Inspection on 06/01/06 for Furzehill Road (9)

This inspection was carried out on 6th January 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Furzehill Road (9) 04/06/07

Furzehill Road (9) 15/06/06

Furzehill Road (9) 14/11/05

Furzehill Road (9) 18/02/05

Furzehill Road (9) 10/05/04

Furzehill Road (9) 14/02/04

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

CARE HOME ADULTS 18-65 Furzehill Road (9) 9 Furzehill Road Borehamwood Hertfordshire WD6 2DG Lead Inspector Mr Tom Cooper Unannounced Inspection 6th January 2006 15:30 Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Furzehill Road (9) Address 9 Furzehill Road Borehamwood Hertfordshire WD6 2DG 0208 953 8401 0208 953 8401 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) www.mencap.org.uk Royal Mencap Society Daniel Smyth Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: 9 Furzehill Road is an ordinary two storey semi-detached house operated by the voluntary organization Mencap as a six bed care home for adults with learning disabilities, located in Borehamwood just off the high street. All the bedrooms are singles and the home has a variety of communal spaces decorated and furnished in domestic styles. All the town facilities are nearby. There is a bus stop outside the home and a railway station within walking distance. The home is staffed twenty four hours a day and aims to support the service users to lead the lifestyles they choose in a safe environment. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection for the current inspection year and took place on a weekday afternoon and evening. Unfortunately, due to an administrative problem the report from the first inspection is not yet available. This report supercedes that inspection although a report will be issued. The main focus of the inspection was to evaluate the service users’ experience of living in the home and to check compliance with the statutory requirements and any action taken in respect of the requirements and recommendations made at the last inspection. Discussions were held with the service users in residence and the support worker on duty. Documentation checked included a sample of service users’ care plans including some person centred planning (PCP) materials, records of accidents and incidents, fridge/freezer temperature records, medication records, and the complaints procedure. A tour was made of the premises. The inspection indicated that the home was running well, with progress made towards implementing person centred planning. The service users said they were content and obviously enjoyed good relationships with staff. What the service does well: The service users all said they liked the home and were very positive about the performance of staff. They said they enjoyed their lifestyles and liked the accommodation. They also liked the food provided. They were mostly aware of how to make a complaint should they wish. The member of staff on duty was very knowledgeable about individual needs and confident in following the policies and procedures of the home. There was obvious mutual trust and respect between the support worker and the service users. Care plans and progress notes seen contained detailed information on individual needs and personalities and the actions agreed for staff to follow. However the monthly care plan update sheets for some service users had not been kept up to date. The home is spacious and well appointed, providing a comfortable domestic environment for the residents. Sound procedures are operated for the handling and administration of medication. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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): Adequate information about the aims of the home and the service and facilities to be provided is available to prospective and current service users. Comprehensive assessments of individual service users’ needs and aspirations are completed. Each service user has a statement of terms and conditions of occupancy at the home. EVIDENCE: The home has a statement of purpose and service user’s guide containing the required information that is available to the service users at all times. No new service users had been admitted since the last inspection. Very detailed assessment information in respect of the current residents was on file. Individual licence agreements detailing the rights and responsibilities of each party were seen in the service users’ personal files examined. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 - 10. Service users’ needs are detailed in individual care plans and staff are working with service users to develop person centred planning. However care plan updates should be consistently completed for all serviced users. Service users are fully involved in decision making in their personal lives and in the running of the home, supported by staff as necessary. Service users are supported to take responsibly assessed risks in order to maximise their opportunities for stimulation and independence. Staff follow the home’s policy and maintain confidential information appropriately. EVIDENCE: A large amount of documentation is held in separate files for each resident. Three files were examined and these contained comprehensive assessment information on individual needs as well as useful instructions to staff on how to proceed to meet them. Major areas covered included personal profiles and background information, visits to medical professionals, review information, physical and medical healthcare issues, protocols for visitors, behavioural Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 10 guidelines, and a record of significant events. In each file there were a number of mostly up to date risk assessments covering a wide range of relevant areas of perceived risk, for example the use of razors, smoking, going out alone, using the kettle, bathing, personal care delivery and so on. Sufficient information is available to meet the standard and ensure the residents’ needs are met however some improvements should be made. The home has a policy of producing monthly care plan update summaries for each resident and examples were in place for three residents, detailing the current agreed goals and care priorities for each person. However these documents were missing in respect of three other service users. While it may not be necessary to carry out monthly updates for each resident (the standard requires care plan updates at least six monthly) staff should act consistently to follow the home’s policy. Also, the personal files seen were very bulky and confusing to access, with some undated documents present and old information mixed up with current information. All documents should be dated as a matter of course to establish their relevance; obsolete information should be archived to improve file accessibility and minimise the potential for confusion in the mind of the reader (see recommendations). Service users said that they were generally able to act as they chose and expressed considerable satisfaction with the level of personal choice they enjoyed. Staff encourage the residents to make decisions about their lives in the home as well as activities and holidays and this is noted in the individual care plan goals. Two residents had produced some person centred planning documents with the assistance of their keyworkers. These demonstrated how they were being placed at the centre of the planning process. This is a commendable development. Where appropriate, residents undertake specific responsibilities for household tasks such as assisting with laying the table for dinner and cleaning. The residents lead reasonably independent lives according to their varying levels of ability. Staff understand the importance of allowing them to take sensibly evaluated risks in order to enjoy a wide range of opportunities. All perceived risks are assessed and documented. The risk assessment format gives full details of the elements of the risk, who is affected, the control measures determined and the benefits to the service user of the activity considered. Examples seen were relevant and mostly up to date. The practice of the home in this area is commendable. Mencap has a policy on confidentiality that staff understand and follow. Service users’ personal files are held securely in the laundry room/office on the ground floor. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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): 12 – 17 Staff encourage and assist service users to make choices with respect to activities in and out of the home, using community facilities in the ordinary way. Service users are able to maintain family and personal relationships. Service users’ rights to make decisions for themselves and undertake appropriate activities are upheld and individual responsibilities are recognised and supported. Service users have healthy diets that correspond to their particular preferences and they enjoy their meals and mealtimes. EVIDENCE: The service users present followed their own pursuits on the afternoon of the inspection, spending time in their bedrooms, watching television in the lounge and conversing with the support worker on duty. They all said they liked their lifestyles and enjoyed their daytime activities away from the home. All service users have ‘one to one’ days each week, on which they do domestic chores and go out to collect benefits, pay their rent and do shopping. Residents take part in a wide variety of age-appropriate activities that they discuss and negotiate Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 12 with staff. One resident has a voluntary job. Regular activities occurring are listed on a timetable displayed on the office wall. This indicated residents were leading stimulating lifestyles. Activities referred to on care plans included social contacts with relatives, social and leisure items. Most of the residents went on holidays during the last year. Staff encourage and support the residents to maintain family relationships, although this is controlled in one case for reasons that are well documented in the care plan. Staff help the residents to make choices, for example in relation to clothes, menu planning, room colour schemes, leisure and social activities and holidays. Residents also take part in some household tasks such as laying the dining table and doing their laundry with staff support and this helps them maintain their independence. One very capable resident does her laundry independently and she commented that the best thing about life in the home was that she could “please herself” without undue staff interference. It was evident that the residents got on well as a group and were happy living together. Service users have a sensible, well balanced diet. They discuss menus with staff and are involved to varying degrees in assisting with shopping and meal preparation. All residents asked said they liked the food provided. Normally most of the residents eat together, although one prefers to eat alone. Meal times are relaxed, social occasions. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 - 20 Staff treat residents with sensitivity and respect, following guidance in the care plans. Staff have excellent knowledge of the residents’ healthcare needs, emotional needs and personal preferences and act accordingly. The home has thorough procedures for ensuring the safe handling, storage and recording of medication that protect service users’ interests. EVIDENCE: The care plans examined contained a good level of detail regarding the personal and healthcare needs of the residents. The support worker on duty demonstrated excellent knowledge of the residents’ individual circumstances and the actions agreed to meet their needs. Very positive relationships were observed between her and the residents. The support worker treated residents with respect and discouraged inappropriate behaviour in a measured and constructive way that corresponded to the behaviour management guidelines noted in care plans. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 14 The healthcare records seen included references to hospital visits, contact with GPs and other health professionals including CPNs, appropriate monitoring of mental health issues and regular weight checks. One resident commented that staff were caring and concerned about her well being and that of the other residents and felt confident that they would be referred to the doctor quickly if necessary. Sound medication procedures were being followed. Drugs are stored securely in a cabinet in the laundry room, mostly supplied in the Complia Pack blister system. The home has a written procedure for the administration of medication that specifies two staff to check that administration has been correct. A single recording error was noted on a MAR sheet, in all other respects the system was being operated well. Items coming into the home and disposed of are recorded in special books. The pharmacist had visited regularly to check medication practice and this acts as an extra quality control measure. One resident self-medicates. Staff give her a dosette box every morning. A thorough risk assessment was in place. A specific emergency procedure was on file for staff to follow if one of the residents were to have a seizure. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 & 23 Service users have ready access to the complaints procedure and they know how to make a complaint. Staff encourage and help service users to make their concerns known. Staff receive training in the protection of vulnerable adults and this ensures that service users are protected from abuse. EVIDENCE: Mencap has a complaints procedure that contains the required elements to meet the standard. A copy of this was on the office wall. The residents said that they knew about the procedure and had a clear idea of how to make a complaint. No complaints had been received in recent months. One resident said that she had formally complained in the past and had been very satisfied with the response. She also expressed confidence in the system. The prevention of abuse and adult protection are covered during the induction of new staff. The support worker on duty said that she had received adult protection training in 2004. She had a fair grasp of the basic principles involved and understood her responsibilities as a member of staff in responding to allegations or suspicions of abuse. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 - 30 The home provides a safe, comfortable and well maintained environment well suited to the service users’ needs. Service users’ single bedrooms are individually arranged to suit their tastes and interests. The communal rooms are varied, spacious and domestic in scale. Kitchen and laundry facilities are accessible and safe for service users to use. Adequate toilets and bathrooms are provided for six residents. Staff maintain a good standard of cleanliness and hygiene, involving service users in cleaning tasks as appropriate. EVIDENCE: The home is well maintained, with good quality domestic style furnishings, fittings and décor. The lounge, kitchen and dining room are smart and comfortable. Residents’ bedrooms seen were nicely decorated and personalised Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 17 with many items such as pictures, electrical equipment, toys and furniture. The large kitchen is modern and well equipped with suitable domestic appliances, with all food stored appropriately and good hygiene practice observed. Bathing and toilet facilities are adequate, and have been improved since the last inspection by the installation of paper hand towel dispensers in each room. The laundry is well equipped to cope with the workload generated by six residents and has an impermeable floor. The garden is fully accessible and provides a useful facility for service users. All areas seen were clean, tidy and hygienic. Staff are aware of good infection control procedures. Service users said they liked their bedrooms and the rest of the facilities and appeared comfortable and at ease in their surroundings. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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): 31, 33, 35, 36 Staff understand and support the home’s aims and their roles in delivering the service promised in the statement of purpose. Adequate numbers of experienced and competent support workers are provided who are appropriately trained to meet the service users’ needs. However relief staff should be recruited to ensure that two staff are always provided on each day shift. The company provides regular relevant training for staff that ensures they are well equipped to assist service users to lead safe and fulfilled lives in accordance with the home’s statement of purpose. Staff are well supported and supervised by senior colleagues to deliver consistent care for the service users. EVIDENCE: The support worker on duty had a clear understanding of the aims of the home and her responsibilities in supporting service users to act independently within a risk assessment framework. She also clearly had good relationships with the residents and was familiar with their individual needs and idiosyncrasies. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 19 The staff rota inspected showed that two staff were on duty most of the time during the day shifts. However at the time of the inspection only one support worker was on duty due to the unavailability of an agency worker familiar with the home and the residents. The support worker on duty explained that given the sensitivity of some of the residents it was considered essential to have personnel who knew the residents. Having observed the residents this appears justified, nevertheless it is impossible to give them the proper level of attention to fulfil their care plan goals without a full complement of staff, therefore it is recommended that efforts be made to recruit suitable relief staff available to cover in such situations. The support worker on duty said that Mencap provided excellent training opportunities, by reference to the training schedule available within the home. Recent courses attended had included topics such as epilepsy, food hygiene, health and safety, moving and handling, fire safety, and mental health. She was part-way through the NVQ3 course. She said she received regular individual supervision from the manager of another Mencap home, who was helping out while the home was without a full strength management team. She felt that staff were generally well supported by senior management including the external line manager of the service. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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, 38, 40 & 42 The home is well run, with service users benefiting from the support and guidance of the well trained staff team. However there is no registered manager therefore the company must put forward a registration application in respect of a suitable candidate. The home is operated in a way that maximises the service users’ control over their lives within a well developed risk assessment framework. The home has a full range of policies and procedures that safeguard service users’ interests. Record keeping is of a generally high standard, although care plan documentation needs streamlining and more consistent updating. The home is safe to live and work in, with appropriate infection control and health and safety procedures followed. EVIDENCE: Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 21 The previous registered manager had left the home in the autumn of 2005 and the deputy manager was acting up. The support worker on duty felt that she had made the transition to running the home well, with the support of the manager of another Mencap home. She rated communications in the home as average and teamwork as high. Clearly in order to maintain high standards the home will need a properly appointed manager. It is also contrary to the Care Standards Act 2000 to manage a home without being registered in respect of it. Therefore an application for the registration of a suitable candidate must be made to the CSCI as soon as possible. The service users expressed a high degree of satisfaction with the service provided. The support worker on duty felt that the processes of running the home were transparent and gave team members scope for innovation. It has previously been established that the home has all the required policies and procedures in place for the proper running of the home. All staff are required to sign to indicate that they have read and understood each policy. All records examined were in good order, with the exception of some risk assessments in need of updating and some undated documents in the service users’ files seen. Accident and incident records were examined and had been diligently completed. The COSHH cabinet in the laundry room was locked. All staff complete mandatory training in fire safety, food hygiene, moving and handling etc to maintain safe working practices. Regular fire alarm tests and drills are carried out. Fridge and freezer temperatures are recorded daily. The home has adequate insurance cover in place to meet legal liabilities to employees, service users and third parties. The home is generally safe for residents and staff, with no health and safety problems noted on touring the premises. Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 1 3 X 3 2 3 x Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA37 Regulation 8(1) Requirement The company must appoint a suitable manager and submit a registration application to the CSCI in respect of that person. (See also s.11(1)Care Standards Act 2000) Timescale for action 31/03/06 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. Refer to Standard YA6 Good Practice Recommendations In line with the home’s policy staff should consistently complete monthly care plan updates for every service user in a simple form to ensure that current goals and initiatives agreed remain suitable for meeting their needs. All care plan documents should be dated as a matter of course to establish their relevance. Obsolete information should be archived to improve file accessibility and minimise the potential for confusion in the mind of the reader. Efforts should be made to recruit suitable relief support workers to cover potential shortfalls in staffing. 2. YA6YA41 3. YA33 Furzehill Road (9) DS0000019392.V277049.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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