Inspection on 11/09/07 for Flaxman Avenue (77) - City of York Council

This inspection was carried out on 11th September 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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Flaxman Avenue (77) - City of... 19/10/09

Flaxman Avenue (77) - City of... 20/09/06

Flaxman Avenue (77) - City of... 31/01/06

Flaxman Avenue (77) - City of... 12/05/05

Flaxman Avenue (77) - City of... 02/03/05

Flaxman Avenue (77) - City of... 02/09/04

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

CARE HOME ADULTS 18-65 Flaxman Avenue (77) - City of York Council 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW Lead Inspector David White Key Unannounced Inspection 11th September 2007 09:15 Flaxman Avenue (77) - City of York Council DS0000034930.V346296.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 Flaxman Avenue (77) - City of York Council DS0000034930.V346296.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. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Flaxman Avenue (77) - City of York Council Address 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW 01904 426428 F/P 01904 426428 carole.aherne@york.gov.uk www.york.gov.uk City of York Council 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) Mrs Carole Ann Aherne Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide respite care services for 2 named service users who have learning disabilities and are over 65 years of age. Date of last inspection 20th September 2006 Brief Description of the Service: Flaxman Avenue is registered to provide residential, personal, and social care on a respite basis for up to 6 adults with learning disabilities. 2 of the beds are for emergency admissions and whilst people can be provisionally booked into them as part of their rolling respite programme, it is on the understanding that if an emergency situation arises, the respite stay may be cancelled at short notice. The home is a single storey purpose built property owned by the City of York Council. All of the bedrooms are for single occupancy, three have en-suite bathrooms and three have en-suite toilets. There is currently a six-person day service being run from the lounge at the front of the home. This is staffed separately from the care service and finishes at 3.30pm so does not interfere with the respite care provision in the home. The home is located on the outskirts of York city centre, in a residential area, with good access to the city’s services and amenities. There is a large car park to the front of the home and an enclosed garden at the back of the property. The responsible individual is Mr Daryoush Haj-Hajafi and the registered manager is Mrs Carole Aherne. The full cost of a weeks stay at Flaxman Avenue was £1123.15 at the time of the site visit on 11 September 2007. The charge to people is based upon income, including benefits and capital. The service has a statement of purpose that explains the aims, objectives and philosophies of the home and this is available in alternative formats. The most recent inspection report is made available to anyone who wishes to see it. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • Reviewing information that has been received about the service since the last inspection. Information provided by the manager on an Annual Quality Assurance Assessment questionnaire. Comment cards returned from five people who use the service, five relatives and four health/social care professionals who have contact with the service. We went to Flaxman Avenue without telling them that we were going to visit. This report follows the visit that took place on the 11th September 2007. The visit lasted for 5 hours with 4 hours preparation time. Time was spent talking to people who use the service and four members of the care staff and looking at some documents. This helped in gaining an insight into what life is like for people who spend time in the home. The findings were discussed with the most senior person on duty at the end of the site visit. What the service does well: People who stay at the home are well looked after by staff, that generally know them well and are respectful towards them. People who stay at Flaxman Avenue enjoy being there. One person said, “I wish I could stay more often”. Each person who stays at the home is encouraged to make their own decisions so that they have control over their own lives. This helps in maintaining their independence. The home offers a good choice of food at mealtimes. This helps in making sure that people have options and can enjoy meals that they like. The home has a lot of equipment to help people with mobility problems. This enables people to maintain their independence in a safe way. People who live at the home say that the staff are “kind and friendly” and the manager is “approachable”. This makes the environment more pleasant for people living at the home. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staff have sufficient information about people using the service so that they are able to provide the specific care and support that each person needs. EVIDENCE: A Social Services care manager will assess the needs of people who are being considered for a placement at the home and the manager obtains a copy of the assessment before a decision is made about the person’s suitability to stay at Flaxman Avenue. People are given information and are invited to visit the home before making any decision to move there. This information is available in different formats to help people who have communication difficulties. From the information provided the home draws up an individual support plan for each person detailing the type of support they need and how this is to be given. This enables people to receive care to suit their needs. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who use the service are encouraged to make their own decisions about their daily lives. EVIDENCE: Each person has an individual support plan to provide guidance to staff about the person’s needs and the actions they need to take to meet these. The support plans focus on encouraging people’s independence and providing support in the way they prefer. Each person has a key worker so that support can be provided on a one to one basis. A new monitoring system has been introduced and this means that support plans are regularly checked so that changes in care needs can be recorded. Staff attend reviews that take place at day service placements for people who are using their service. This helps in making sure that information is kept up to date and consistent care is provided. Whilst most people where possible are Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 10 involved in the drawing up and agreement of their support plan, in one case the support plan did not have information to show that this had happened. People are encouraged to make their own decisions whilst staying at the home and this could be seen at the time of the site visit. One person who stays at the home from time to time said, “I wish I could spend more time here”. Risk assessments are in place so that any risks or limitations on the person can be taken into account in planning their care. One person’s care records contain information about their potential to be physically aggressive. The person’s support plan clearly states the measures that are to be taken to minimise any risks from the behaviour. A health professional made comments that “the home has experienced staff who are good at managing behaviours that challenge the service”. The home is introducing a new booking system for arranging stays for people at the home. This will help in making sure that the staffing skills mix is suitable to meet the level of needs of the people in the home at any one time. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who are using the service are supported to maintain and develop their preferred lifestyles. EVIDENCE: Most of the people who use the service are able to say what their needs are. Staff have received some specialist training to support them in their communication with people who have communication difficulties. Individual support plans include information about each person’s social and leisure interests and people are supported to pursue these whilst living at the home. Those who usually attend day services and work placements are able to continue with this. Activities are planned and arranged with people. On the day of the site visit one person was going on a visit to the local railway museum. Another person at the home said they enjoy visits to the pub and Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 12 going bowling and there are sometimes trips out on a weekend, although these have been less frequent of late due to some staffing shortfalls. Staff do have access to a car and a minibus and they are used to support people in going out. People are able to maintain their relationships with family and friends during their stay at the home. There is a telephone that is available for people wishing to contact relatives and friends. Most of the people who stay at Flaxman Avenue are well known to the staff. Menus are planned around people’s preferred tastes and people at the home said there were always alternative meals available if they didn’t like the food that was on offer. Special diets are catered for and the home keeps a special diets book detailing the specific individual dietary needs of people who use the service. This helps them in the planning of meals if they know someone is coming to stay at the home. The menus include healthy eating and non-meat options. People are able to choose whether they eat alone or with others and the dining area provides a pleasant environment in which to eat. People are able to help themselves to drinks and snacks, as they want. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People’s personal and healthcare needs are well met. EVIDENCE: At the time of the visit staff interacted well with people who were staying at the home and treated them with a lot of respect and dignity. People at the home said that any personal support is provided in private and describe staff as “kind and helpful” and a health professional made comments that the home is “good at maintaining people’s privacy”. The individual support plans state how support is to be given to each person. Flaxman Avenue is a respite care service so people do not live at the home on a permanent basis. However, if during that time they develop health problems then the home supports them in making sure that they receive the proper care and treatment. Each person’s support plan provides information about contact details of professionals involved in each person’s care so that staff know who they need to speak to if concerns arise. Records are kept of any changes to people’s care so that staff are aware of any actions they need to take from Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 14 this. There are specialist aids and adaptations in place to help people with their independence and to minimise any potential risks to them. Health professionals made comments that staff are “professional and follow advice as given and that they had experienced positive support and experiences when discussing emergency situations with the staff team”. Records are kept of any medication that is brought into the home, administered and handed back to them by staff following their stay at the home. People who stay at the home are able to administer their own medication if they choose, and are safe to do so. There are locked facilities in bedrooms to enable people to store their own medication safely. At the time of the site visit one person was keeping and administering their own medication. However, there were no records of what the medication was, so that staff and health professionals did not know what medication was being taken. This meant that staff and health professionals might not be able to relate any changes to the person’s health, mood or behaviour through potential omission or side effects from the medication. This issue was also raised at the last inspection visit and needs addressing. Since the previous inspection visit measures have been put in place to make sure that all eye and eardrops are dated when they are opened so that staff know when it has to be used by. This reduces the risk of people being given any medication that is out of date. Some people who use the service have epilepsy and staff have received specialist training so that they are able to administer medication quickly in the case of an emergency. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People’s concerns are listened to and acted on. People staying at the service are better protected by improvements in the way overnight care is provided and recorded. EVIDENCE: The home has a complaints procedure detailing how people can make a complaint and what will happen from this. Three complaints had been made to the home and these were documented along with the action that was taken from them. Staff knew what to do if complaints were made to them and this helps in making sure that any concerns are properly dealt with. A relative said that they had once complained about a staff member and was “kept well informed about what was happening”. The service also has a complaints book and a commendations book so that the staff team are made aware of areas that need to be put right and what they are doing well. The City of York Council Adult Protection Policy provides guidance for staff on procedures for responding to abuse and all staff have attended abuse awareness training and receive regular updates. One matter was referred to the local authority following a serious incident at the home that involved the police. The police took no further action following the investigation. There was some discussion about the use of monitors at the home which had been considered as a result of the incident and investigation. The service has Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 16 now changed its procedures to ensure that in future monitors are only to be used if care plans clearly specify the reasons for this and the person where possible or their family is in agreement with their use. These measures provide positive outcomes for people who use the service because people will be protected and free from having their sleep disturbed. The service has also improved the way in which they record the checks made by night care staff on people staying at the home so that it is clear as to what actions if any have been taken from the checks. This helps in making sure that people’s needs are being met and their safety is protected. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is clean, comfortable, suitable and safe for people staying there. EVIDENCE: The accommodation is all on one floor and can be easily accessed by people with mobility difficulties. The home is well maintained and provides very good specialist aids and adaptations to meet the needs of people who live there. A new specialist bath and bed have been purchased since the previous inspection visit and people living at the home said they found the new bath to be “very relaxing”. The kitchen has been adapted so that people who use a wheelchair can use the facilities in there and this helps to maintain their independence. The home has a lounge that has been recently re-decorated and where people can sit and watch television. There is a separate dining area where most people choose to eat. Bedrooms are spacious and modern although as discussed at the time of the site visit one of them is in need of some redecoration. People are able to bring their own personal possessions with them Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 18 when staying at the home. At the rear of the building there is a patio and seating area where people can smoke if they want to. At the time of the site visit the home was clean throughout. There are separate laundry facilities and procedures are followed to reduce any risk of infection. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are receiving a good standard of care from an experienced staff team who are well trained to meet the needs of people who use the service. EVIDENCE: At the time of the site visit staffing levels were sufficient in meeting the needs of the people in the home. There are some staff shortfalls at the present time due to various reasons and this has meant that some permanent staff have been working additional hours and relief workers have been used at times. The home is in the process of advertising for new staff so that staffing deficits can be addressed. At the time of the site visit staff could be seen to be supporting people in a relaxed and unhurried way. The home has a low staff turnover and staff did say it was “a good place to work”. People who use the service said that they feel there are always enough staff about although weekend trips out in the minibus are not as regular as they used to be. Some staff re-structuring is taking place. This will mean that there will be new regrading systems that will encourage more flexible ways of working based around the needs of the people using the service. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 20 There have been no new appointments of staff since the previous inspection visit. However, in the past proper recruitment checks have been made to safeguard people who use the service from any risk of harm. Staff made comments that they receive good training to support them in meeting people’s needs. Most staff have either completed or are doing the National Vocational Qualification (NVQ) programme and attend other courses that are relevant in the care of people with a learning disability. Records are maintained of all training that is undertaken. Staff said that they receive supervision where any training needs can be identified. A health professional said, “I have confidence in staff’s abilities and their knowledge in meeting people’s needs”. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who stay at the home benefit from a well-run service that puts their interests first and gives proper attention to their health and safety. EVIDENCE: The registered manager who was not present at the time of the site visit is well experienced in running the home. Staff and people who use the service describe her as “supportive and approachable” and the home is well organised. A health professional said the manager is “approachable and good at liaising with other services if difficulties arise”. Although a professionally recognised quality assurance system has not yet been put in place they have other ways to seek people’s views. Usually there Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 22 are weekly meetings with people who are using the service, although because of the staffing issues these meetings are limited. It is recommended that these take place more often, especially as people are at the home for respite care and don’t normally stay at the home for long. An annual questionnaire is sent out to relatives and there is a complaints and compliments book for people to make their views known. Regular staff meetings take place to offer staff the opportunity to voice their views and concerns. The home now has a communication book to pass on information about people who are using the service so that staff have updated knowledge of their needs. Health and safety records and certificates are up to date. Fire safety measures are well maintained and the manager has carried out an updated fire risk assessment of the premises. Good systems are in place for monitoring various aspects of health and safety throughout the home. All staff receive health and safety training and this is updated as needed. Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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 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 3 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 4 3 2 X 3 X 2 X X 3 X Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA20 Regulation 13(1)(b) 13(2) 17(1)(a) Schedule 3(3i) Requirement A record must be kept of all medication brought into the home, even when service users are self-medicating and looking after their own medication. This will help in making sure that staff and professionals have the information to explain possible reasons for any health changes. Timescale of 28/11/06 not met. Timescale for action 11/11/07 Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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. Refer to Standard YA6 Good Practice Recommendations Individual support plans should be signed by each person living at the home or their representative to show that they are in agreement with the actions being taken. One bedroom that was identified at the time of the site visit should be re-decorated so that it is more pleasant for people who use it. Meetings between staff and the people who use the service should take place more often to give more people an opportunity to voice their opinions about the care and services on offer. 2. YA24 3. YA39 Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Flaxman Avenue (77) - City of York Council DS0000034930.V346296.R01.S.doc Version 5.2 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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