Inspection on 18/08/06 for Fairview House

This inspection was carried out on 18th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fairview House 30/01/09

Fairview House 09/01/08

Fairview House 01/02/06

Fairview House 06/09/05

Fairview House 26/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Fairview House Gypsy Lane Warminster Wiltshire BA12 9AR Lead Inspector Alyson Fairweather Key Unannounced Inspection 18th August 2006 12:00 Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fairview House Address Gypsy Lane Warminster Wiltshire BA12 9AR 01985 847680 F/P01985 847680 fairviewhouse@rethink.org www.rethink.org Rethink 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) Vacant Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Fairview House is registered to provide nursing care for ten adults with mental health problems. It is located in a residential area in the town of Warminster, Wiltshire, and has a local shop within walking distance. The home is domestic in character and offers comfortable single room accommodation. All communal rooms are light and airy, and furnishings are of good quality. A separate room is provided for people who wish to smoke. There is a large, secluded garden at the back of the house, with far reaching views over the local countryside and several seating areas as well as a paved patio. There are car parking spaces at the front of the house. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day in May, when seven residents and three staff members were spoken to. Ms Sharon Morris, the manager at Fairview House, is currently on secondment from another Rethink service. She has a great deal of experience of working with people with mental health problems, and is registered with the Commission for Social Care Inspection (CSCI). It is envisaged that this situation is a temporary measure until a permanent manager is employed. Various documents and files were examined, including care plans, health & safety procedures, risk assessments, staff files and medication records. A random inspection was also conducted in May 2006. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: A great deal of work had been done on residents’ care plans. They contained information about people’s likes and dislikes and how their needs could best be met, as well as detailed information about their physical and mental health, their activities, their family contacts and any personal care needs. These care plans are reviewed on a regular basis with the resident. Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time. Staff place great emphasis on encouraging residents to be as independent as possible, and they are supported to enjoy activities outside the home. The home used to have a cook who prepared residents’ meals, but now residents are encouraged to be more independent and to help cook their own meals and prepare their own snacks. Residents’ care plans outlined the support each person needed with this task. Healthy options are encouraged, and fresh fruit and vegetables, juices and yoghurts are available. One resident said how happy she was to have the use of a separate kitchen in which to prepare meals and store food shopping. Residents also enjoy an occasional take away meal. There is a large, domestic style kitchen, with a dining room which is light and airy and comfortably furnished, so people can enjoy mealtimes. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Prospective residents and families are given information leaflets so that they can choose whether or not they wish to use the service. They have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to this service. EVIDENCE: The home has recently updated its Statement of Purpose and Service User Guide which give an overview of the service which will be provided. This is given to every potential service user, and also gives details of the organisation’s complaints procedure. All residents are referred to Fairview House by staff of other mental health services, for example the Community Mental Health Team (CMHT). This referral includes a detailed application form, risk assessments where present and details of the current multidisciplinary care plan. The home’s manager then conducts a referral interview, at which stage residents are able to say what they feel their needs and goals are, and to assess whether the home might be able to help with these. Potential residents make several visits to the home, and can spend time getting to know staff and other residents. This allows further assessment of their needs to take place. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 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 Support plans reflect the needs and personal goals of residents. People are encouraged to make choices and decisions about their own lives, and are supported to take risks as part of an independent lifestyle. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All potential residents work with staff on how they might achieve their goals in life, and this helps form the basis of their support plan. It was clear that staff have been working hard to transfer information from residents nursing plans to their new Recovery Support Plans. Each plan now has an index page which quickly shows where to find specific care plans. Care plans include information on communication, accommodation, literary skills, health and social activities, as well as individual’s community care assessments. Daily records are kept for each resident, and whilst these are currently completed by staff, it is hoped that some residents will begin to complete these themselves. Each resident has a care plan meeting (CPA) on a regular basis with the local Community Mental Health Team (CMHT), and also has a weekly meeting with their keyworker. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 10 This helps staff to get to know residents, and can help to inform their support plans. It is recommended that staff sign and date residents’ support plans when they help to complete them. Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have family involvement or other support. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. Risk assessments were on file for all service users, and these are reviewed regularly. They included things like smoking, bathing and mobility. Risk assessments completed at CPA meetings are also on file. Staff place great emphasis on encouraging residents to be as independent as possible, while trying to minimise any risk to their safety. It is recommended that staff sign and date risk assessments when they help to complete them. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 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 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. People can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. Residents’ rights are respected and responsibilities recognised in their daily lives. They are offered a healthy diet, with their preferences taken into account. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents attend a range of activities, including day centres, sheltered workshops, activity centres and college courses. One resident who used to be a cook spoke of her enjoyment of baking cakes for the others, and a delicious coffee cake was on offer that afternoon. Two other residents had been out with their keyworker, and another had been out shopping on his scooter. One resident had just returned from attending a day centre, and spoke about the activities she enjoyed, including a catering course and helping others at a day Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 12 centre. People also visit the local pubs, cafes, shops, library and cinema. Some people use public transport. Several residents felt that they were unable to take part in outside activities, but took pride in helping staff around the house. Residents are also encouraged to prepare meals and snacks for themselves independently. One resident of another Rethink service has been helping to tend the garden. Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time, and can entertain and choose to see who they like either in the privacy of their own bedrooms or in the communal areas available. Previously, there were certain areas of the house which were locked to residents, including the large kitchen and the pantry. Residents now have unrestricted access to the home and grounds, and can come and go as they please. They can choose when to be alone or in company, and when not to join an activity. Staff enter residents’ bedrooms only with the individual’s permission. Daily routines are flexible, with people choosing what they want to do when they return from day services. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. Residents who are out all day open their own mail when they come home, and a new post-box system has been introduced so that people can access their mail more easily. The way that meals are prepared has changed. The home used to have a cook who prepared residents’ meals, but now residents are encouraged to be more independent and to cook their own meals and prepare their own snacks. Residents’ care plans outlined the support each person needed with this task. Healthy options are encouraged, and fresh fruit and vegetables, juices and yoghurts were available. One resident now has the use of a separate kitchen in which to prepare meals and store food shopping. Residents also enjoy an occasional take away meal. There is a large, domestic style kitchen, with a dining room which is light and airy and comfortably furnished, so people can enjoy mealtimes. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 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 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. Residents are encouraged to self administer medication wherever possible, and there are policies and procedures in place in relation to medication support. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. Although Fairview House caters for people with mental health needs, one or two residents have had major physical problems which has necessitated having personal care support from staff, who have supported all the district nurse, GP and hospital appointments needed. Most residents have their medication supplied in blister packs, with other medication being stored in dossette boxes. As a result of the change of registration status fro nursing home to residential, medication is no longer Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 14 administered by qualified nurses. A great deal of work has been done by staff to amend medication policies and procedures, and advice has been sought both from the local pharmacy and the pharmacist inspector. The home now has a designated, lockable medication room where residents’ medication can be stored. The medication cupboard has been moved from the busy office, and means that staff have fewer distractions. New staff have medication induction training, and shadow an experienced member of staff until they are deemed competent. Staff are also given information about the side effects of various medication which residents might experience. There were protocols in place about the use of PRN medication, and risk assessments were recorded. However, when a stock check of one resident’s medication was checked, it seemed that there were too many tablets left in the box. It proved difficult to trace back the number of tablets given, making it impossible to establish if the resident had been given the correct amount of medication. The manager has been asked to ensure that accurate records of administered medication are kept, in order to facilitate an audit trail. There was some confusion around the storage of the medication administration records, with various boxes being filled in a haphazardly way, making it difficult to find various records. It is recommended that these records are stored in a more methodical manner. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 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 Residents’ views are listened to, and any concerns are acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in the home which outlines the steps to take if any one has a complaint. The home’s change of registration, and subsequent loss of qualified nurse, has meant that residents have been concerned about whether their mental health needs would be met. Regular residents’ meetings have been held in order to keep people informed of any changes, and to try to reassure them. One complaint had been received and the manager was seen to have responded appropriately. No formal complaints have been received by CSCI about Fairview House. The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members have received Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. The home had recently made one appropriate referral to the vulnerable adults’ team. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 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 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Fairview House is a large, comfortably furnished home with bright, airy rooms. Residents’ bedrooms were homely and each contained individual personal items, such as stereos and TVs. A separate room is provided for people who wish to smoke. There is a large, secluded garden at the back of the house, with far reaching views over the local countryside and several seating areas as well as a paved patio. Since the last inspection, several areas have been decorated, and new pictures and shelves put up around the house, making it feel much more homely. The dining room has had the furniture changed around, making it more welcoming. Residents have been issued with laundry baskets in which to carry their washing to the laundry. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Residents are supported by competent staff, and their individual and joint needs are met by appropriately trained staff. They are supported and protected by the home’s recruitment policy and practices. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service EVIDENCE: Each staff team member has a training record which shows the training they have done. This has included health and safety, race equality, medication, fire instruction and Protection of Vulnerable Adults. The change in registration status of the house has meant that qualified nurses are no longer employed as such, and Community Mental Health Workers have now been recruited. Some staff have an NVQ, but the newer staff will have specific mental health training, and will receive a Community Mental Health certificate, the equivalent of an NVQ. However, whilst examining training files, it was seen that several training updates had not taken place. The manager has been asked to ensure that this is done. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 18 Staff recruitment is assisted by Rethink’s human resources department. All potential staff members meet with residents informally and it is hoped that some will become more involved in the formal interview. Staff are interviewed using a standardised set of questions and a scoring system. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Two written references are also required. There is a six month probationary period, and the manager meets with staff half way through this period to review progress. All the staff files looked at contained the appropriate documentation. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 19 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 Service users benefit from a well run home, where they can be confident their views are important to the development of the service. Their health safety and welfare is promoted and protected, although regular fire drills would help this further. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager at Fairview House is Ms Sharon Morris, who has been seconded from another Rethink service to oversee the transition period from nursing home to residential care home. She is registered with Commission for Social Care Inspection, and previously registered by the NCSC as manager of similar registered services in Hampshire. She qualified as a nurse, has a Diploma in Welfare Studies and a Certificate in Counselling. She is also planning to complete her Registered Managers’ Award. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 20 There are various quality assurance methods used in the home, including weekly residents’ meetings, regular sessions with residents and key workers, and monthly, unannounced visits to the home by the provider’ representative. Rethink also conducts its own internal audit of all its services. A resident survey has been conducted, and it is planned to introduce a similar survey for relatives. One resident commented that she really enjoyed living in Fairview House. It is recommended that the home should respond to people who take part in their quality assurance questionnaire, telling them how they plan to deal with any concerns. All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell is tested weekly and the emergency lights and fire fighting equipment are tested monthly. Food and water temperatures are recorded regularly and an annual Legionella test is done. Portable electrical appliances are tested annually, and the gas cooker serviced annually. The home has a designated fire warden, and a fire risk assessment is in place, although the manager said that this was being further developed. There had been two recent instances where the fire alarm had sounded and no-one had called the fire brigade. The manager had sought advice from the fire department, and had been very clear with staff that the expectation was that they would call the fire brigade if this happened again. Fire drills are supposed to be conducted on a quarterly basis, and it was noted that this had not always happened. The manager has been asked to ensure that this is done from now on. It is also recommended that staff record the initials of all those staff and residents who attend the fire drill. This will make it easy to note who has not taken part and involve them in future drills. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 21 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 X 3 X 3 X X 2 X Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 2 3 Standard YA20 YA35 YA42 Regulation 13 (2) 18 (1) (c) (i) 23 (4) (e) Requirement Accurate records of administered medication must be kept. All staff must receive regular training updates. Fire drills must be conducted on a regular basis. Timescale for action 18/08/06 18/11/06 18/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA7 YA9 YA20 YA39 YA42 Good Practice Recommendations Staff members should sign and date residents’ support plans when they complete them. Staff members should sign and date risk assessments when they complete them. Medication administration records should be stored in a more methodical manner. The home should respond to people who take part in their quality assurance questionnaire, telling them how they plan to deal with any concerns. The initials of all residents and staff members attending fire drills should be recorded. Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Fairview House DS0000028080.V308720.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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