Inspection on 12/07/06 for Combe House

This inspection was carried out on 12th July 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Combe House 03/07/07

Combe House 31/10/05

Combe House 23/06/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Combe House Castle Road Horsell Woking Surrey GU21 4ET Lead Inspector Pauline Long Key Unannounced Inspection 12th July 2006 09:00 Combe House DS0000062711.V303920.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 Combe House DS0000062711.V303920.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. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Combe House Address Castle Road Horsell Woking Surrey GU21 4ET 01483 755997 01483 773681 val.coomber@brookhurstcare.co,uk 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) Brookhurst Care Limited Valerie Jean Coomber Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 18-45 YEARS One named service user who is between the ages of 17 and a half &18 years with prior written agreement with C.S.C.I may be accommodated at Combe House 23rd June 2005 Date of last inspection Brief Description of the Service: Combe House is situated in a quiet residential area of Horsell Village, a short distance by car from Woking town centre. It is a new property, which is tastefully developed and blends in well with the surrounding properties.This home provides care and accommodation for young adults with a learning disability. The accommodation consists of six individual en suite bedrooms, five of these being on the first floor and one on the ground floor. There is no lift access to the first floor. Communal areas consist of two bathrooms, a dining room, sitting room and easily accessible kitchen and laundry room. The dining room, kitchen and sitting room have doors leading directly onto a large terrace and medium sized secure back garden. The home has a good-sized area for parking at the front of the building. The fees at the home range from £1,350.00 to £1,650. 00 per week. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of the CSCI year 2006-2007 and was unannounced. It was carried out by the lead inspector for the service and lasted for six hours. The home has 3 vacancies. Discussions were had with residents, the deputy manager and care staff. Documents sampled included residents files and care plans, staff files, policies and procedures, pre-inspection questionnaire, and other service records. A full tour of the home and the garden took place. Comment cards were received from service users and relatives, and some of the comments have been included in this report. Verbal feedback from one of the residents at home on the day was limited due to his communication difficulties, however facial expressions, body language and sounds indicated a general wellbeing. The CSCI would like to thank the residents, deputy manager and staff for their hospitality and co-operation during the inspection. What the service does well: What has improved since the last inspection? What they could do better: One of the service users files sampled did not have contract of care service provided, all service users contracts must be open for inspection as evidence that they or their representatives have had the opportunity to agree to the terms and conditions at the home. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 6 Service users wishes in respect of their deaths had not been discussed or documented indicating that in the event of a death staff would not be aware of a service users wishes. Whilst routine risk assessments are carried out and documented at the home, it was a concern to note that the health, safety, welfare and protection of service users and staff had not been considered or risk assessments completed in respect of the workmen in the home. Care staff must not leave service users unsupervised whilst workmen or other visitors are in the home. One of the service users is prescribed PRN (as required) medication. Some guidelines were in place, however they were not clear enough for the reader to understand. They must be reviewed to ensure that all staff would be aware of when PRN medication was required. There were some areas around health and safety, which should be addressed. Hand towels must be provided for staff to wash their hands to ensure that any risk to cross infection is minimised. Attention must be paid the fire doors to ensure that they close at the appropriate speed and not cause injury to the service users and staff. The paving stones in garden must be repaired/replaced to ensure there is no risk to service users and staff. Requirements were made in respect of these standards. Please refer to pages 26 and 27 of this report. 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. Combe House DS0000062711.V303920.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 Combe House DS0000062711.V303920.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): 2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive needs assessments are completed prior to a service user being admitted to the home. Service users are provided with a contract of the care service provided at the home, however on the day one could not be located. EVIDENCE: The home accepts referrals from both social services and privately funded service users. In the first instance care needs assessments are sought from the social and health care management teams. The home would visit the prospective service user at their home/school to carry out their initial needs assessment. The deputy manager commented that the proprietor and the manager would normally carry out the initial assessment and that several visits to a service users home/school may be made in this respect. Prospective service users would be encouraged to visit the home several times prior to admission, in order to further assess their needs and for them to become familiar with their surroundings. Once admitted the needs assessments would be on-going. Two of the three service users personal files sampled contained a contract of care, and it was positive to note that the service users in question had been given the opportunity to sign the contract. The deputy manager commented Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 9 that all of the service users had been issued with a contract and that the missing contract must be with the providers. A requirement has been made in respect of service users contracts. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Holistic care plans are in place for the service users. The staff had a good understanding of the service users needs and choices and were observed to encourage and support service users in decision making at the home. EVIDENCE: The staff on duty on the day had a good understanding of the service users personal care needs. This was evident from the positive interactions and relationships observed. Care plans were sampled, and were found to be comprehensive, to include all daily living activities. The care plans gave clear instructions and guidelines to the reader about a service users care needs, demonstrating that the care staff would be aware of these needs. Risk assessments were clearly documented and guidelines in place to minimise the risks. All care plans and risk assessments had been regularly reviewed. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 11 Staff were observed supporting the service users in respect of decision-making and choices for example: going to the shops or for a walk or just going into the garden. One service user was observed helping himself to a drink in the kitchen, a member of staff supported him from a distance. This support was offered in a sensitive, respectful and unhurried manner. Combe House DS0000062711.V303920.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): 12,13,15,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are encouraged and enabled to maintain fulfilling lifestyles in and outside the home. The home promotes contact with family, friends and the local community. The meals offered in the home are good. EVIDENCE: None of the service users at Combe House are in paid employment, they do however attend various day services. The routines in the home were determined only by the timings of the visits to and from the day services, and to other appointments. On the day, one service user was at school, one had accompanied a member of staff to the local shops. The other service user was observed moving freely around the home, at one point he was enjoying a music therapy session. The home is committed to ensuring that the residents maintain their relationships with their family and friends and the local community. The care staff discussed various activities for example: disco, social clubs, cinema, Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 13 football and ice-skating. One service user discussed going for long walks and has recently been to Snowden in Wales for a walking holiday. He was keen to discuss the activities he took part in and was particularly looking forward to the air show in a nearby town. None of the service users practices their faith, but the deputy manager commented that if they did they would be supported and enabled to do so. Families and friends are encouraged to visit the home, some are regular visitors and some keep contact by phone. The care staff stated, that service users are encouraged to choose their meals from pictorial and written menus. The deputy manager explained that the home has proposed menus, which rotate on a four weekly basis. However these can be changed depending on resident’s likes and dislikes on a given day. On the day of inspection the service users were observed to enjoy the lunchtime meal of sausage and onion sandwiches, one service user commented that he really enjoyed his sandwich. Lunch preparation was observed and food supplies and storage were checked. Fridge, freezer and cupboards were well stocked, and there was fresh fruit and vegetables in good quantities. Combe House DS0000062711.V303920.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): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the residents physical, emotional and health support needs, this was evident from the positive interactions and relationships observed. Service users are protected by the home’s policies and procedures for dealing with medicines. However further work is required in respect of the guidelines around PRN medication and service users wishes around dying and death. EVIDENCE: As discussed earlier in this report care plans included clear guidelines on any support each resident required with personal, emotional and health care needs. Daily records included visits to the doctor, various health related appointments and reviews of care. Relatives commented that some of the staff were exceptional and that the residents were well cared for at Combe House. None of the service users are responsible for their medication. Medication procedures, storage and medication records were sampled. All of the medication record sheets were checked and were found to be properly completed and medication storage was good. One service user requires PRN (as required) medication, and there were guidelines in place, however they need to be reviewed in order to provide the reader with clarity as to what particular behaviours might indicate the need to administer this medication. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 15 There was no evidence in the service users files sampled, to indicate that any discussions had been undertaken in respect of a service users wishes around death and dying. This was discussed with the deputy manager, who commented that this would be a difficult issue to discuss with the service users due to their communication and understanding difficulties. Requirements were made in respect of these standards. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.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): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has satisfactory policies and procedures in place for dealing with concerns, complaints and the protection of the service users. However further work is required in respect of safeguarding adults. EVIDENCE: The CSCI have received no complaints about this home since the last inspection. The complaints file was sampled and evidenced that any complaints made at the home had been responded to in a timely manner and satisfactorily resolved. Relatives commented that they were aware of the complaints procedures and if complaints are made they are dealt with in a timely manner. No referrals have been made under the Surrey Multi Agency Safeguarding Adults procedures. Discussions were had with all of the staff on duty in respect of abuse and abusive situations and it was positive to note they demonstrated a good understanding of the current policies and procedures. However it was a concern to note that one service user was left unsupervised whilst workman were in the home. This was brought to the deputy manager’s attention, who promptly addressed the situation. Requirements have been made in respect of safeguarding adults. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good and meets the needs of the residents. However the patio in the back garden requires attention. EVIDENCE: Combe house provides a homely, clean and comfortable environment for the service users. The fabric and decoration in the communal areas was satisfactory and it was evident that some re-decoration had been undertaken for example, in the sitting room, kitchen and two of the bathrooms. The rest of the home will require updating in due course and a programme is in place to address this. The care staff commented that they do the re-decorating on their days off. Combe house has presented challenges to the providers in respect of the floor coverings as the carpets in the home are very light colour, are easily soiled subsequently require regular cleaning. The carpet in the hall has been replaced and on the day the upstairs landing carpet was being replaced. Two of the service users rooms reflected that of any other young persons room for example: pop posters on the walls, music centres, soft toys and pieces of sensory equipment. One of the bedrooms was quite stark and was not personalised. The bedrooms were bright and clean and no malodours were Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 18 noted. The carpet in one of the bedrooms had been replaced with more appropriate flooring. The bathrooms were clean and tidy, however there were no hand towels provided for care staff to dry their hands, which could have a negative impact on the control of cross infection. The home has a good-sized back garden and on the day one of the service users was observed to be enjoying spending time walking around. It was noted that one of the paving stones was broken and had the potential to present a trip hazard and risk to the service users. Requirements have been made in respect of these standards. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment practices in this home have improved. The home employs a reasonably stable, efficient and appropriately trained staff team. However improvements are required in respect of staff one to one supervision meetings. EVIDENCE: The home has clear policies and procedures for staff recruitment. Three new members of staff have been recruited since the last inspection. These recruitment records were sampled and demonstrated satisfactory recruitment and selection practice. It was noted that on one of the files one verbal and one written reference had been received, this was discussed with the deputy manager, who commented that a second written reference had been received and was with the provider. The home benefits from a reasonably stable staff team, providing a consistent care service. On the day staffing levels were adequate and consisted of a deputy manager and 3 care staff. One to one discussions were had with all of the staff on duty. They demonstrated that they had an awareness of their individual roles and responsibilities. Work based observations evidenced competent and confident Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 20 staff carrying out their various tasks. Staff training is given a high priority in this home, and training records demonstrated many statutory and current good practice training had been undertaken since the last inspection. Staff are undertaking National Vocation Qualifications (NVQ). The manager and deputy are undertaking The Registered Managers Award and NVQ 4 qualification. One relative commented that “ the high grade staff are so enthuastic” There is a formal one to one staff supervision programme in the home, and records were sampled, however staff are not receiving the required number of formal one to one supervisions with a manager. Requirements have been made in respect of these standards. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42,43 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the service users, however attention must be paid to some health and safety issues in respect of fire doors and the risks associated with broken paving stones. EVIDENCE: The home holds resident’s meetings in which the care staff support the residents to express their views. Service user questionnaires are routinely sent to families and other health and social care professionals. Some were sampled, and had positive comments. One relative commented that initially there were problems, however these are now solved and they have regular meetings with staff and managers. Another commented “ I am absolutely delighted with the care at Combe House, my son has made more progress than he has made at the last 3 homes he has lived in”. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 22 Health and safety checks are routinely carried out at the home and there were records to evidence this, however it was noted that some of the fire doors were closing too quickly and could potentially injure a service user or a member of staff. This was discussed with the deputy manager, who commented that the problem had already been identified and would be addressed by the homes handyman, she was not sure when this would happen. As discussed earlier in this report there were no hand drying facilities in service users bathrooms and toilets. Records evidenced that water temperatures, fire drills and fire bells were regularly checked. Kitchen records in respect of fridge, freezer and food temperatures were well kept. Records in respect of service users personal monies were sampled and were found to be in good order. Requirements have been made in respect of these standards. Please refer to pages 26 and 27 of this report. Combe House DS0000062711.V303920.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 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 X 2 3 3 X 4 X 5 3 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 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 3 X X 2 3 Combe House DS0000062711.V303920.R01.S.doc Version 5.2 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 YA5 Regulation 15(1)(b(c Schedule 4(1) Requirement Timescale for action 12/08/06 2. YA23 3. YA23 4. YA23 5 YA20 6. YA21 7. YA42 The registered person(s) must ensure that all service users are issued with a contract of care provided and that these contracts are available for inspection. 12(1)(a) The registered person(s) must 13(4)(a(b(c ensure that risk assessments are carried out on all workmen who come in to the home. 12(1)(a) The registered person(s) must 13(4)(a(b(c, ensure that service users are 13(6) never left unsupervised whilst workmen or other visitors are in the home. 12(1)(a) The registered person(s) must 13(7) ensure that all staff undertake a refresher course in safeguarding adults. 13(2) The registered person(s) must ensure that guidelines around PRN medication is reviewed and amended to ensure clarity. 12(2)(3) The registered person(s) must ensure that service users wishes around dying and death are discussed and documented in a service users file. 13(3) The registered person(s) must ensure that hand towels are DS0000062711.V303920.R01.S.doc 19/07/06 13/07/06 12/08/06 12/08/06 12/09/06 12/08/06 Combe House Version 5.2 Page 25 8. YA42 23(4)(c )(iv) 23(2)(o) 9. YA42 10. YA36 18(2)(a) 11. YA34 19 Schedule 2 provided in all of the homes bathrooms and toilets. The registered person(s) must ensure that the fire doors are closing appropriately and safely. The registered person(s) must ensure that the broken paving stone in the back garden is replaced. The registered person(s) must ensure that all staff received the required number of one to one supervisions meetings with a manager. The registered person(s) must ensure that staff references are kept on staff files and open to inspection. 19/08/06 19/07/06 12/09/06 12/08/06 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. Refer to Standard YA24 Good Practice Recommendations It is strongly recommended that the providers review the arrangements for re-decorating the home and consider the appropriateness of care staff decorating the home on their days off. Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Combe House DS0000062711.V303920.R01.S.doc Version 5.2 Page 27 - 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!