Inspection on 08/09/05 for Colne House

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

Other inspections for this house

Colne House 15/08/07

Colne House 16/05/07

Colne House 23/05/06

Colne House 04/01/06

Colne House 22/03/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Colne House 22 Manchester Road Slaithwaite Huddersfield HD7 5HH Lead Inspector Alison McCabe Unannounced 8 September 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Colne House Address 22 Manchester Road Slaithwaite Huddersfield HD7 5HH 01484 844775 01484 842777 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) Bridgewood Trust Limited Mrs Jean Heald Care home - personal care only 8 Category(ies) of 8 x Learning disability registration, with number of places Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 22 March 2005 Brief Description of the Service: Colne House is registered to provide accommodation and personal care for up to eight adults with learning disabilities. The home was taken over by the Bridgewood Trust in December 2004. The Bridgewood Trust is a local voluntary organisation providing a range of services to people with learning disabilities. Colne House is a substantial stone-built three storey detached property set in its own grounds on the outskirts of Slaithwaite, a pennine suburb of Huddersfield. Access to the property is via steps and a steep driveway. Parking is available to the rear of the property. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place between 11.25am and 4.10pm. One inspector conducted this inspection visit. The inspector had the opportunity to talk to three service users during the course of the inspection. The inspector also talked to the manager and two care staff. The inspector examined records, and accessed all areas in the home used by residents. The last inspection was conducted on 22nd March 2005. Colne House has been home to the same eight residents for many years. The residents are becoming older and more physically dependent therefore the building needs adapting to reflect the changing needs of the residents. The residents appear to be happy and good care is provided within the constraints of the building and equipment available. What the service does well: What has improved since the last inspection? Residents have been provided with a contract setting out the terms and conditions of their placement. Hoisting equipment and tracking has been ordered for a resident and is due to be installed soon. A new boiler has been installed. New staff have been recruited so that there are no staff vacancies. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 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. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 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 standard(s) 5 Clear contracts detailing terms and conditions are in place for residents. EVIDENCE: A contract setting out the terms and conditions of the placement was in place in those records that were examined and contained all the required information. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 Residents’ care plans fail to fully meet all their health and welfare needs. Identified risks to residents have not been assessed appropriately. Necessary steps to minimize risks need to be agreed, recorded and implemented. EVIDENCE: The inspector examined the care plans and risk assessments of two residents. The system in place is a combined care plan/risk assessment. The organisation has identified that this does not adequately address all areas required and is in the process of piloting a revised system. The manager reported that she would be attending training workshops regarding the new system in the near future. The care plans examined did not contain sufficient detail about how to meet residents’ needs, for example, it was described that a resident ‘needs assistance’ with personal care. No further information was available detailing how the assistance should be offered. Action plans are in place that describe actions required to meet identified aims. A weekly summary of whether or not this has been achieved is recorded. The inspector found that the aims are not always achieved and that some of the actions to meet the aims seem Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 10 unrelated. For example, the action required to support a resident to maintain family contact was recorded as ‘do life book’. Daily records are not kept and it is recommended that this be introduced to evidence whether or not residents’ identified needs have been met. It was noted that some identified risks had not been appropriately risk assessed. It is a requirement that this be addressed so that staff take the necessary measures to reduce identified risks. It was noted in a resident’s records that fluid/food intake must be monitored, however no monitoring was in place. Movement and handling, tissue viability and nutritional assessments had not been completed. From the information recorded, it was clear that these are areas that require assessment and detailed care planning. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,17 Good opportunities are offered to residents to access community based activities. A good range of leisure activities is available at this home. Residents enjoy the food that is provided. Accurate records of food provided to residents need to be kept. Staff need to offer residents more opportunities to plan, prepare and serve meals. EVIDENCE: Five residents attend day placements for adults with learning disabilities. The manager reported that one of the residents had only recently started attending day services and that he was enjoying this. Through examination of records and discussion with staff and residents, there was evidence that residents regularly access community facilities including football matches, evening clubs, trips on the train, cafes, shops and restaurants. There was evidence that residents had had a holiday this year. A resident told the inspector how much he had enjoyed this. A vehicle is provided for use by the residents at Colne House. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 12 A range of leisure activities is available in the home. In the basement is a large activities room that is regularly used by residents. The inspector noted that many of the activities were children’s toys, and that the room has been decorated with mural of a scene from a children’s book. The manager has identified that age appropriate activities need to be introduced and offered to residents, and is approaching this gradually with residents. The manager told the inspector that there are plans to redecorate the activity room so that it is more appropriate to the ages of the residents. Menus were examined and found to offer a varied diet. The full range of vegetables and fruit offered are not recorded and this must be added to the menu. There are no records kept of what residents have actually eaten, and a requirement has been made in respect of this. This is of particular concern where there are concerns about residents’ dietary intake. It was noted that, on the day of inspection, the lunch provided was different to the planned menu. It is therefore not possible to assess whether or not residents receive a nutritionally balanced and varied diet as the records do not accurately reflect what is offered. A resident told the inspector that he liked the meals at Colne House. The manager told the inspector that residents enjoy baking and are offered this opportunity each week. Staff prepare and serve the meals; residents do not participate in this activity. It is recommended that residents be offered the opportunity to plan, prepare and serve meals if they choose to do so. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,20 Residents’ healthcare and personal care needs are not being met consistently. Care plans and risk assessments do not provide clear information to make sure that all staff are clear about how residents’ needs should be met. Medication is generally managed well by staff, although more care taken in recording would improve practice in this area. EVIDENCE: More detailed information about how residents prefer to be supported with their personal care and moving and handling needs to be recorded. The equipment provided for moving and transferring a resident is unsuitable. A mobile hoist is available, however this does not fit under the bed or through the doorframes. Staff are therefore not using this equipment. The manager reported that new hoisting equipment had been ordered for a resident’s bedroom; this tracking system extends to the en-suite bathroom. The inspector was concerned that a resident who is unable to weight bear is being moved around the home in a shower chair. This is not suitable as there are no footplates, safety belt and it is for use in a shower. The manager told the inspector that the resident has a wheelchair, however it does not fit through the door to the lounge. Consideration needs to be given as to how the resident will access all communal areas of the home using appropriate equipment. The manager told the inspector that arrangements had been made Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 14 to view alternative seating. Records showed that a referral to the occupational therapist had been made. The manager agreed to check the waiting times. The inspector was concerned that staff seemed unclear about how many staff were required to safely move and transfer a resident. No movement and handling risk assessment was in place, however the manager told the inspector that it ought to be two staff. The rota was examined and showed that on occasions only one staff member is on duty. At the time of inspection, one member of staff was in the home with three residents, one of whom reportedly requires two staff to transfer. It is essential that at all times sufficient staff are available to safely move and transfer residents. Medication was examined as part of this inspection. This home uses the Boots monitored dose system. Most of the records and medications could be reconciled, however three errors in recording were identified. These were pointed out to the manager at the time of inspection. More care needs to be taken to avoid errors being made. Evidence that staff have received training in the safe administration and recording of medicines was seen in staff training records. The medication cabinet, although locked, had the key in the lock. The manager was reminded of her responsibility to store medication securely. This was rectified at the time of inspection. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 15 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 standard(s) 22 The home has a clear complaints procedure. No complaints have been received since the last inspection. EVIDENCE: A satisfactory complaints procedure is in place that is also available in symbol format. No complaints have been received since the last inspection. From the residents spoken to, the inspector was unable to establish whether the residents understood how to make a complaint. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 16 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 standard(s) 24,25,26,27,28,29,30 Residents live in a clean, comfortable home with plenty of communal space. As the residents have become older and more physically dependent, the building has become unsuitable. Significant changes to the premises are required in order to meet the needs of the existing residents. EVIDENCE: The inspector conducted a tour of all areas used by residents. The Bridgewood Trust took over this home in December 2004, and is in the process of planning refurbishment of the building. The home is clean and comfortable and is domestic and homely in style. Due to the increased frailty of some residents, adaptations are necessary to enable all residents to be able to access all communal areas of the home safely. The manager explained that there are plans for a ramp to be built to provide disabled access to the home. A resident now reliant on a wheelchair to go out, is lifted by staff up external steps if she wants/needs to go out. This practice is not safe and puts the staff and resident at risk. Doorways are not wide enough to accommodate wheelchairs and this must be addressed. The inspector noted that the banister at the top of the stairs is low. The manager said that she too had concerns about this because of the risk of a resident falling. The manager reported that she had Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 17 arranged for a health and safety risk assessment of the building to be conducted by the health and safety assessor employed by the organisation and that she would draw this to his attention. Four residents have single bedrooms and there are two shared bedrooms. Seven residents are accommodated on the first floor. Two of the single bedrooms are very small. The organisation is looking into how the building can be altered to provide bigger bedrooms and all single occupancy rooms. Residents’ bedrooms are personalised to reflect individual interests and tastes. There is insufficient space to provide all the recommended furnishings in some bedrooms. Residents do not have keys to their bedrooms and the inspector saw evidence in a resident’s records that this had been risk assessed. It was unclear from this assessment what the identified risks were and whether any discussion/agreement had been sought with the resident. This must be reviewed. The bathroom and toilet facilities at the home no longer meet the needs of the residents. The bathroom that had been available on the ground floor is now used as an en-suite for a resident that has moved to the ground floor due to her increased level of support needs. However, the resident is unable to access the en-suite bathroom or downstairs toilet as the hoist will not fit through the door. The new tracking system will enable access to the bathroom. There is a toilet with wash hand basin for residents’ use on the ground floor, and a shower room with toilet and wash hand basin on the first floor. A second toilet is also available on the first floor, however there is no wash hand basin. The bath in the en-suite bathroom is very low and only accessible on one side. The inspector advised the manager to seek advice from the occupational therapist regarding suitability of this bath. The manager explained that refurbishment of the bathrooms will be looked at as part of the general refurbishment plans. An action plan detailing refurbishment plans with timescales should be provided to the CSCI. Plenty of shared space is provided to residents. A good-sized lounge, separate dining room and kitchen are available. There are gardens to the front, rear and side of the property. Additionally, there is a large activities room in the basement along with a laundry area and storage room. There are two selfcontained flats within the home, one on the ground floor and one on the second floor of the building. The previous owners who lived on the premises used these. Residents do not currently use these areas, as they do not comply with fire safety regulations, however there are plans to adapt these so that residents can use this space. Environmental adaptations are necessary throughout the home in order to meet the increasing personal and healthcare needs of the residents. The manager should arrange for the homes facilities to be reassessed by an occupational therapist or other suitably qualified person. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 18 There is a large laundry room in the basement of the home. A commercial washing machine is available and the manager reported that the existing domestic tumble dryer is to be replaced with a commercial dryer. A cleaner is employed for nineteen hours per week; the home was clean and free from offensive odour at the time of inspection. A new boiler has been installed since the last inspection. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 Staffing levels are adequate to meet the needs of the residents most of the time. The manager needs to make sure that there are sufficient staff on duty all of the time. Relevant training is provided to staff. EVIDENCE: Staff were observed to interact with residents in a positive and respectful manner most of the time. Residents seemed to be relaxed in the company of staff. Residents told the inspector that staff were kind to them and that they liked the staff. Staff on duty were responsive to the needs of the residents and communicated effectively with residents. Staff have a range of skills and experience. Of eleven care staff, three are qualified to NVQ level 2 or above in care and two are registered on the course. In order to meet standard thirty two, 50 of care staff should be qualified to NVQ level 2 or equivalent by the end of 2005. There are eleven care staff and the manager employed to work at Colne House. The current staffing levels provides two staff on duty per shift during the waking day, one sleep in staff member at night and one waking night staff most of the time. A new waking night staff started on her induction on the day Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 20 of inspection. The manager reported that from Monday 12th September the home would have a full complement of staff both for days and nights. There are occasions when there is only one staff member on duty during the day; given the needs of the residents, this arrangement must be reviewed and sufficient numbers of staff available at all times. There is a comprehensive training and development plan in place. Since the last inspection, staff have received training in health and safety, movement and handling, food hygiene, fire safety, Boots advanced medication course, and on the day of inspection some staff were attending training in breakaway techniques. This is in addition to NVQ training, which is ongoing. New staff will complete the Learning Disability Award Framework induction and foundation training. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health, safety and welfare of service users and staff is not adequately protected in all areas. The fire alarm must be tested weekly and records of test improved. The building must be reassessed given the increased physical dependency of the residents. EVIDENCE: Records regarding health and safety matters were in good order. There was evidence in the records that most of the required checks and maintenance of safety equipment is carried out. Fire alarm tests are not always conducted weekly and the manager must ensure that this is addressed. It was also noted that when the fire alarm is tested, a record has not been kept of which alarm point was checked. This must be recorded to ensure that each alarm point is tested in rotation. The manager reported that self-closing devices had been ordered for the door to the basement, the activity room and the laundry. As mentioned previously in the report, the practice of staff carrying a resident in her wheelchair up the stone steps to the rear of the property is unsafe. Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 22 Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 1 1 1 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 1 Standard No 31 32 33 34 35 36 Score x x 1 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Colne House Score 1 x 1 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 24 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 6,18 Regulation 15 Requirement The registered person shall prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. Unnecessary risks to the health or safety of residents are identified, and so far as possible eliminated. A record must be kept of all food provided to residents; vegetables and fruit must also be recorded when provided. Food provided must be wholesome and nutritious. Accurate records in respect of medication must be kept.Medication must be stored securely. The registered person shall having regard to the number and needs of the residents ensure that the physical design and layout of the premises to be used as the care home meet the needs of the service users, and the size and layout of rooms occupied or used by residents are suitable for their needs. Suitable adaptations must be made and necessary equipment Timescale for action 31/10/05 2. 9 13 31/10/05 3. 17 16(2)(i), 17(2) Schedule 4(13) 13 30/9/05 4. 20 30/9/05 5. 24,27,28,2 9 23(2)(a)(f )(n) 31/10/05 Colne House 20050908 Colne Hs IR YA J51 v248753 s62797.doc Version 1.40 Page 25 6. 33 18(1)(a) 7. 9,42 13(5) and facilities provided to residents who are old, infirm or physically disabled. The organisation should provide an action plan with proposed timescales to the CSCI by the date shown. The registered person must ensure that at all times there are sufficient numbers of staff on duty to meet the health and welfare needs of the residents. Suitable arrangements must be made to provide a safe system for moving and handling residents. Movement and handling risk assessments must also be completed. 30/9/05 15/10/05 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. Refer to Standard 6,41 9,17 42 Good Practice Recommendations Daily records should be kept to demonstrate how the individual service users’ needs are being met in line with their individual service user plan. Residents should be offered the opportunity to participate in the planning, preparation and serving of food taking into account individual risk assessments. The fire alarm should be tested every week and a record kept of the fire point tested. 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