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Inspection on 31/05/05 for Fern Croft

Also see our care home review for Fern Croft for more information

This inspection was carried out on 31st May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

New people wishing to move into the home have the opportunity to visit and then stay overnight before making up their minds whether they would like to live there. Care plans reflect the needs of people living at the home who have been involved in this process. They sign many records on their files. They spoke positively about the staff team supporting them. People living in the home have access to a wide range of social, recreational and educational activities that reflect their needs, goals and wishes. The standard of accommodation at the home is of a very high quality. People have en suite facilities in their rooms and access to homely and comfortable communal spaces.

What has improved since the last inspection?

The quality of written records has improved. New care plans and risk assessments are in place that are being regularly reviewed. The records maintained for personal finances have significantly improved. These safeguard people living at the home from financial abuse. Staff have attended training in the management of challenging behaviour which has reduced the use of physical intervention. There has been some improvement in recruitment and selection records.

What the care home could do better:

Staff must not be employed without a Povafirst check in place and the necessary employment information. Staff must ensure the safe administration of medication. Training which relates to the needs of people living in the home should be provided for staff. Night staff must attend regular fire training.

CARE HOME ADULTS 18-65 Fern Croft 14 Heathville Road Gloucester GL1 3DS Lead Inspector Lynne Bennett Announced 31 May 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fern Croft Address 14 Heathville Road Gloucester GL1 3DS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01452 505803 01452 528587 New Beginnings (Gloucester) Ltd To be appointed Care Home only (PC) 7 Category(ies) of LD - Learning Disability - Both (7) registration, with number of places Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th December 2004 Brief Description of the Service: Fern Croft is a residential care home registered for seven adults with a learning disability in the Kingsholm area of Gloucester. The home specialises in supporting people who may present with behaviours that challenge services. There are presently three people living at the home and a fourth person was due to move into the home the day after the inspection. The home is part of ‘ New Beginnings’ that was first established in Gloucester in 2002. The home, which opened in January 2004 provides single en suite accommodation for six people and a second floor bed sit for one person. They have access to a large comfortable lounge, spacious dining room and domestic size kitchen. To the rear are spacious gardens that are being landscaped to include a patio, decking and sensory area. People living at the home have access to the home’s small mini-bus and use local transport. The home has access to local facilities and is conveniently situated near to Gloucester city centre. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection began at 9.30 on a day in May 2005 and lasted just over six hours. All people living at the home were spoken to along with three members of staff, the acting manager and the quality assurance manager. A tour of the home was completed. A range of records were examined including admission information, care plans, risk assessments and financial records. Staff files were sampled and health and safety records were also available. A pre-inspection questionnaire was provided with copies of the rota, menus and staff training. An immediate requirement was left stating that the registered person must not allow staff to work in the home without a Povafirst check in place and the other documents as identified in Schedule 2 of the Care Homes Regulations. What the service does well: What has improved since the last inspection? The quality of written records has improved. New care plans and risk assessments are in place that are being regularly reviewed. The records maintained for personal finances have significantly improved. These safeguard people living at the home from financial abuse. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 6 Staff have attended training in the management of challenging behaviour which has reduced the use of physical intervention. There has been some improvement in recruitment and selection records. 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. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The admissions process provides prospective residents with the opportunity to make an informed choice about whether they wish to live at the home. Comprehensive information is obtained about people wishing to move into the home so that the home can ensure that they can meet their needs. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed since the last inspection and are accessible to people living at the home. One person was due to move into the home the day after the inspection. The placing authority had provided admission information for this person. This included a community care assessment of need and an individual plan provided by the CLDT. Managers from the home visited the person compiling their own assessment with input from the family. The person had visited the home on several occasions building up to an overnight stay. Full records of these stays have been kept by the home. Staff spoken to have a good understanding of the needs of the new person and how they are to be supported. Information about the person’s condition had been provided to staff. New Beginnings has arranged for continued support for the person from the Community Learning Disabilities Team (out of county) when the move to Fern Croft is completed. The statement of terms and conditions has been amended by New Beginnings to reflect that people living at the home do not make a contribution towards Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 9 transport. Placing authority contracts are accessible to people living in the home. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9. People living at the home are fully involved in care planning and agree and sign records on their files. Individual risk assessments encourage and support people living at the home to challenge and deal with problem areas in their lives. EVIDENCE: A new format has been introduced for care plans and risk assessments. These are partially based on a Pathways to Independence assessment and provide a record of people’s individual needs and personal goals. People living at the home sign them. It was evident that annual reviews are taking place with records being provided by the placing authority. Key workers produce a monthly review of each person’s needs. Since the last inspection there has been considerable involvement with the Community Learning Disabilities Team. People living in the home have had access to the Community Team, Speech and Language Therapist and Consultant Psychiatrist. A consultant psychologist has been employed by the home to set up reactive strategies and provide additional support to people living in the home and Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 11 staff. Staff monitor any incidents at the home using ABC charts. Any incidents affecting the wellbeing of people living at the home are being reported to the Commission. Any restrictions to peoples’ rights, freedoms or choices are clearly recorded in consultation with the person and a social worker. All parties have signed these records. They are in place to protect the health, safety and welfare of people living at the home. There has been a significant improvement in the record keeping for people’s personal finances. Expenditure is cross-referenced with receipts and debits from bank accounts are monitored regularly. This addresses concerns highlighted at the last inspection. Risk assessments cover a wide range of hazards that people living at the home may face. These are regularly reviewed and are signed by people living at the home and staff. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15 and 17. Social and leisure activities are varied and tailored to individual need enriching the lifestyles of people living at the home. Contacts with family and friends are supported. Contacts are being established locally enabling people living at the home to be part of their local community. EVIDENCE: People living at the home access a wide range of social, leisure and educational facilities. They said that they enjoy going to two social clubs each week to meet with friends. They also use the local post office and church on a regular basis. Trips to a café each week are a favourite. They said that they like to help prepare meals and to help with the weekly food shop. Some are supported to attend college in Gloucester and they are planning to attend a summer workshop at Stroud College. In addition to regular activities one-off day trips are arranged and an annual holiday. The home is adopting the total communication approach and is planning to produce a range of information using photographs and symbols. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 13 Contact with family and friends are supported either through visits, by telephone or meeting at social events. People living at the home decide the menu for the week each Sunday. Once a week they have a takeaway meal and a roast dinner. Another evening two people attend cookery class at college and produce a meal that they eat at college. A range of fresh and frozen ingredients are provided including fresh vegetables and fruit. On the day of the inspection people living at the home enjoyed a lunch of a baked potato with cheese and baked beans. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18.19 and 20. The healthcare needs of people living at the home are clearly recorded and monitored enabling people to access healthcare professionals when required. An improvement is needed in the administration and control of medication to reduce errors so ensuring the health and safety of people living at the home. EVIDENCE: The way in which people living at the home would like to be supported is recorded on their files. Staff have a good understanding of their personal needs. People living at the home are registered with a GP and there is input from other healthcare professionals on a regular basis. The Community Learning Disabilities Team is helping to desensitise one person at the home who has a fear of medical treatment and hospitals. Staff are taking this person to the café in a local hospital as part of this process. This appears to be helping. It is apparent that staff monitor the health and wellbeing of people living at the home and take appropriate action when necessary. Staff administer medication to people living at the home. They have completed accredited training in the safe handling of medication as well as epilepsy and the administration of rectal diazepam. Consent forms for people Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 15 receiving medication must be in place. Two people should countersign handwritten entries on medication administration records. A list of homely remedies that can be used is in place and this has been approved by the GP. Protocols are in place for the use of ‘as required’ medication and stock records are kept for these drugs. Two recent medication errors had been reported to the Commission under Regulation 37 and action had been taken by the acting manager to reduce the risk of these occurring again. This included re-training and re-assessment of staff. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 An environment is being created where people living at the home are able to air their concerns. There has been a significant improvement in the management of challenging behaviour protecting the safety and welfare of people at the home. EVIDENCE: A complaints procedure has been produced in a format appropriate to the needs of people living at the home. One complaint had been received by the home and dealt with appropriately. Staff have access to the Gloucestershire Adults at Risk policy and procedures although they have not received training in the protection of vulnerable adults. This must be arranged. Staff have a good understanding of the whistle blowing procedure and are confident that the acting manager would challenge poor practice. There has been a substantial improvement in the management of challenging behaviour at the home. Staff have completed training with a provider accredited with BILD and commented that they feel more confident using diversion and de-escalation techniques. ABC charts evidence a reduction in the use physical intervention. The consultant psychologist is developing a protocol and strategies for the home in the management of challenging behaviour. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,27,28 and 30. The home provides a homely and comfortable environment with ample communal spaces but also privacy for people living there. The home must meet with the requirements of the fire service ensuring a safe environment. EVIDENCE: The standard of accommodation provided at Fern Croft is very high. Since the last inspection a new three-piece suite has been provided and environmental issues identified in the last report have been actioned. An immediate requirement was issued to ensure that the side gate that is a fire exit is rehung to open in the opposite direction. This is an outstanding requirement from a fire inspection. There are also plans to remove the fence to create a larger car park. The rear garden is laid to lawn and patio. The acting manager is planning to redevelop this large area. People living at the home provided a tour of the building and their rooms. They said they are happy with their rooms. They reflect their interests and Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 18 their personalities. All rooms have en suite facilities. Toilets and additional bath/shower rooms are satisfactory. A new person moving into the home does not like to have windows open. The home must provide an alternative source of ventilation for the room. There were some minor environmental issues which must be resolved including fixing a fly screen to the kitchen window, repairing cracks to an external wall at the rear of the home and to repair the window frame in the outhouse. The inspection was carried out on a warm day in May but the heating was on throughout parts of the home. There are problems with the boiler so that when hot water is required the heating is coming on automatically. Some radiators have been shut off but those with radiator covers were still functioning. This must be resolved. Staff have access to a small laundry. Personal protective clothing is provided and red disposal bags are in situ for soiled laundry. Staff are completing training in infection control in June. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35 and 36. A satisfactory training programme is in place for staff that could be further improved to ensure that this reflects the needs of people living in the home. There are serious concerns about the recruitment and selection of staff and that it could be failing to ensure the safety of people living at the home. EVIDENCE: People living at the home are supported by a staff group of mixed experiences, knowledge and skills. Six of the staff team have a NVQ award in care and two are completing awards. Some staff are completing a Care Practice course which is equivalent to the Skills for Care Foundation Award as part of their induction. The Learning Disability Award Framework training is not yet available to staff at the home although the manager is looking into this. Staff complete mandatory training and refresher courses as appropriate. Staff said that they would benefit from specialist training particularly in the area of autism and specific to the needs of people living at the home. Fire training is scheduled for the beginning of June. Night staff are presently not receiving training at appropriate intervals. One member of the night team is not attending the annual training provided by an external provider. All night Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 20 staff must attend at least an annual training course of this type with three internal training sessions. This must be put in place. Staffing ratios reflect the needs and commitments of people living at the home. There is presently a vacancy for a night staff member. Files for two new members of staff confirmed that there is evidence of their identification in place, as well as a full employment history and two references. The acting manager must ensure that the reason for leaving is obtained from previous employers in the care field. Although both staff have a Criminal Records Bureau check in place, one member of staff started work before a Povafirst check was obtained. Staff must not commence work in the home without this check and other information as listed in Schedule 2.1-6 and 8-9. An immediate requirement was issued and a warning letter was sent to the Responsible Individual indicating that if this happens again the Commission will take further action. The process for appointing staff without a Criminal Records Bureau check was explained to the acting manager and what would need to be put in place. Criminal Records Bureau checks for other staff were sampled and found to be satisfactory. The acting manager is scheduling supervision sessions every six weeks and senior and team meetings monthly. These have recently been put in place. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38 and 42. The acting manager has a clear developmental plan and vision for the home that will improve the quality of care provided. Health and safety systems are mostly satisfactory providing a safe environment in which to live. EVIDENCE: The acting manager is being processed by the Commission to become the registered manager for the home. She is completing a Registered Managers Award at Level 4. Certificates of registration and insurance were displayed appropriately. The acting manager has shown a willingness to work with the Commission. Staff said that the acting manager was open and approachable and that the management team were making positive improvements within the home. Health and safety records confirmed information supplied in the pre-inspection questionnaire that a safe environment is being maintained in the home – with Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 22 the exception of the rear fire exit. The environmental risk assessment was reviewed in May 2005. Staff are monitoring fridge and freezer temperatures, temperatures of cooked food and water outlets on a regular basis. Systems are in place for the monitoring of fire equipment, drills and training. Hazardous products are locked away and COSHH data sheets being obtained for any new products purchased. Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 1 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fern Croft Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 24 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. 2. 3. Standard 20 23 24 Regulation 13(2) 18(1)(c) 23(4)(b) Requirement Consent forms for the administration of medication must be in place. Training in the Protection of Vulnerable Adults must be provided. The fire exit gate from the back garden must be rehinged so that it opens in the opposite direction. Provide an alternative source of ventilation in the room for the new service user. Make good the window frame in the outhouse. Repair cracks to external wall at rear of house. Resolve problems with hot water and heating supply. Staff must not commence work without a PoVAFIRST check in place and without written confirmation of the reason they left former care positions. Night staff must attend fire training every three months. Timescale for action 30 June 2005 31 Dec 2005 30 June 2005 30 Sept 2005 4. 24 23(2)(b) (q) 5. 34 19(1) Sch 2 31 May 2005 6. 35 23(4)(e) 30 June 2005 Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 25 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. Refer to Standard 20 28 34 35 Good Practice Recommendations Handwritten entries should be countersigned by two people. Medication records should include a photograph of each service user. A flyscreen should be fitted to the kitchen window. Staff should complete LDAF training as part of their induction. Specialist training should be provided - eg autism Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 26 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Fern Croft D51_D03_S48719_Ferncroft_V227978_310505_Stage4_A.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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