Inspection on 27/07/05 for Crossways Residential Home

This inspection was carried out on 27th July 2005.

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 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

Crossways Residential Home 07/02/07

Crossways Residential Home 03/11/05

Crossways Residential Home 16/03/05

Crossways Residential Home 13/09/04

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 Crossways Residential Home North Terrace Mildenhall Suffolk IP28 7AE Lead Inspector Kevin Dally Announced 27 July 2005 th 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. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crossways Residential Home Address North Terrace, Mildenhall, Suffolk, IP28 7AE 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) 01638 515556 01638 712730 None National Autistic Society Mrs Christine Taylor Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 03/03/05 Brief Description of the Service: Crossways is part of the National Autistic Societys “Mildenhall Service”, which comprises Crossways and Middlefield Manor (the second, larger Care Home situated approximately 2 miles from Mildenhall in Barton Mills). The Home provides residential care for eight young adults with Autistic Spectrum Disorders. The Home is a large detached house (formerly a private residence) in a residential area close to Mildenhall town centre, at the junction of two main roads. The entrance to the Home is from Folly Road and there is a small parking area for the Home’s two vehicles as well as for visitors.The Home is well maintained, clean, light and airy and the eight service users are accommodated in single bedrooms; three on the ground floor and the remaining 5 on the first floor. Two bedrooms have the additional benefit of en suite facilities and there are sufficient bathrooms and toilets to meet the needs of the eight residents.The Home has a fitted kitchen, a laundry area, a large lounge, dining room as well as a separate but adjoining quiet room. The residents also have use of a pay phone for incoming and outgoing telephone calls. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an announced inspection at Crossways, a care home that provides care and support for up to eight younger adults with Autistic Spectrum Disorders. The inspection was conducted over a 6.5 hour period from 9.15 am to 3.45 pm, and included joining the residents for lunch. Mrs Christine Taylor, the homes manager, was present at the inspection, and she contributed throughout the day. This inspection found that of the 32 National Minimum Standards inspected, that the home fully met 27 of these with 5 being partially met. Two of the 27 standards were assessed as “standard exceeded”. Overall, the quality of the support and lifestyle offered by the home, continued to be to a very good standard. The environment was found to be well maintained, very clean and hygienic. Residents and staff were spoken with, and questionnaires were received from one resident, and one relative. The feedback received from service users was very positive. What the service does well: What has improved since the last inspection? What they could do better: This inspection required that when personal freedoms are restricted, that documentation clearly identifies the reasons why this has happened. This inspection required that a door be repaired and that additional training be provided for one staff member. The home also must ensure that where hot water tap temperatures are excessive, but pose no risk to service users, that a Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 6 risk assessment is maintained of this assessment. Staff must also ensure that residents personal money procedures are strictly adhered to. 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. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.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 Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.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) 1,2,3,5 People can expect that they will receive good quality, informative and helpful information about the service provided. They could expect to have their care needs properly assessed and appropriately met by the home. EVIDENCE: Residents were provided with a Statement of Purpose and Service User Guide, which clearly described for them the type of support and services that the home could provide. This was also provided in a picture format for residents ease of reference. The manager would usually assess a new service user, prior to any offer of a place at the Home. This would involve the undertaking of extensive assessment around that potential residents identified needs and requirements. Factors that would also be considered by the home would include how they integrated with the other residents. This would be assessed over a 4-6 week period, and feedback would also be received from the current residents. Although there had not been any recent admissions, the manager provided a copy of the assessment form that would be used. The three residents records examined demonstrated that extensive assessment had been undertaken for those service users. This included assessment of their support and care needs. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 9 Two residents spoken with confirmed that the home met their personal care and support requirements, and stated that they found the staff supportive. As Crossways care home is a specialised service for people with Autistic Spectrum Disorders, staff were found to have been appropriately trained to meet the specialised needs of the resident group. This included autism training, epilepsy and behavioural de-escalation training. Staff spoken with, records checked and the Staff Training Plan for 2005 examined, confirmed that staff continued to receive good training, which enabled them to meet the needs of the service user group. Three care plans examined demonstrated that the staff had undertaken extensive assessments, which confirmed that the residents care needs could be met. From the information gathered it was clear that the home was able to meet any specialised requirements of the service user group. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 standard(s) 6,7,8,9 People can expect to receive very detailed planned care which would be regularly updated and which would reflect their individual needs and wishes. Furthermore, they can expect to be enabled to make decisions about their life, and be supported to achieve more independence, and to follow their own personal goals. EVIDENCE: Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 11 Three residents care and support plans were tracked by reading records. Care records included very detailed assessment of the residents needs and included a communication profile, significant events profile, personal care, education plans, and a summary of life long goals. In addition to these documents there was a behavioural support plan for each resident that provided very positive guidance for staff, for dealing with difficult behaviours. Agreement to these plans had been reached with each resident, and who were activity involved in working towards their next goal. For some residents, a particular goal may take many months to achieve, but the importance of having a personal goal, whatever that may be, was considered very important by the home. Discussion with two residents revealed that they were happily settled at the home. Residents confirmed that they were able to work towards their own goals and were able to be independent, and choose how they ran their life. These residents found staff supportive, so enabled them to be more involved with the community, pursue work development opportunities and social pursuits. Due to the extensive detail provided in the care plans, standard 6 was considered as above the national minimum standard. One resident was found to have restrictions placed on their drinking, and although this was for medical reasons, this was not clear in the documentation. This was discussed with the manager, and who thought that this restriction might not now necessary apply. However, it was agreed that should this restriction still be necessary, that the manager must ensure that the current documentation clearly stated why this restriction was necessary, and on who’s authority. Further, agreement to this procedure should be extended beyond the manager and resident, to include any family member or personal advocate, their social worker or any relevant medical personal. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 standard(s) 11,12,13,14,15,16,17 People can expect to have very good opportunities for personal development and participation within the local community, and as a result of these opportunities, they could expect to lead a more independent and fulfilling lifestyle. Relatives and friends can expect to be made welcome when visiting the home. People can expect to receive meals that are nutritious, balanced and meet the needs of the residents. EVIDENCE: Residents were found to have access to and able to participate in the local and wider community. Residents and staff members spoken with confirmed that the home provided varied opportunities for service users to participate in. These included day centres during the week, personal activities within the home, and opportunities in the evenings and at weekends for both social and leisure activities. One resident confirmed that they enjoyed visiting the local pub, where they were known personally. Three residents records included various details of home visits with their family, a visit to a disco, a holiday out of county, a BBQ, and a birthday celebration. Residents were able to make Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 13 contact with their friends and families, and one resident confirmed that they went home every second week. Resident’s day care programmes demonstrated that people have a full schedule of meaningful and varied activities throughout the week that enabled both work related and social opportunities for personal development. These have been developed with their respective key workers and examples included attending college, life skills training, music therapy, a sheltered workshop, learning and development centres, hydrotherapy pool, various sports opportunities, and shopping within the community. Due to the excellent opportunities provided by the home, standard 11 was considered as above the national minimum standard. The menu choice showed that residents were provided with a balanced, varied, and sufficient diet with appropriate meal choices. The menu was found to be very personalised, but also ensured that appropriate national nutritional recommendations were followed. The inspector was invited to join residents and staff for lunch. The meal was a very well presented Mexican meat dish with salad, onions and light spices, which was appropriate to the needs of younger adults. This dish was typical of the varied menu options provided over a four week period, as recorded within the homes menu cycle plan. Chicken was on the menu for teatime, when all residents would have returned from their respective day centres. Two residents confirmed that the “meals were great” and that they always enjoyed the options provided by the home. One resident’s menu record demonstrated very good menu options, as did the menu plan. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 People can expect to receive good quality personal healthcare support. EVIDENCE: Crossways care home continued to provide a supportive and empowering environment for its current residents with Autistic Spectrum Disorders. The routines of the home were sufficiently established to provide continuity, but were flexible enough to allow appropriate independence, where this was needed. An example of this was that one resident was able to leave the home unaccompanied. Staff also respected a resident’s need for privacy, while continuing to provide essential support where necessary. Crossways promoted and maintained good levels of health care for its residents, and a record was maintained for each person, which included visits to or from their Doctor, the Chiropodist, Dentist and the Optician. Staff confirmed that staffing levels were adequate ensuring appropriate personal care and time available to meet the health care needs of the residents of the home. The staff group spoken with confirmed that they “were very happy working at the home with adequate time to work closely with residents”. The accident log was checked and found to contain no recorded incidents during the last 12-month period. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 15 Medication procedures were examined and the home was found to use the Medication Dispensing System (MDS) system with blister packs and Medication Administration Records (MARS) sheets, to record administered medication. One resident’s medication records checked were found to be complete. Policy guidance was found in place around the storage, recording, administration, reordering, receipt and maladministration of medication. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 standard(s) 22,23 People can expect to have their complaints taken seriously and acted upon. People’s safety will be ensured by appropriate recruitment checks. EVIDENCE: The homes complaints procedure described how a resident could make a complaint to either the home or the Commission for Social Care Inspection (CSCI), and the time scales involved. The complaints procedure was discussed through awareness of how to complain. No complaints had been received by the home or made to the CSCI within the last 12 months. The home had suitable Adult Protection policies and procedures in place and the manager was aware of her obligation in the reporting of any allegations of abuse to Social Services, the police and/or the CSCI. Two staff members records checked included a Criminal Records Bureau (CRB) disclosure and 2 references. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,30 People can expect to find the home clean and hygienic, and generally well maintained and comfortable. EVIDENCE: The home provides accommodation for up to eight younger adults within a large detached house (formerly a private residence) in a residential area close to Mildenhall town centre. The home was well maintained, clean, light and airy and the eight service users would be accommodated in single bedrooms; three on the ground floor and the remaining 5 on the first floor. Two bedrooms have the additional benefit of en suite facilities and there are sufficient bathrooms and toilets to meet the needs of the eight residents. The home has a fitted kitchen, a laundry area, the lounge/dining area, as well as a separate but adjoining quiet room. On the day of the inspection the house was found to be very clean and hygienic and had been well maintained. New carpet had been fitted to the hallway and stairs. The upstairs bathrooms and toilet areas were found to be clean but the bathroom door had been damaged and was in need of repair. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 People could expect the home to be adequately staffed, with employees who were competent, supervised and trained to meet the specialised needs of the service user group. People could expect that residents would be safe due to the homes recruitment procedures. EVIDENCE: The home maintains a minimum of two care staff on each duty during waking hours, and two staff on a sleepover during the night period. An additional carer is sometimes employed to manage any “extra hours” required during the day, in order to meet any additional needs that residents may have. For example accompanying them to the day centre. The manager was available during office hours, Monday to Friday. Residents and staff spoken with confirmed that sufficient staff were employed to meet the needs of the service user group. One resident stated, “staff were good”. Records checked confirmed that staff had been appropriately trained and were able to undertake their respective job roles, and were able to meet the needs of the service user group. Two staff member’s recruitment records were examined and suitable recruitment and employment procedures were found in place. The staff member’s records included CRB, and reference checks and a record of their proof of identity. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 19 A group of staff spoken with and two staff member’s records checked confirmed that the home continued with the provision of appropriate training for its employees. Examples of this included moving and handling, first aid, Epilepsy training, Autism training, and medication training. The pre-inspection questionnaire stated that 3 staff had obtained their NVQ level 2 in care training. The manager confirmed that an assessment of training needs is usually undertaken in supervision and the staff member would then be placed on one of the National Autistic Society short training courses. One staff member had not yet received protection of vulnerable adults training, which was required. Supervision was undertaken on a regular basis to ensure that staff were regularly supported within the team. Two staff member’s records provided details of recent and ongoing supervision. Staff members spoken with confirmed that they were regularly supervised and felt supported by the Home. Supervision could include discussion around their job role, training needs, any problems experienced and their general performance. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 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) 37,38,39,42,43 People could expect that the home would be well managed, although it could not be guaranteed that the environment was fully safe, until a risk assessment had been completed around excessive hot water tap temperatures. People could normally expect to have their personal money protected, although this could not be guaranteed until staff adhered the correct checking procedures. EVIDENCE: The home was well managed with sufficient administration support and management to ensure the efficient and effective management of the home. The home’s aims and objectives encouraged a culture of resident inclusion, choice and independent living opportunities. Further, the home ensured that quality was assured for each service user with either 6 or 12 monthly reviews, where feedback was formally received from each resident. An environmental tour of the premises was undertaken of the ground and first floor. This included sampling the hot water tap temperatures of the shower and the laundry. The ground floor laundry hot water tap temperature was found to Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 21 be around 56 degrees Celsius, and the ground floor shower hot water temperature was found to be 52 degrees Celsius. Both of these temperatures were considered excessive. It was therefore a requirement of this inspection that the manager undertake a full risk assessment to determine if the laundry hot water tap temperature and the shower hot water pose any risk to residents. If the risk assessment shows that residents are at risk, these risks must be reduced or eliminated to ensure that residents cannot be scalded. Four service users personal finance records, and their cash held by the home was checked. Two of the four balances checked recorded 2 small discrepancies, although the balances had been audited only a few days previously. This was examined more fully and it was found that a staff member had forgotten to adjust the balances that morning. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 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 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 2 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crossways Residential Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 2 I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 23 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 7 Regulation 17(1)(a) Schedule 3(3)(q) Requirement Timescale for action 1/09/05 2. 3. 24 35 4. 42 5. 43 Where restrictions on residents freedoms are in place, the home must ensure that the current documentation clearly states why this restriction was necessary, and on who’s authority. 23(2)(b) The bathroom door must be repared. 18(1)(i) Protection of vulnerable adults training must be provided for the one staff member for whom this is outstanding. 13(4)(a)(c A full risk assessment must be ) undertaken to determine if the laundry hot water tap temperature and the shower hot water pose any risk to residents. If the risk assessment shows that residents are at risk, these risks must be reduced or eliminated to ensure that residents cannot be scalded. 17(2) Staff must ensure that residents Schedule personal money procedures are 4(9) strictly adhered to. 1/10/05 1/10/05 immediate Immediate Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 24 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 7 Good Practice Recommendations Where restrictions on residents freedoms are in place the home should consider expanding this agreement beyond the manager and resident, to include any family member or personal advocate, their social worker, or any relevant medical personal. Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP28 7AE 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 Crossways Residential Home I54-I04 S24368 Crossways V217791 050721 Stage 4.doc Version 1.40 Page 26 - 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. 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