particularly important when working with Service Users who have behaviour that challenges. There are monthly Service User meetings where individuals can express their views about what happens at Clearview. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 23 The Inspector was shown the Health and Safety systems by one of the staff. Monthly checks are made of the home by a member of staff to ensure that all is in order. Where issues are noted these are dealt with, and a record is usually made of this. There is a general risk assessment for the building- this covers all risks, except fire, where there is a separate risk assessment. The risk assessment makes recommendations of actions or checks to be taken to keep the home safe. The majority of these recommendations were being implemented however not all, this included checks in relation to Legionella. There was a fire risk assessment and a fire logbook that indicated that regular checks were being made of the fire system and that staff received regular training in relation to fire safety. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 4 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 3 X 3 X X 3 X Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 01/12/06 1 YA6, 15 2 YA7 15 3 YA23 YA7 20 4 YA9 13 5 YA16 YA7 15, 13 Each Service User must have a plan at the point they move to the home. This should provide clear information about how the individuals needs, including health care needs, will be met, reflecting their preferences. The guidance to staff should be clear and detailed with regard to the actions they are to take. Service user plans must include details of service user skills relating to finance and details of the support required. Benefits paid to the Service User must not be paid into the Care Home’s own account. The Care home may make charges for services provided. All Service Users must have comprehensive risk assessments that help ensure that risks are managed. The Registered Provider must review the use of listening devices, monitors or alarms in the home, and ensure that such systems are only used for a period of time that has been DS0000003465.V290572.R01.S.doc 01/12/06 01/12/06 01/12/06 01/12/06 Clearview Version 5.2 Page 26 6 YA18 12 7 YA20 13 8 YA20 13, 15 agreed as part of a multi-agency review. Service Users must be given the opportunity to purchase their own clothes, whenever possible, rather than having this done on their behalf. The current system of medication must be reviewed so that it reflects good practice guidance, and the home’s own policy on administration of medication. Guidance must be available to staff as to when to administer “as required medication”. 01/12/06 01/12/06 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA30 YA42 Good Practice Recommendations The Registered Provider should seek the advice of the Environmental Health Officer in relation to the freezer being kept in the laundry room. The Registered Provider should ensure that all actions identified in risk assessments are carried out. Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Clearview DS0000003465.V290572.R01.S.doc Version 5.2 Page 28 - 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!