Inspection on 13/09/05 for Combs Court Residential Home

This inspection was carried out on 13th September 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Combs Court Residential Home 07/11/07

Combs Court Residential Home 07/02/07

Combs Court Residential Home 07/06/06

Combs Court Residential Home 04/04/05

Combs Court Residential Home 12/10/04

Combs Court Residential Home 27/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Combs Court Residential Home Edgecomb Road Stowmarket Suffolk IP14 2DN Lead Inspector Claire Hutton Unannounced Inspection 13th September 2005 11:45 Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Combs Court Residential Home Address Edgecomb Road Stowmarket Suffolk IP14 2DN 01449 673006 01449 674203 combcourt@craegmoor.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) Parkcare Homes (No. 2) Limited Mrs Joanne Woodhead Care Home 30 Category(ies) of Learning disability (30), Learning disability over registration, with number 65 years of age (8) of places Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th April 2005 Brief Description of the Service: Combs Court is a care home providing personal care and accommodation to 30 adults with a learning disability, eight of whom can be over the age of 65. It is owned by Parkcare Homes Ltd and is a member of the Craegmoor Group Ltd. Combs Court is situated in the small village of Combs Ford. It is close to the village centre and within walking distance of several shops and a bus link to Ipswich & Bury St Edmunds. The establishment comprises of two eight bedded bungalows, one eight bedded house and one double and four single flats for more independent people. There is also an office block with an attached day care centre. Combs Court is along by a short drive with a gate that is kept shut. There is parking beyond for visitors and the homes transport. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in September and lasted for 6 hours. The inspection team was made up of Claire Hutton and Jess Scotford. Time was spent in bungalow 1 and bungalow 2. Six residents were met and spoken with, some in private. Eight care staff were met and spoken with and from 3pm the acting deputy manager was available and given feedback from the day. One visiting professional was met and spoken with. Records examined included the duty roster, care records including assessments, plans and daily statements, medication records, staff recruitment and training records. Some records such as evidence of CRB, accident records, complaint log and evidence of quality assurance were not accessible due to being locked away. Communal areas of the two buildings were visited and one bedroom, with permission of the resident. Any key standards not assessed in this report can be found in the previous report from 4th April 2005. What the service does well: What has improved since the last inspection? In May this year 10 staff were trained in managing violence and aggression. In August and September this year a further 18 staff were trained in control and restraint. A further 6 staff had been trained in breakaway techniques. There was a period of time when the usage of agency staff was said to decline as more care staff were recruited. The flats now appear to have designated hours allocated to them to support the residents with independence skills. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 and 5 People who use this service cannot be assured that they have a statement of terms and conditions fully defined, but it was clear that the home continues to assess the needs of the residents. EVIDENCE: There have been no admissions to the home since the last inspection. However it is clear from care plans and talking to staff that resident’s needs are continually monitored and plans reviewed and updated. There was evidence from the last statutory reviews held in December 2004 that placements remain appropriate. There was evidence from care plans that the home seek advice and assessments from health professionals where required. This had led to appropriate equipment such as a bed and mattress being supplied to the resident. Most people at Combs Court had a standard Social Care contract. The home had previously been required to ensure everyone had a contract with terms and conditions agreed. At this inspection due to there being no manager the progress on this matter could not be assessed. However, the administration person believed it to be in hand. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 the following standard(s): 6,7, and 9 The majority of care plans and risk assessments in place accurately reflect resident’s needs, however, in complex cases plans are not guaranteed to be based on best practice therefore people may be placed at risk of injury. EVIDENCE: Five care plans were examined. These were very detailed and showed evidence of regular review and update. Each plan had a photograph of each resident and the key worker clearly identified along with the role of the key worker and evidence that families were involved. One resident spoken to was aware of who their key worker was. Care plans were based upon elements of daily living and went on to state what the individual could do for themselves and what support was needed by staff. Risk assessments included nutritional needs; moving and handling as well as those that were more individually based. One persons needs around manual handling had recently changed. The risk assessment needed to be updated to reflect the change. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 10 At the last inspection it was noted that one plan did not contain sufficient information on the individualised procedures to manage aggressive behaviour. Staff spoken with were not clear as to what they would do in each circumstance, but would do the best they could, as they believed each circumstance would be different. Staff were spoken with again in relation to this and a behaviour management plan had been developed. The plan defined the behaviour and known triggers along with a proactive plan, however, it did not include specific details in the reactive plan as to what restraint should be used in what circumstances and for how long and how frequently it was permitted to repeat the restraint. Detailed and specific instruction must be available for staff to follow. It was not clear as to who had been involved in developing this plan, as there was no signature. Staff spoken to were asked if they had knowledge of The Department of health Guidance For Restrictive Physical Intervention. The document was shown to staff who confirmed they had never seen it. A copy was left at the home. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 the following standard(s): 11,12, 13 and 14 Residents at Combs Court are supported to lead ordinary lives that allow them to participate in the community and therefore lifestyle is individualised. However, residents in the flats cannot be assured they will receive support to enable them to lead an independent and fulfilled lifestyle. EVIDENCE: At the last inspection it was reported that mealtimes in the house could be rather overcrowded with residents from the flats coming over, as there are no dedicated staff in the flats. At a weekend staff in the house produce a full Sunday roast and 2 other meals a day from the small kitchen to feed eleven people. The dining room would be very cosy to fit everyone plus staff in. Although at this inspection hours had been identified to support people in the flats at key times no persons had been employed, therefore the situation remained the same. One resident from the flats was seen to enter the bungalow and freely make use of the resident’s facilities. One resident was asked about day time occupation and trips out, on the whole they felt their life was comfortable and that they had trips to the shops frequently enough and if they could not go due to health then staff would bring Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 12 back their requests. Residents were seen to participate in daily routines and chores about the home that they chose to do. Individual plans set out daytime occupations for the residents and these were a wide mixture of use of the on site day service, external day services and luncheon clubs. Choice to attend was respected by staff. Residents spoke fondly about social clubs and outings and holidays they were planning. Two residents were asked about the food, all felt the food was very good and that there was enough of it. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20 People who use this service can expect records relating to healthcare and medication to be appropriately kept, but cannot be assured that all care staff that administer medication are appropriately trained. EVIDENCE: Healthcare needs in care plans were well detailed. Details of contact and each visit to a professional were well recorded and specific health assessments such as physiotherapy were recorded for care staff to read. One resident spoke of an ailment and this was recorded in terms of GP visit and subsequent medication prescribed and administered. Upon arrival at the home one resident was met returning from an appointment at a clinical psychologist and a community nurse accompanied them. Medication administration records (MAR) for 8 residents in bungalow 1 were assessed. No residents were self-medicating. The medicines were in a locked cupboard in the dining room. Creams were kept in a locked cupboard in the bathroom. At commencement of her late shift the senior member of staff was seen to check the contents of the cupboard and medication records. Records were seen to be well kept apart from one MAR sheet without a photograph of the resident. Risk assessments were appropriately included Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 14 within medication files and care plans. E.g. possible side effects of increased photosensitivity with some medication. Medication that was ‘as and when required’ (PRN) had information documented for staff to follow. More details were on the care plan copy, but not in the medication record. Two members of staff designated to administer medication were asked about their training for this role. One had undertaken Project Initiatives training (indepth portfolio) the other had not attended accredited training. This was also confirmed in staff records. The staff-training matrix that shows all staff training for the home did not include training on the administration of medicines for any staff. A member of staff in bungalow 2 stated that although untrained in this role they had been expected to give out medicines when working with agency staff. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 the following standard(s): 22 It is not possible to form an exact judgement around complaints, but it is believed that complaints received at the home would be dealt with appropriately. EVIDENCE: The home has a complaints procedure in place and this forms part of the Statement of Purpose and Service Users Guide. It was also displayed in the main entrance and around other parts of the home. In bungalow 1 the copy referred to the regulator as the Joint Inspection Unit. The correct details of the CSCI need to be on every document. Other details relating to complaints were not accessible as a key was unavailable, even to the person in charge. Therefore it was not possible to explore how many recent complaints have been received and dealt with, but in the past all complaints have been dealt with promptly and appropriately. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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 the following standard(s): 24,25, 26, 27 and 30 The environment at Combs Court suits the people who live there. However, people cannot be assured that hygiene and control of infection is controlled adequately. EVIDENCE: Communal areas were visited in bungalow 1 and 2. Most areas seen were clean and without any odours. In bungalow 1 there were sufficient armchairs that were comfortable. One armchair had the covers removed. In bungalow 2 the carpet in the hallway was not as clean as it could be. A member of staff confirmed that the carpet cleaner had broken and required replacing. There were sufficient toilets and bathrooms and showers appropriately placed, clean and fresh in bungalow 1. At the last inspection it was confirmed that an appropriate washing machine to deal with soiled linen had been ordered, however some six months later this had not been installed and delivered. Both staff in bungalow 1 and 2 confirmed they were required to launder soiled linen. With permission one resident showed their bedroom. This appeared comfortable and individual in bed linen and curtains. However, because this resident had a wheelchair that was stored in their bedroom there was not Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 17 sufficient space for an armchair. The resident said they would like an armchair as they only used the wheelchair when going out. Also the personal possessions of the resident were said not to be working for example, organ and television. The grounds and gardens were beautifully maintained. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 18 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): 33, 34 and 35 People who use this service cannot be assured that all staff that are completely trained or know them due to the high use of agency and relief staff which are used to support them. They can however expect staff to be appropriately recruited. EVIDENCE: The position regarding staffing was discussed with the administration assistant and the current roster was examined. The roster had sufficient detail on it to show what staff were deployed where and what additional cover was required, hence the administration assistant was trying to ring round care staff and cover 15 shifts for the following week. This did not include the shift identified in the flats. Agency staff were also being used. The situation had arisen because there were 2 full time posts vacant in bungalow 2 as well as the one to one support full time for one resident. In bungalow 1 there was 4 shifts per week to cover and on nights there was 5 shifts a fortnight to cover, plus all the identified shifts in the flats. Recruitment was said to be under way. The one to one post had been appointed to and the home was processing the necessary checks required. Recruitment records were examined for 2 new staff. These are believed to be satisfactory. There was evidence of one person’s induction over one week and Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 19 evidence of part of an induction for the other person. A new induction pack was shown that related to the revised NVQ format, but no one was sure when these would commence. There was no evidence that one of the care staff had received manual handling training as part of their induction, no certificate on their file and a gap by their name on the statutory training register provided by the home. However they would be placed in a position of night work whereby this would be expected of her. Evidence of training received was available. In May this year 10 staff were trained in managing violence and aggression. In August and September this year a further 18 staff were trained in control and restraint. A further 6 staff had been trained in breakaway techniques. The home have developed a training register that details all staff training on it seven staff were identified as needing to have manual handling training. Following the inspection a letter was received from the home detailing the qualifications of two staff trained to teach staff manual handling at the home and an assurance that those staff identified would receive training in manual handling in October 2005. There also appeared to be a number of gaps in training register for staff. There were 20 people identified as requiring training around infection control, including cleaning staff. Seven people identified as requiring training around fire and 6 people in health and safety. In talking to staff they were not totally confident in dealing with soiled laundry. The new acting deputy who came on duty at 3pm has NVQ 4 in care. One other carer had just enrolled in NVQ 4. Other new enrolments included 5 people on NVQ 3 and 8 people on NVQ 2. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 20 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): 39 People who use this service can expect that processes will be in place to check quality, however they cannot be assured that these will be implemented comprehensively. EVIDENCE: There was no manager on duty for most of the inspection. Records required in order to fully assess this standard remained inaccessible despite the newly appointed deputy manager being on duty from 3pm. These included complaints, accidents and quality assurance records. The administrator and acting deputy manager confirmed that Craegmoor quality assurance questionnaires were used 6 monthly within the home. A blank copy was shown which was in picture format. The acting deputy manager participated in the last audit in which key staff members assisted selected residents from whom they did not give direct care, to complete the questionnaire. The results were not available. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 21 Policy on quality assurance was seen which stated that relatives would also be given a questionnaire. Staff did not confirm this. Relatives do attend the resident’s reviews. Evidence of this was seen in the 5 care plans tracked. Interviews with residents that formed part of the review process were also seen in the care plans. Care plans were comprehensive, well maintained and had been regularly audited. Two members of staff stated that residents meetings were held in day care on a regular basis, usually every other month. The only minutes available were from September 2004. Six residents were spoken with. One had expressed a wish to attend chapel, which was documented in the care plan. This had not been fulfilled in recent months, as there was no evidence in the daily statement. Not all requirements identified within the last inspection report had been actioned. The organisation has delegated a person to visit the home once a month, unannounced. A report of this visit has been sent to the CSCI on a regular basis. This fulfils their obligation under regulation 26. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 22 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 2 Standard No 22 23 Score 2 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 X X 2 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 3 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Combs Court Residential Home Score X 3 2 x Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000024362.V250481.R01.S.doc Version 5.0 Page 23 Yes 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 5(3) Requirement Evidence of contracts and terms and conditions must be available for inspection. (This is a repeat requirement from 12/10/04 and 04/04/05.) Care plans must establish individualised procedures for residents likely to have challenging behaviour. Staff must be clear as to what they are permitted to do in each circumstance, for how long & how frequently to repeat. This is especially required in using physical restraint. (This is a repeat requirement from 04/04/05) Manual handling assessments must be up dated to reflect changes in practice. Residents in the flats must have more opportunities given to them to develop independent living skills. (This is a repeat requirement from 04/04/05) Staff who administer medication must be adequately trained. Displayed complaint procedures must contain correct contact details of the regulator for the DS0000024362.V250481.R01.S.doc Timescale for action 01/11/05 2 YA6 15 13 (7)(8) 17/10/05 3 4 YA9 YA11 13 (5) 15 16 (2)(h) 17/10/05 01/11/05 5 6 YA20 YA22 13 (2) 17 (2) sched 4 17/10/05 01/11/05 Combs Court Residential Home Version 5.0 Page 24 service. 7 YA26 23 (2) (e)(f)(i) Resident’s bedroom must include suitable furniture and space to meet their lifestyle. E.g. remove wheelchair and replace with an armchair. The premises must be kept clean and hygienic and throughout and systems in place to control the spread of infection. Therefore: appropriate equipment must be available to - Launder clothes. (repeat requirement from 12/10/04 and 04/04/05) - Clean carpets. The home must have an effective staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times. The registered person must ensure that there is staff training and development programme, which ensures staff fulfil the aims of the home and meet the changing needs of residents. There must be an effective quality assurance and quality monitoring systems, based on seeking the views of service users, in place to measure success in achieving the aims, objectives and statement of purpose of the home. Records must be kept available for authorised inspection at all times. 17/10/05 8 YA30 13 (3) 23 (2)(d) 17/10/05 9 YA33 18 (1)(a)(b) 17/10/05 10 YA35 18 (1) (c) 17/10/05 11 YA39 4 (1)(c) 21, 24 01/11/05 12 YA39 17(3)(b) 17/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000024362.V250481.R01.S.doc Version 5.0 Page 25 Combs Court Residential Home 1 Standard YA6 2 3 YA24 YA26 The home and staff should be aware of best practice publications such as The Department of health Guidance on Physical Intervention for people with a learning disability. Armchairs should have a spare cover when covers require repeated laundering. Residents should be supported to maintain their personal possessions in working order. Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Combs Court Residential Home DS0000024362.V250481.R01.S.doc Version 5.0 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!