Inspection on 23/11/05 for Fallings Heath House

This inspection was carried out on 23rd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 21 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fallings Heath House 14/04/08

Fallings Heath House 17/04/07

Fallings Heath House 20/11/06

Fallings Heath House 15/08/06

Fallings Heath House 03/06/05

Fallings Heath House 22/11/04

Fallings Heath House 05/07/04

Fallings Heath House 21/02/04

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

CARE HOME ADULTS 18-65 Fallings Heath House Fallings Heath House Walsall Road Darlaston West Midlands WS10 95H Lead Inspector Lesley Webb & Linda Brown Unannounced Inspection 23rd November 2005 09:20 Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fallings Heath House Address Fallings Heath House Walsall Road Darlaston West Midlands WS10 95H 0121 568 6297 0121 526 7023 dudleys@walsall.gov.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Walsall Metropolitan Borough Council Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That the additional bedrooms are used for the service users (whose names have been provided to the NCSC) only. A report from the Fire Authority must be received by the NCSC stating that the additional bedrooms comply with Fire Safety Regulations. Once the named service users have moved under the reprovision process the home shall revert back to its original registration number. One service user identified in the variation report dated 10.12.04 may be accommodated at the home in the category LD(E). This will remain until such time that the service users placement is terminated. 3 June 2005. Date of last inspection Brief Description of the Service: Fallings heath is a purpose built, single storey building which provides accommodation and personal care for up to 16 persons who have a learning disability with additional complex needs. It is owned by Walsall Metropolitan Borough Council. The home is located in Darlaston, on the outskirts of Walsall, close to a few shops, pubs, the post office and other amenities. The home is divided into three units, each unit having its own lounge, dining area and kitchenette. All bedrooms are single and there are no en-suite facilities. There is parking to the front of the building and an enclosed garden to the rear. It is proposed that services within the home will cease in 2006 and therefore no new service users are being admitted to the home. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspectors arrived unannounced at 9.20am and stayed until 5.30pm. Due to the complex needs of the people living at the home the inspectors were unable to have in-depth conversations with anyone however time was spent formally interviewing 4 care staff, looking at records and indirectly observing care practices before giving feedback to members of the management team. As this is the second inspection to take place at the home this year, both this report and the one published in June should be read by interested parties in order to gain a complete overview of standards maintained by the home. Since the last inspection the previous manager has left and a senior care manager promoted to the vacant position. By the end of the visit the inspectors were satisfied that although this change in management has caused some disruption it does not appear to have affected the care provided to people living at the home. What the service does well: What has improved since the last inspection? Since the last inspection training systems in the home have been altered resulting in the home now having its own allocated budget. This has resulted in staff undertaking more training which has increased their knowledge needed for caring for people at the home. Training undertaken includes adult protection and communication, as well as some mandatory training such as fire. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 6 Also since the last inspection staffing levels have been maintained to an acceptable standard. This has greatly improved the level of care provided, with service users able to now participate in more activities. As part of the quality monitoring systems in place the views of service users and their families have been sought. These now need to be analysed and incorporated into future development plans for the home. 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. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed at previous inspection. EVIDENCE: Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9. Risk assessment processes although adequate do not promote independence for service users. EVIDENCE: The inspector sampled 3 service users files and found that they all contained risk assessments that correspond with aspects of their plans of care such as activities, the building, health needs and communication. However it was noted that many of these have not been based on the individual needs and capabilities of each person living at the home. For example each person has a risk assessment for swimming and the use of the sandpit that contains identical information despite one person have specific mobility needs who does not access these facilities. The inspector also found that risk assessments did not contain agreed review dates and that some had not been reviewed since 2003. When interviewing staff they were asked if service users are allowed to take risks and to explain the risk assessment process. No one demonstrated knowledge in this area, comments included, “no they cannot take risks, we have to make sure no harm comes to them” and “I only filled in a risk assessment on Monday, I had never seen one before.” Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 14 and 16. Care planning to support personal development is poor and does not demonstrate that independence is increasing. Recording of activities is poor in this home and does not demonstrate that service users are offered daily variation. The daily routines in this home are flexible and support service users to exercise choice and control over their lives. EVIDENCE: Due to the planned closure of the home with the majority of service users moving into supported living environments particular attention was given to assessing the support service users receive to develop their living skills and education. All files that were sampled contained information relating to activities that service users like to participate in and some also contained activity timetables for domestic skills, sensory awareness and communication skills, however no care plans were found to be in place for anyone that detailed specific aims, what staff support is required and progress to meeting aims. In addition to this the individual diaries used by the home to record activities undertaken by service users were found to contain very little evidence of Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 11 activities taking place. For example one service users diary stated that for a 3month period they had ‘played with toys and relaxed in the bath’. It was also noted that monthly summary sheets for activities sampled for 3 service users had not been completed since May 2005. These issues were discussed with the management present who acknowledged improvements in recording systems were required. The lack of consistent recording systems was also reinforced when interviewing staff, many of whom were unsure of where to find information and also where to record information relating to activities. For example one person stated, “the diaries are used to detail activities and care plans only give health information,” yet another person stated, “staff look in the care plans to find out what activities a person enjoys”. The home should be congratulated for the Essential Lifestyle Plans that are in place for each service user. These provide staff with specific information aimed at promoting service users independence and involvement it decisions relating to their care. They contain detailed information of preferences and dislikes for all aspects of their life including clothing, foods, people, activities and environment. The inspector found these to contain information that was important when delivering care and recommended that staff as part of the induction process read these. The majority of service users living at the home have learning disabilities and other complex needs which impact on them being able to undertake rights such as opening their own mail. Because of this written consent has been obtained from service users representatives for the home to undertake many of these daily tasks. All staff that were interviewed demonstrated knowledge of how to support service users to be independent and their rights to make choices. Responses include, “we offer 2 meals or 2 items of clothing, if a service user points at one we use that as a sign of choice” and “we try to let people do as much for themselves. If bathing we encourage to wash and only give assistance if needed”. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 12 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): 20. Minor amendments will ensure medication practices protect those living at the home. EVIDENCE: During the inspection records for the administration of medication were assessed. Three files were checked and all contained a photograph of the service user and fully completed MAR sheets. Care plans reflected the correct medication as prescribed on MAR sheets by GP. There are no risk assessments in place for the service users with regard to self-administration. Discussion took place with the manager; Service users must be encouraged to promote independence however small the task. There are clear guidelines and procedures for the administration of medication. The policies however do not reflect practice with regard to the storage of controlled drugs. EG policy states “controlled drugs are not to be stored with any other medication “ but in practice they were in the same cupboard. The inspectors were concerned to see that medication was no longer in a separate cupboard. Care files were now kept in with the medication. Meaning that some medication was left on the top. And staff had access to the cupboard. Discussion took place with the manager with regard to this practice. She assured inspectors the files would be removed. Controlled drugs were also stored in this cupboard. It is recommended the pharmacy inspector be contacted to advise on the correct storage of medication. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 13 Regular reviews took place with consultants and GP but records are unclear. GP signs to say, “records reviewed” but no evidence of how many or whose medication had been reviewed. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 14 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): Standards assessed at previous inspection. EVIDENCE: Although not assessed it was noted by the inspectors that since the last inspection the majority of staff have now undertaken adult protection training. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 15 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 (not assessed in full). The standard of the environment within this home is adequate, generally providing service users with a comfortable place to live. EVIDENCE: The inspectors completed a tour of the building and found generally that the home is maintained to an acceptable standard. It was however noted that several bathroom and bedroom windows were open resulting in these rooms being very cold. The fire department inspected the home in September 2005 making 4 requirements, 2 of which still require addressing. The manager stated that the fire department had informed them that these would not require attention due to the home closing next year. The inspector said that if this was the case written confirmation must be obtained from the fire department and forwarded to CSCI otherwise the requirements still stand. The laundry was inspected and found to be well ordered, with a clear procedure for the washing of soiled laundry. Two washing machines were available one, with sluice facility and also a separate sluice room. Hand sinks; paper towels and protective clothing are all available for staff. The laundry was clean and tidy. Staff interview during the inspection were aware of Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 16 the infection control procedures. They also confirmed they would be attending training in infection control the following day. There is evidence of knowledge and good practice however the policies and procedures do not reflect this. There are some corporate policies and guidelines from the Internet and other organisations but none for Fallings Heath. A risk assessment for infection control needs to be completed. The manager had already identified the need for a risk assessment but had not yet completed one. Cosh records are kept for all cleaning materials used. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 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): 33, 34, 35 and 36. Improvements in staff training have resulted in staff gaining sufficient knowledge to care for the people living at the home. Generally staffing levels are maintained to a satisfactory level, ensuring service users receive a consistent service. Further improvements must be made in relation to recruitment practices to ensure service users are not placed at risk. Staff do not receive regular formal supervision, this has the potential to affect moral within the home. EVIDENCE: On the day of inspection many of the staff at the home were undertaking communication training (a requirement identified in a previous inspection) in order that they can communicate effectively with service users. The manager was informed that once a date is arranged for the outstanding staff members this requirement would be met. There is presently 18 staff employed at the home, 4 of which hold an NVQ level 2, 4 of whom are working towards this and on who is working towards attaining a NVQ level 3. No records could be found that demonstrated arrangements being place for the remainder of the staff group to undertake this qualification. Records seen by the inspectors confirmed that staffing levels are now being maintained to agreed levels. The Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 18 home was congratulated regarding this as previously staffing shortages had been impacting on service provision. The home has partly addressed a previous requirement to ensure the appropriate staffing records are maintained in the home. 4 files were sampled, all contained some information but none contained everything required by legislation. The inspectors were particularly concerned that one person did not have a CRB disclosure and that a POVA first check had not been obtained as an interim measure. The manager explained that this person has no direct contact with service users and never works in isolation, however the inspectors instructed that a POVA first check be obtained and a detailed risk assessment completed. Some improvements to training systems have been made since the last inspection, with the home now having its own budget and training being arranged based on the needs of the home. Further work is still required to address requirements identified in previous inspections relating to equal opportunities training and training assessments. No progress has been made to address requirements relating to staff meetings and supervision sessions. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 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): 39 and 42. Although the home monitors the quality of service provision, this is not completed systematically, focusing on improvements to those who receive a service. Generally management practices within the home promote and safeguard the health, safety and welfare of service users, staff and visitors. EVIDENCE: Quality Assurance monitoring has been started. Residents and families have completed questionnaires. It is to be complemented that advocates were involved in supporting residents to complete forms. The information has been collated but further development needs to take place. Regular monitoring of some records e.g. fire, medication and care plans take place but a formal system of monitoring needs to be developed. The manager informed inspectors that an action plan was completed for 2004/2005 however she was only able to evidence some sections of the plan. Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 20 Pre-inspection documentation supplied to CSCI demonstrates that the carries out health and safety checks of the building and facilities including gas, electrical items and compliance for Legionella in line with its obligations. A requirement relating to staffs mandatory training in areas of health and safety has been partly met with the majority of staff now having undertaken fire training and dates arranged for food hygiene, infection control and first aid. When looking at the policies and procedures for the management of fires the inspectors were concerned that these did not reflect the needs of the service users and staffing ratios (in particular at night). Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 2 12 2 13 X 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fallings Heath House Score X X 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000033324.V268580.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9 Regulation 13(4) Requirement Risk assessments must be completed for all service users based on their individual needs and capabilities. Risk assessments must include agreed review dates. Risk assessments must be reviewed on the agreed review dates. 2 YA11 16(1) The home must implement care plans for the social, emotional, communication and independent living needs of service users. Care plans must include specific aims; support needed by staff and agreed review dates. The home must review and amend the recording systems in place relating to service users activities. Records must demonstrate that service users are offered a range of in house and external activities, on a regular basis. The home must implement self medication risk assessments DS0000033324.V268580.R01.S.doc Timescale for action 31/01/06 31/01/06 3 YA14 16(1) 31/01/06 4 YA20 13(2) 31/01/06 Fallings Heath House Version 5.0 Page 23 5 YA20 13(2) based on each persons individual capabilities. The home must follow its policies and procedures for the storage of medication. Further detail must be recorded when medication is reviewed by the GP. Room temperatures must be maintained at a constant throughout the winter months. All requirements identified in the fire departments report must be acted upon, or written evidence supplied to CSCI from the fire department stating that this is no longer the case. Policies and procedures for the control of infection must be specific to practices within the home. A risk assessment for infection control must be implemented. All staff must hold a NVQ level 2 or above, or be working towards achieving this. The home must ensure staff (including regular agency staff) have training in communication methods relevant to the needs of service users – Part met. Requirement originally made February 2004. The home must ensure that all records in Schedules 2 and 4 of the Care Homes Regulations 2001 are kept in the home for all staff, including regular agency staff – Part met. Requirement originally made July 2002. A risk assessment must be completed for the staff member who does not hold a CRB disclosure. A POVA first check must be 31/01/06 6 7 YA24 YA24 23(p) 23(4) 23/11/05 31/12/05 8 YA30 16(1) 31/01/06 9 10 YA32 YA33 18(1) 18(1) 31/03/06 31/01/06 11 YA34 Schedules 2,4 31/12/05 12 YA34 19 30/11/05 Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 24 obtained for anyone who does not hold a CRB disclosure. 13 YA35 18(1) The home must ensure all staff; including regular agency staff receive equal opportunities training – Requirement originally made February 2004. The home must ensure all staff, including regular agency staff have an individual training and development assessment – Part met. Requirement originally made February 2004. An impact assessment of all staff development must be undertaken to identify the benefits for service users and to inform future planning – Requirement originally made February 2004. Issues discussed in staff meetings should have evidence of action taken, by whom and date completed – Requirement originally made June 2005. All staff, including regular agency staff must have at least 6 supervision sessions a year – Requirement originally made June 2005. Information gathered from the service user/family questionnaires must be analysed, with the findings incorporated into the development plan for the home. A formal quality assurance system must be implemented. An annual audit of the quality assurance system must take place. All staff, including regular agency 01/02/06 staff must undertaken moving and handling, fire safety, food DS0000033324.V268580.R01.S.doc Version 5.0 Page 25 31/01/06 14 YA35 18(1) 31/01/06 15 YA35 18(1) 31/01/06 16 YA36 18(2) 31/12/05 17 YA36 18(2) 31/01/06 18 YA39 24 31/01/06 19 YA42 13(3-6) Fallings Heath House 20 YA42 13(3-6) 21 YA42 13(3-6) hygiene, first aid and infection control training – Part met. Requirement originally made September 2003. All staff that complete risk assessments must undertake training in order to complete this task – Requirement originally made June 2005. The home must review all of its fire policies and procedure and ensure they are specific to the needs of service users and the numbers of staff on duty during the day and night. 31/01/06 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA7 YA20 Good Practice Recommendations It is recommended that the home implement service users meetings as a tool to involve them in decision making processes It is recommended that the home seek advice from the pharmacy inspector in relation to the storage of medication Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Fallings Heath House DS0000033324.V268580.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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