Inspection on 07/02/07 for Fen Grove (76)

This inspection was carried out on 7th February 2007.

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

The inspector 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

Fen Grove (76) 04/10/05

Fen Grove (76) 05/07/05

Fen Grove (76) 06/01/05

Fen Grove (76) 30/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Fen Grove (76) 76 Fen Grove Blackfen Kent DA15 8QQ Lead Inspector Lorraine Pumford Unannounced Inspection 7th February 2007 14.30p Fen Grove (76) DS0000038222.V307676.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 Fen Grove (76) DS0000038222.V307676.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. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fen Grove (76) Address 76 Fen Grove Blackfen Kent DA15 8QQ 01622769100 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) MCCH Society Limited Mrs Tina Donna Morgan Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2006 Brief Description of the Service: 76 Fen Grove is a care home, which provides care for up to four adults with learning disabilities. Maidstone Community Care Housing Ltd (MCCH) operates it. The home is a detached bungalow, situated in a residential area and within easy reach of local transport, services and shops. There is a large kitchen/diner, a lounge with patio doors, which open onto the garden and a small utility room. There is no dedicated office, so the utility room is also used as an office. The home has a bathroom with toilet and there is an additional toilet. There are two single bedrooms and one double and a large rear garden. At the time of the inspection, there were four service users in residence and no vacancies. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over a two-day period. During this time the manager and staff were spoken with. The service users have profound learning difficulties and therefore their ability to contribute verbally to this inspection was limited; however staff completed surveys on their behalf. A number of documents and records were examined, in particular those relating to the care of two service users and two members of staff. A tour of the premises was also undertaken. Prior to this inspection taking place service users and their representatives were given the opportunity to complete questionnaires and their comments have been incorporated into this report. The home has received one other inspection in the past twelve months; this was to ascertain progress in relation to requirements made at a previous inspection. What the service does well: MCCH has systems in place to assess prospective service users to the home. Care plans are comprehensive and identified service users’ needs and action to be taken by staff to meet them. All of the documents are service user friendly and where possible a pictorial format is used. This includes adult protection information for service users. There are comprehensive risk assessments undertaken in relation to service users’ day-to-day activities. Service users benefit from the home having its own minibus and are able to participate in local community events. Staff endeavour to find activities for service users, which reflected their interests. Sound medication procedures safeguard service users’ health and well-being. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The privacy screen in the shared bedroom is inadequate for the purpose and is also potentially hazardous as it could easily fall over if inadvertently leant against - more appropriate screening must be provided. An audit of furnishings must take place as it was noted that the doors and draws to some bedroom furniture were in need of remedial work or replacement. Discussion took place with the manager regarding the purchasing of bedroom furniture, furnishings and bed linen. The manager stated that in the past service users’ money has been used to purchase replacements. The manager was advised that it was the responsibility of MCCH to ensure the home is appropriately furnished to the National Minimum Standards and the service Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 7 users’ personal allowance should only be used to purchase items when individuals have the ability to make choices for themselves. A requirement has been made following a number of previous inspections stating that the use of the laundry room as an office is unsatisfactory as there is no space for private conversation i.e. supervision, or to store confidential records. MCCH have explored a number of ways to address the issue; however the cost of converting either the garage or attic prevented a longterm solution to the problem. The CSCI acknowledge that this option is not financially viable for such a small service and therefore a requirement has not been made in relation to this issue. However, the organisation should continue to seek alternative ways of addressing the issue. There was no evidence that POVA checks have been completed on staff and the manager was advised that the system operated by the organisation should be able to provide evidence in relation to this. 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. The summary of this inspection report can be made available in other formats on request. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 8 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 Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is good. The needs of prospective service users are assessed prior to admission. EVIDENCE: The service user group has remained the same for the last four years. MCCH has systems in place to assess prospective service users to the home. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide staff with sufficient information to enable them to meet the assessed needs of service users. EVIDENCE: It was possible to get a clear and individual picture of each service user from records seen. Care plans are comprehensive and identified service users’ needs and action to be taken by staff to meet them. There was guidance for staff in relation to interpreting and understanding the behaviour exhibited by service users who have limited ability to verbally express themselves. All of the documents are service user friendly and where possible a pictorial format is used. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 11 Detailed records of service users’ health, activities and general demeanour are maintained by staff on a daily basis. A new form has recently been introduced which will provide key information in the event of a service user being admitted to hospital in an emergency. Staff were able to demonstrate ways in which they encourage service users to make decisions by offering service users the choice of activities they wish to participate in, clothing, food and drink. The support of an advocate has been arranged for one service user who does not have any regular contact with relatives to act on his behalf. None of the service user group is able to manage their finances independently and the registered manager is the named appointee. From discussion with the manager and records seen it is apparent that there are procedures in place to safeguard service users’ money. An audit was undertaken of two service users personal allowance - the money held tallied with records seen. In addition each service user benefits from their savings being deposited in a building society account. Records seen indicate that there are comprehensive risk assessments undertaken in relation to service users’ day-to-day activities, i.e. risk assessments was seen in relation to service users travelling outside the home and attending the swimming pool. Risk assessments had also been completed for the use of equipment such as safety rails and wheelchairs. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with relevant social and leisure activities and a varied nutritional diet. EVIDENCE: A requirement was made at the time of the previous inspection asking the manager to ensure staff provided written evidence service users are provided with the opportunity to participate in varied social and leisure activities. Action has been taken to address this requirement and it was apparent from talking to staff and records seen that service users are provided with a varied range of social activities. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 13 Service users benefit from the home having its own minibus and are able to participate in local community events. In addition service users also attend local day centres for part of the week. Service users have an annual holiday which they pay for themselves. MCCH pay for food and the staff to accompany service users. From discussion with staff it is apparent that they endeavour to find activities for service users, which reflected their interests. For example one service user enjoys watching cowboy films on TV and staff have arranged to take him on a Western weekend. Service users are supported to maintain links with family and friends. The manager stated that a number of parties are held throughout the year and relatives are invited to attend. Lots of photographs had been taken of these events which had happened in recent months. None of the service user group are able to participate in household tasks and require the assistance of staff to open and process correspondence. Staff working in the home interacted with service users and included them in conversation and household activities they were undertaking. Menus seen indicated that service users are provided with a varied nutritional diet. Staff stated that people who require a soft diet have the same food as the other service users and food is pureed in a food processor to a consistency, which is safe for them to eat. Information in one service user’s care plan stated needs to establish a weight loss programme . Discussion took place with the manager regarding the need for specific guidance for staff to follow, to be provided following discussion with the practice GP or nurse. The majority of service users required assistance with meals; the inspector observed that staff assisted service users in a calm relaxed and appropriate manner. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with appropriate health care. Sound medication procedures safeguard service users health and well-being. EVIDENCE: The manager has obtained personal health profiles which enable staff to keep relevant information regarding service users’ healthcare and appointments. It was good to see this document has been produced in a pictorial format which is user friendly. The manager stated she has asked all staff to record information regarding service users’ appointments in the staff communication book. Staff have also received training to help routinely provide service users with basic health checks i.e. observation of changes to body shape as part of their personal care routine. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 15 Since the last key inspection the manager has arranged for the appropriate health care team to carry out risk assessments for each service user regarding the likelihood of them developing pressure areas. Those assessed as a high risk received appropriate pressure relieving equipment such as specialised mattresses, sheepskin covers for wheelchairs etc. In addition service users are able to benefit from an Aromatherapist who visits up to three times a week to massage services at risk of developing pressure areas. An audit of medication was undertaken for two service users. Medication is safely stored, recorded and administered. The manager stated she carries out a regular audit of medication and medication is also checked at the time of daily staff handovers. Relevant protocols were in place for PRN medication. Staff spoken with confirmed that they have received training in relation to the administering rectal Diazepam to service users if required. The practice nurse attached to the GPs surgery stated that communication from the home was good and she was satisfied with the overall care provided in the home. A requirement was made at the time of the previous inspection stating the walking frame essential for a service users mobility should either be repaired or replaced. Action has been taken to address this. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good .This judgement has been made using available evidence including a visit to this service. MCCH ensures that service users and their relatives are provided with information regarding the organisations complaints procedure. EVIDENCE: MCCH has a comprehensive complaints procedure, which is also available in a pictorial format. The CSCI have received no complaints regarding the care or service provided in the home since the last inspection. Relatives who completed CSCI surveys stated they were aware of the organisation’s complaints procedure; however there had been no reason to raise any concerns with them. In addition MCCH have prepared pictorial adult protection information for service users, is someone hurting you. This was clearly displayed in the kitchen/diner at an appropriate height for wheelchair dependent service users. A member of staff spoken with stated that she had not yet attended an adult protection training course; however, this had been addressed at the time of her induction and she was aware of the term whistleblowing. She stated that if Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 17 she had any concerns she felt able to discuss them with senior staff working in the home. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are provided with a homely environment. EVIDENCE: Two service users are accommodated in a double bedroom. The manager stated that in the event of one of the service users moving on the room would be occupied by one service user. At present there is a freestanding screen which is used to protect service users’ privacy when requiring assistance from staff with personal care. The screen is inadequate for the purpose and is also potentially hazardous as it could easily fall over if inadvertently leant against. The manager agreed to provide appropriate curtains for the purpose. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 19 Since the last inspection the lounge has benefited from redecoration. Staff have provided support to enable service users to individually personalise their bedrooms. An audit of furnishings must take place as it was noted that the doors and draws to some bedroom furniture were in need of remedial work or replacement. Discussion took place with the manager regarding the purchasing of bedroom furniture, furnishings and bed linen. The manager stated that in the past service users’ money has been used to purchase replacements. The manager was advised that it was the responsibility of MCCH to ensure the home is appropriately furnished to the National Minimum Standards and the service users personal allowance should only be used to purchase items when service users have the ability to make choices for themselves. A requirement has been made following a number of previous inspections stating that the use of the laundry room as an office is unsatisfactory as there is no space for private conversation, supervision, or to store confidential records. Discussion took place with the manager and the Client Service Manager regarding this issue. The client service manager stated that MCCH had explored a number of ways to address the issue; however the cost of converting either the garage or attic prevented a long-term solution to the problem. The CSCI acknowledge that this option is not financially viable for such a small service. However, the organisation should continue to seek alternative ways of addressing the problem. For example discussion took place regarding the possibility of building a conservatory which could be appropriately furnished and heated for the purpose of an office. Staff stated that laundry equipment is appropriate to meet the current needs of the service users accommodated. Red sacks are used to transport linen around the home to the laundry. The home was free from any unpleasant odour on the day of inspection. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have benefited from the increased number of permanent staff employed. EVIDENCE: Since the last inspection action has been taken by MCCH to recruit additional staff to work in the home on a regular basis. At 11 a.m. the two members of staff on duty were still assisting service users with personal care and preparation for the activities that day. Staff stated that as none of the service users were due to attend the day centre it was possible to take more time to undertake these tasks. Discussion took place with staff in relation to the tasks still to be undertaken for that day. This not only included activities (additional staff came on duty to assist with this) but also meal preparation, cleaning and laundry etc. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 21 The staff rota seen indicated that staff working in the home were routinely undertaking additional shifts as bank staff and in some instances staff were subsequently working long days i.e. from 8 a.m. to 10 p.m. The inspector voiced concern that the size of the home meant that it was not possible for staff to have adequate breaks away from service users. Tippex had also been used to amend changes to the staff rota, and discussion took place with the manager regarding the fact that the rota is a legal document and a more appropriate method of amending documents was discussed. At present there is only one member of staff on waking night duty. The manager stated that this was based on the fact that none of the service users residing in the home required any attention during the course of the night. Discussion took place with the manager regarding the need to keep under review the current staffing levels. All staff employed either have obtained an NVQ2 qualification or are due to commence the course in the near future. A requirement was made at the time of the previous inspection in relation to the need for records pertaining to staff recruitment to be kept in the home and available for inspection. The files of two members of staff recently employed were examined, and these indicated action had been taken to address this. There was evidence that prospective staff had completed applications and provided names of referees which had been taken up. There was also evidence that CRB checks had been undertaken. There was no evidence that POVA checks have been completed and the manager was advised that the system operated by the organisation should be able to provide evidence in relation to this. Copies of staff training certificates had also been retained and were available for inspection. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place to monitor the quality of the care and service provided. EVIDENCE: The manager has a number of years experience working with people with learning disabilities and holds a relevant qualification. Staff spoken with stated that regular staff meetings take place and they are able to voice their views and opinions. A requirement was made at the time of the last inspection that a monthly audit should be undertaken by a representative of MCCH and that a copy of the Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 23 subsequent report should be forward to the CSCI. Appropriate action has been taken to address this issue. A member of care staff has the responsibility of ensuring that regular tests to the fire alarm take place and that staff received regular fire drills and training updates. Records seen indicate that hoists in use are serviced on a regular basis. From records seen and discussion with staff it is apparent they have received moving & handling training, food hygiene and a first aid qualification. The home also has an up-to-date insurance notice. Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 24 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 3 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 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 3 X 3 X 3 X X 3 X Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 25 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 YA24 Regulation 12 (4)(a) Requirement Timescale for action 02/04/07 2 YA24 3 YA34 The registered person must make suitable arrangements to ensure that the care home is conducted In a manner which respects the privacy and dignity of service users. In this instance provide appropriate privacy screen in the shared bedroom. 16(2) (C) The registered person must provide in rooms occupied by service users appropriate furniture, bedding and other furnishings, including curtains and floor covering, and equipment suitable to the needs of the service users and ensure that they are well maintained in a good state of repair. The Care The registered person should Homes provide evidence available in Regulations the home to indicate that POVA 2001 checks are undertaken on all schedule staff employed. 01/05/07 31/05/07 Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 26 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 YA17 Good Practice Recommendations Guidance and advice should be sought from a health care professional in relation to any variation of a service users diet. MCCH should continue to seek ways to provide appropriate office space for the purpose of private conversation and storage of confidential material. The managers should review staffing levels on a regular basis to insure they continue to meet service users needs. 2 YA24 3 YA33 Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Fen Grove (76) DS0000038222.V307676.R01.S.doc Version 5.2 Page 28 - 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. 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