Inspection on 13/12/05 for Franklyn Lodge 71a District Road

This inspection was carried out on 13th December 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Franklyn Lodge 71a District Road 06/09/06

Franklyn Lodge 71a District Road 20/09/05

Franklyn Lodge 71a District Road 08/03/05

Franklyn Lodge 71a District Road 09/11/04

Franklyn Lodge 71a District Road 23/02/04

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

CARE HOME ADULTS 18-65 Franklyn Lodge 71a District Road Franklyn Lodge 71a District Road Wembley Middlesex HA0 2LF Lead Inspector Mr Ram Sooriah Unannounced Inspection 13th December 2005 10:30 Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Franklyn Lodge 71a District Road Address Franklyn Lodge 71a District Road Wembley Middlesex HA0 2LF 020 8902 5205 020 8903 9860 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) Residential Care Services Ltd Ms Margaret Avan-Nomayo Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Franklyn Lodge belongs to Residential Care Services Ltd, a private company, based in Brent specialising in providing personal care and accommodation for younger adults with learning disabilities in care homes. The home is located in a residential area of Sudbury. There are some local shops about five minutes walk from the home. Public transport is available on the main road, where District Road starts. There is a driveway with parking for one to two cars. Additional parking is available on District Road, which does not have parking restrictions. The home is a detached bungalow, with most of the accommodation on the ground floor. The attic is used for storage. There are three single bedrooms (one with en-suite toilet and wash hand basin), a through lounge/dining area, a bathroom with a bath and shower and a kitchen. There is a paved area in front of the home with wheelchair access and a maintained garden at the back and a patio, which can be reached from the lounge/dining area. At the time of the inspection there were two service users in the home. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection is the second of the statutory inspections for the period 2005-2006. The inspection started on Tuesday 13th December 2005 at 1030 –1330 and continued on Friday 16th December at 1600-1700. The inspector checked for compliance with past requirements and recommendations; observed care practices in the home; looked at a sample of records; and inspected some of the premises. He also spoke to the manager, some of her staff and to the service users. The inspector would like to thank the service users, the manager and her staff for a kind welcome, cooperation and support during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person must ensure that the assessments of the needs of service users are comprehensive to include the mental health needs. Care plans and risk assessment must be signed not only by the member of staff who has drawn them, but also by the service user/representative where this is possible. While the healthcare needs of service users were generally being met, records showed that service users were not always seen by the dentist or optician at the yearly interval. While the home provides good training for staff, some of this training could be geared to ensure that staff achieve the Learning Disability Award Framework. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 6 The home was generally safe but the health and safety risk assessment and the fire risk assessment needed to be updated. 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. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 4 The home has an appropriate admission procedure, which it implements to ensure that the needs of prospective service users are identified prior to a decision being made to accept the service users. The prospective service users are also given the opportunity to make decisions on the suitability of the home to meet their needs. EVIDENCE: The inspector looked at the care plans of both service users who were accommodated in the home. One of the service users has recently been admitted from another care home, which belonged to the parent company. The manager and her staff had the opportunity to work with the service user prior to the admission being finalised. Staff from the home went to the other home to work with the service user and to understand his needs. There was evidence that the service user was given the opportunity to visit 71a District Road to familiarise himself with the home prior to admission. He apparently visited on a number of occasions and he stayed a night. The inspector was informed that the service user/relatives was given the opportunity to choose the bedroom of the service user and to bring personal possessions to make the room homely and personalised. The room of the service user indeed demonstrated that this was the case. Prior to the transfer of the service user to 71a District Rd a review meeting was arranged to discuss the transfer. Minutes of a review meeting held six weeks after the transfer were also available to evaluate the effects of the transfer on the service user. The above showed that good practice was adopted to ensure that the needs of the service users were the determining factor in the transfer. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Care plans are reviewed/updated at least every six months. These were not always signed by a member of staff or the service user/representative. The care plan of a service user did not address his mental health needs in a comprehensive manner. Risk assessments were not always present in cases where service users were being encouraged to develop individual living skills. EVIDENCE: The key workers of service users were identified in the care plans. Care plans were typed and were in good condition, but the files were bulky and the information not always easy to find. It is recommended that a ‘working’ care file is devised which would be easy to follow. This could for example follow an assessment-plan-action-evaluation format, as these would be the information which would be regularly used as compared to other information such as minutes of review, meetings, correspondence and some health records which are not used that regularly and which could be put at the back of the file. There were some attempts at using signs and symbols in some of the documents, however the size of the letters were fairly small and could pose a problem to read. The inspector noted that care plans were reviewed at least every six months, but he did not always see a signature of a staff member/key worker or that of the service users/representatives to show that the service users/representatives have agreed to the care plan. There was however Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 10 evidence to suggest that the care of one of the service user was discussed in a review meeting. The manager stated that the care plan was then seen by the relatives of the service user. The care plans were generally comprehensive and addressed the needs of the service users. However in the case of a service user who has mental health needs and behaviour problems, there was no clear assessment of these mental health needs and plans were not in place to deal with them. Care plans of service users also addressed their personal development and the development of individual living skills. The care plans described the tasks and actions that service users are able to carry out or where they need to develop skills. These were appropriate and demonstrated that service users were encouraged to develop independence, confidence and to take part in the local community. These must however take place within a risk assessment context for the safety of the service user and of other involved. One of the service users did not have any risk assessments with regard to developing individual living skills such as with regard to making tea with boiling water, helping in the kitchen and going out in the community. The other service user had risk assessments in place but these had not been reviewed on a six monthly basis and there was no evidence of the involvement of the service user/representative in this process. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,14 and 17 The home in the main supports service users in identifying opportunities for personal development and in having a fulfilling life. More could have been done in the case of one service user with regard to identifying a suitable programme of activities for him. Meals provided for service users are appropriate to meet their needs. The menu did not reflect the needs/tastes of service users with regard to nutrition. EVIDENCE: One of the service users goes to a day centre and the other service user receives in the main one-to-one input from a carer in the home. There was evidence to show that service users were offered the opportunities to learn and to develop practical skills. The inspector was able to observe the progress, which has been made by one of the service users with regard to this aspect. He has been able to learn new skills. The care plans described the social and recreational needs of service users. One of the service users had a programme of activities to keep him occupied during the day. The other did not have a clear programme of activities. It was therefore not clear how he was spending his time in the home and what arrangements were in place to meet his social and recreational needs. Records Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 12 about activities arranged for him suggest that this was limited to walks in the community about once a week. The home has a four weekly menu cycle. Appropriate records were kept about the meals cooked in the home. The inspector noted that the meals, which were being cooked in the home, were not always according to the menu. There was however no evidence to suggest that service users were not receiving appropriate meals, but it is recommended that the menu be reviewed according to the needs of the service users. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Personal care and support are provided to service users in an appropriate manner and according to their needs. Service users were not always seen by the dentist or optician yearly. The management of medicines in the home was generally safe. EVIDENCE: The service user presented as appropriately dressed and groomed. Issues about personal care were appropriately detailed in care plans. The minutes of the review meetings showed that areas where service users require support were discussed and agreed in these meetings. The home kept a record of service users’ visits and contacts with healthcare professionals and the resulting outcomes. These included the GP, chiropodist and consultant in the hospital. There was no clear evidence to show if one of the service users had recently been seen by the dentist or optician and in the case of the other service user by the optician, who had recommended a yearly visit in his last report dated February 2004. The inspector also noted that service users did not always have a Health Action Plan. The Department of Health of Health has indeed suggested that all adults with a learning disability should have a Health Action Plan (See www.dh.gov.uk). Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 14 The inspector looked at the management of medicines in the home. He noted that this was being carried out in a safe manner. Medicines were provided in dosette boxes, which were filled by the chemist. There were also arrangements in place for the supply of medicines when service users go for home visits. The inspector noted that a medicine which was written on the medicine chart and which was to be given on an as required basis, was not in stock. It was not clear if the medicine has been discontinued or if it was just out of stock. As a result it is recommended that medicines, which have been discontinued, be crossed off the medicines chart or if not discontinued that a stock is kept in the home as per the GP’s prescription Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has systems to ensure that the views of service users are listened to and acted on. It also has systems to ensure that service users are protected from abuse. EVIDENCE: The home had a complaint procedure. This was recently provided to service users in signs and symbols and a copy was available for inspection. While this was a good attempt, it consisted mainly of a series of pictures/symbols linked together with no words describing what it was about. There were no contact details of any of the persons/organisations that the service user could complain to. As a result the provider should review the way the complaint procedure is presented in signs and symbols. The home has not received any complaints since the last inspection. There were certificates in the personnel files to show that the permanent members of staff in the home have had training on abuse and on protection of vulnerable adults. Staff, including bank/agency staff, were aware of the whistle blowing policy. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 and 30 The home is appropriately maintained and personalised to meet the needs of the service users. EVIDENCE: The outside of the home was appropriate for the time of the year. It was mostly clean. The exterior of the home was also maintained and was in keeping with other building in this quiet residential area. The home was warm, clean and appropriately decorated. The through lounge/dining area was furnished with comfortable armchairs and a dining table with four chairs. The lounge was also decorated in pleasant colours and looked inviting. There was a TV with satellite connection as well as a music system. The dining area of the home is also used at night as the sleep-in area for staff. There is one bathroom with a bath and electric shower; a toilet and a wash hand basin. There are wash hand basins in two of the bedrooms and the third bedroom has an en-suite with a toilet and a wash hand basin. The bathing facilities in the home are appropriate for the service users in the home. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 17 The three bedrooms are on the ground floor and were all appropriately decorated, maintained and furnished to provide a warm and homely environment. The two occupied bedrooms were personalised appropriately. The home was clean and free from unpleasant odours on the day of the inspection. The carpet in front of the bathroom would benefit from shampooing or cleaning. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The home has a permanent core of staff, which needs to be increased to ensure continuity of care. While the home generally provides appropriate training, it would be beneficial if this training were provided within the Learning Disability Award Framework. EVIDENCE: There were three care support workers employed by the home and two from bank/agency. The manager stated that she was in the process of recruiting more permanent staff now that there are two service users in the home and that one of the service users needs one-to-one support. The home had only one service user at one point and the number of staff, which was being used at the time, reflected that. The manager clarified that bank staff were being used to cover the shift. There was therefore an issue with regard to ensuring the stability of the staff team for the service users who need continuity of care and who take time to build a rapport with individual members of staff. The manager added that she was aware that she needed to re-establish processes such as staff supervision and staff meetings. The members of staff employed by the company had NVQ qualifications or were in the process of studying for them. The personnel files of two members of staff were inspected. They were all tidy and appropriately kept. They all contained the necessary information as per Schedule 2 of the Care Homes Regulations 2001. They did not contain results of CRB checks, but the inspector was informed that all members of staff employed by the company have had CRB checks and that these are kept Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 19 separately at the head office for confidentiality purposes. The manager added that there are processes in place to ensure confirmation that all agency staff have also had CRB checks before being referred to the home. The training programme was perused. It showed that most members of staff were up to date with regard to training in statutory areas and abuse. Staff have also attended training on challenging behaviour, autism and medicine administration. There was however not much progress with regard to members of staff achieving the Learning Disability Award Framework (LDAF). Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The manager runs the home in an open and inclusive manner. Service users have the opportunity to exercise choice and to contribute to the running of the home within their possibilities and interests. The home was maintained to ensure the health and safety of service users and staff. The health and safety risk assessment and fire risk assessment were not up to date. EVIDENCE: The manager has been in post for a number of years. She stated that she has a certificate in advance management and that she was in the process of studying for a degree in social work. Conversation with her showed that she was familiar with the needs of the service users in the home. As previously noted, no staff meeting has been held recently because of the number of staff in the home. She stated that once she recruit her staff she will start organising the meetings again. The manager stated that she is well supported by the operations manager and the directors in running the home. The inspector from his experience of the organisation and of the service acknowledges that this is indeed the case. Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 21 The home is not accredited to a quality system. There were however some internal processes to monitor the quality of the service. The chemist does medicines audits every six months, and the directors do spot checks as well as visits per regulation 26 on a monthly basis. Reports were available for inspection following regulation 26 visits. The home had up to date electrical wiring certificate, portable appliances test certificate and a gas safety certificate. A health and safety risk assessment was available for inspection. It was however dated from April 2003 and was due for review in April 2004. It has not been reviewed. There was evidence of maintenance of the fire system, fire fighting equipment and emergency lights. It had a Fire Risk Assessment, but did not have a Fire Emergency Plan. The fire risk assessment had also not been reviewed since April 2003. It is recommended that the guidance from the London Fire Brigade be followed and that the Fire Risk assessment be reviewed in line with the format provided by the London Fire Brigade and that an emergency plan is also formulated (http:/www.london-fire.gov.uk/fire_safety/at_work/at_work.asp ). Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 2 15 X 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Franklyn Lodge 71a District Road Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 x DS0000017442.V273100.R01.S.doc Version 5.0 Page 23 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 YA6 Regulation Requirement Timescale for action 31/01/06 2. YA6 3. YA9 4. YA14 14(1),15(1) Care plans and risk assessments must be signed by the member of staff responsible for drawing them. Service users or/and their representatives must also be encouraged to sign them to show that they have agreed to them. 14(1,2) Care plans including the 28/02/06 assessment of needs must be comprehensive and must include the assessment of the mental health needs of the service users. Care plans must then be in place where there are identified needs. 14(2) There must be clear risk 31/01/06 assessments in cases where service users are being encouraged to develop individual living skills. Risk assessments must also be reviewed at least every six months or when the condition of service users change and must be agreed with the service user/representatives. 16(2)(m,n) There must a planned 31/01/06 programme of activities to keep service users occupied in the DS0000017442.V273100.R01.S.doc Version 5.0 Franklyn Lodge 71a District Road Page 24 5 YA19 13(1)(b) 6 YA42 13(4) 23(4) home, according to their assessed needs. Records must be kept to show that service users are seen regularly by the dentist and the optician. The registered person must ensure that the health and safety; and fire risk assessments are up to date and that a Fire Emergency Plan is in place in the home. 28/02/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA6 YA17 YA18 YA20 Good Practice Recommendations It is recommended that the size of the letters used in records/documents accessible to service users are made bigger. The registered person should review the menu to reflect the needs of service users. It is recommended that each service user have a Health Action Plan as advised by the Department of Health. It is recommended that medicines, which have been discontinued, be crossed off the medicines chart or if not discontinued that a stock is kept in the home as per the GP’s prescription. The registered person should review the way the complaint procedure is presented in signs and symbols, to ensure that it can be easily understood and used by service users. The home should continue in its efforts to ensure that members of staff achieve the Learning Disability Award Framework. 5 6 YA22 YA35 Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Franklyn Lodge 71a District Road DS0000017442.V273100.R01.S.doc Version 5.0 Page 26 - 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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