Inspection on 10/04/06 for Enmore Lodge

This inspection was carried out on 10th April 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Enmore Lodge 07/08/07

Enmore Lodge 28/11/05

Enmore Lodge 09/06/05

Enmore Lodge 13/01/05

Enmore Lodge 01/06/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Enmore Lodge 34-36 Enmore Road South Norwood London SE25 5NQ Lead Inspector Mohammad Peerbux Key Unannounced Inspection 10th April 2006 9:30am Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Enmore Lodge Address 34-36 Enmore Road South Norwood London SE25 5NQ 020 8405 1831 020 8656 9792 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) Enmore Lodge Limited Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow two specified service users over the age of 65 to be accommodated. 28th November 2005 Date of last inspection Brief Description of the Service: Enmore Lodge is a service designed to cater for sixteen generally younger adults with past / present mental illness. Using a long-term therapeutic model, service users are encouraged to engage in the day-to-day activities of the home, as well as become involved with the local community where wished, or where timetabled as part of their care programme. Enmore Lodge is a substantial building set back off Enmore Road with a large car park to the front and a paved patio area to the rear with a small plot of garden. The building is designed to provide single accommodation for all but two of the service users who share the sole double-occupancy room. The range of weekly fees is between £403 and £700 and this information was gathered on the day of the inspection (10/04/06). Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/07. It was an unannounced inspection and took place over three and half hours. Some times were spent looking at the policies and procedures, talking to staff, manager and to some of service users. A tour of the building was also carried out. Service users spoken to stated that they were happy with the care being provided. What the service does well: What has improved since the last inspection? What they could do better: Although service user’s care plans are comprehensive and include detailed information about their needs and personal goals, these care plans would have far greater authority if service users were involved where possible in their development. A “missing person” profile must be in place for all service users who are at risk of absconding. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 6 The home’s complaints procedure must be given and/or explained to each service user in an appropriate language and format for them to understand. The home must have a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. Staff need to be supervised on a regular basis. The registered person needs to ensure so far as is reasonably practicable the health, safety and welfare of service users and staff are promoted and protected at all times. 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. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. All prospective service users have their needs assessed prior to admission to ensure that the home and staff are aware of their assessed needs. EVIDENCE: All service users are admitted via a Care Programme Approach referral through the integrated Community Mental Health Team, therefore full CPA service user plans usually accompany an admission. There was evidence that service users have a full care needs assessment in place and this form the basis for the care plans. The manager is reminded that all new service users are admitted only on the basis of a full assessment undertaken by people competent to do so, involving the prospective service user, using an appropriate communication method and with an independent advocate as appropriate. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 and 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service user’s care plans are in place and include detailed information about their needs and personal goals. However these care plans will have far greater authority if service users were involved where possible in their development and that they were regularly updated to ensure the service users’ needs are met. The home operates a risk management strategy thus enabling the service users to participate in activities in the home and in the community with appropriate support however they must be kept up to date. EVIDENCE: Three service users’ care plans were sampled, it was noted that they were not all up to date and not well maintained. There were missing information on the care plans regarding to the service user’s details and as to when these care plans were drawn up. Overall, the plans demonstrated a thorough needs Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 10 assessment, which clearly set out how current and anticipated needs would be met. It was also noted that none of the care plans were drawn up with the involvement of the service user together with their family, friends and/or advocate as appropriate, and relevant other agencies/specialists. The registered manager must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. The care plan must also be made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. Risk assessments for three service users were examined and it was noted that they were not always up to date and did not cover all the risks that have been identified in the care needs assessment. The registered manager must ensure that service users’ risk assessments identify potential risks covering all aspects of their daily living both inside and outside the home. The risk assessments must give details to what action is required to minimise identified risks and hazards. The registered manager must also ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk assessment and risk management strategies. One of the service users is at risk of absconding however he did not have a completed missing profile in place. The registered person is required to have a completed missing profile in place for all service users who are at risk of absconding. On the day of inspection there was a new service user who was being admitted to the home. Following discussion with the manager it was identified that the home was not aware if he has any identified risks. The registered manager must ensure that risk is assessed prior to admission according to health and social services protocols and in discussion with the service user and relevant specialists; and risk management strategies are agreed, recorded in the individual plan, and reviewed. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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): 12,13,15, 16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. Dietary needs are well catered for and a well balanced diet is provided, to ensure a nutritious diet based on personal preferences. EVIDENCE: The home encourages all its service users to maintain their life skills and participate in activities appropriate to their abilities. The home also offers inhouse activities. Staff help service users find out about and take up opportunities for further education and vocational, literacy and numeracy training. The manager stated that from September 2006 some of the service users would be attending computer and yoga classes. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 12 Service users are able to access a wide range of community activities. All the service users are registered to vote. The home also values and seeks to reflect the racial and cultural diversity of service users and of the community in which it is located. One of the service users is of Muslim faith; the home ensures that all his religious needs are being met. He goes to the mosque every Friday and the home also ensures that there is halal food for his consumption. The home respects the service user’s choice of whom to engage with; there are small Visitor’s Rooms available in the home for people to meet - without having to invade the ‘privacy’ of a service user’s own bedroom. Individual service users’ own space is also respected; many were individually furnished and kept to the level appropriate and suited to the specific service user’s character. Relationships both within and outside the home are encouraged. Service users, who were at home at the time of this inspection, appeared to enjoy some level of independence. Routines can be very flexible and are well observed to take into account all the service users individual needs. All service users have a key to their bedrooms. No service user is given a front door key, the reasons for this relate to the staff of the home needing to know who service users bring back with them and service user’s vulnerability to strangers outside of the home. The home promotes service users health and well being by ensuring the supply of nutritious, varied and balanced meals in a congenial setting and at flexible times. Service users are offered a choice of suitable menus, which meet their dietary and cultural needs, and which respect their individual preferences. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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): 18,19 and 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Overall the arrangements for health care needs of the service users are good and they receive personal support in the way they prefer. EVIDENCE: Staff provide sensitive and flexible personal support to maximise service users’ privacy, dignity, independence and control over their lives. The manager stated that where needed, guidance and support regarding personal hygiene is provided. Times for getting up/going to bed, baths, meals and other activities are flexible. Service users have some choice of staff who work with them, such as staff from the same ethnic, religious or cultural background or the same gender. Service users at the home are registered with a General Practitioner. They are supported by the staff team when attending outpatient or other medical appointments as required. It was evident that records of all medical/health appointment/visits were being maintained. It was previously required that the manager must ensure that medication administration records are accurately completed at all times. All medication Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 14 administration records were up to date and accurate at the time of the inspection. The home has a policy on the administration of medication and medications are stored in a locked cupboard. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 and 23 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home has appropriate complaints procedure and suitable vulnerable adult protection and abuse prevention measures in place to ensure that service users are so far as reasonable practicable, protected from abuse, neglect or harm. EVIDENCE: The current complaints procedure is good and gives a clear step-by-step guide of how to make a complaint however it is only available in written format. The registered person must ensure that the home’s complaints procedure has been given and/or explained to each service user in an appropriate language/format, including information for referring a complaint to the Commission for Social Care Inspection at any stage should the complainant wish to do so. The manager stated that there have been no complaints since the last inspection. The home has its own protection of vulnerable adults policy in place. The home should also have a copy of the Croydon adult protection policy, guidelines and procedures. The manager stated that all staff have attended the “Abuse Awareness” training however not all the attendance certificates were available. Some certificates were forwarded to the Commission following the inspection. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 and 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the service users’ health and emotional wellbeing. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet service users’ individual and collective needs in a comfortable and homely way. Service users’ bedroom are personalised to reflect their individual needs, and personalities. Overall the home was decorated to a good standard throughout and appeared to be comfortable and warm. However the home is not complying with fire regulations and there are also some health and safety issues (see standard 42). During the inspection it was also noted that the flooring in the dining room was damaged and service users, visitors and staff are at risk of tripping over. The registered manager must ensure that the flooring in the dining room is either replaced or repaired for the safety of staff, visitors and service users. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 17 The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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): 34,35 and 36 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Generally staff are recruited appropriately and employed in sufficient numbers to meet the health and social needs of their service users. However care staff are not receiving supervision on a regular basis, which could have an impact on the standards of care being provided to service users. EVIDENCE: At the time of the inspection recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. The manager stated that staff have regular training however it was very difficult to ascertain which training they have undertaken, as the training records were not up to date. The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered manager must also ensure that a training needs assessment is carried out for the staff team as a Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 19 whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. From staff supervision records it seems that not all staff are having at least six sessions per year. The registered provider must ensure that formal supervision sessions are held with all care staff at least six times a year, and that these sessions are recorded and signed by both the supervisor and supervisee. It is also recommended that staff have an annual appraisal in order to review staff performances against their job descriptions and agree career development plans. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally managed well however the health, safety and welfare of service users and staff are not being promoted/protected and this potentially places them at risk. EVIDENCE: The registered provider who manages the home is a Registered Mental Health Nurse; he has completed an NVQ 4 in management and is waiting for the units to be assessed. He has extensive experience of managing care establishments; having managed this home for eighteen years and ten years previous management experience in mental health hospitals. The manager informed that there are regular service users’ meeting where the service users have an opportunity to discuss about the service they are being provided. There is also an annual quality assurance audit that is carried out to measure the home success in achieving its aims and objectives. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 21 During the inspection it was noted that one of the service users’ bedroom door was left open and the room was unoccupied. The manager stated that the service user like to have the door left open. The registered provider must ensure that any bedroom doors, that service users wish to leave open, have magnetic catches of a type that close the door automatically in the event of a fire, fitted. It was also noted that a number of food products have passed their use by date. This could potentially results to serious repercussions to the health and welfare of service users. The registered manager must ensure to promote and make proper provision for the health and welfare of service users as far as food is concerned. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 1 X Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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 YA6 Regulation 15(1) Requirement The registered manager must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. Care plan must be made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. The registered manager must ensure that service users’ risk assessments identify potential risks covering all aspects of their daily living both inside and outside the home. The registered manager must ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk DS0000025780.V288581.R01.S.doc Timescale for action 30/06/06 2. YA6 15(2) 30/06/06 3. YA9 13(4) 31/05/06 4. YA9 13(4) 31/05/06 Enmore Lodge Version 5.1 Page 24 assessment and risk management strategies. 5. YA9 Schedule 4 (16) The registered person is required to have a completed missing profile in place for all service users who are at risk of absconding. The registered manager must ensure that risk is assessed prior to admission according to health and social services protocols and in discussion with the service user and relevant specialists; and risk management strategies are agreed, recorded in the individual plan, and reviewed. The registered person must ensure that the home’s complaints procedure has been given and/or explained to each service user in an appropriate language/format, including information for referring a complaint to the Commission for Social Care Inspection at any stage should the complainant wish to do so. The registered manager must ensure that the flooring in the dining room is either replaced or repaired for the safety of staff, visitors and service users. The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. 10/04/06 6. YA9 13(4) 10/04/06 7. YA22 22(2) 30/06/06 8. YA24 16(2) 31/05/06 9. YA35 18(1)(C) 30/06/06 Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 25 10. YA35 18(1)(C) The registered manager must also ensure that a training needs assessment is carried out for the staff team as a whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. The registered provider must ensure that formal supervision sessions are held with all care staff at least six times a year, and that these sessions are recorded and signed by both the supervisor and supervisee. The registered provider must ensure that any bedroom doors, that service users wish to leave open, have magnetic catches of a type that close the door automatically in the event of a fire, fitted. The registered manager must ensure to promote and make proper provision for the health and welfare of service users as far as food is concerned. 30/06/06 11. YA36 18(2) 30/06/06 12. YA42 13(4) 10/04/06 13. YA42 13(4) 10/04/06 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 YA36 Good Practice Recommendations It is also recommended that staff have an annual appraisal in order to review staff performances against their job descriptions and agree career development plans. Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Enmore Lodge DS0000025780.V288581.R01.S.doc Version 5.1 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!