Inspection on 16/11/06 for Gate House

This inspection was carried out on 16th November 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gate House 16/10/08

Gate House 25/01/06

Gate House 05/10/05

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

CARE HOME ADULTS 18-65 Gate House High Street Eastry Sandwich Kent CT13 0HE Lead Inspector Julie Sumner Key Unannounced Inspection 16th November 2006 10:00 Gate House DS0000064755.V308088.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 Gate House DS0000064755.V308088.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. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gate House Address High Street Eastry Sandwich Kent CT13 0HE 01304 611600 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) fchltd.headoffice@virgin.net Family Care Homes Limited Miss Rosemary Chapman Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Gate House is a purpose built unit within the grounds of Eastry House. Gate House offers a service to a mixed sex group of seven younger adults with learning disabilities, complex needs and challenging behaviour. Gate House has its own registration, although the manager of Eastry House has retained the overall management responsibility for the home. The current fees for the service at the time of the visit range from £480.29 to £971.00. Information on the home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The provider web address is included in the previous page with other contact details. The unit is modern in design, and this is reflected in the minimalist style of the décor and furnishings, which are of good quality. The accommodation is arranged around the centralised open plan communal spaces, with bedrooms, kitchen, laundry and staff office coming off this. All people living at the home have single occupancy bedrooms with en-suite facilities of either a shower or bath dependent on their preference. The staffing ratio of the unit is on a 5:7 basis. Currently there is one waking night staff with access to back up from the main house if needed in emergency. An on-call person is also available by phone if required. People living at the home have access to a range of activities in community and educational opportunities through college attendance for specific courses, they are also able to access the day centre next door for sessions of particular interest to them. Access to Gate house is either via the main house or through the main gates into the grounds of the main house and the day centre and one other unit, the main gates are usually kept locked. Limited parking is available in the main car park although there is a free car park in the village high street and some street parking is also available. A bus service is available to Eastry and runs through the high street, the village has a number of small shops, two pubs, and a post office. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The inspector visited the home to talk to service users, the manager and staff and view records and practices. The time spent in the home overall was just under 5 hours. Information was gathered for this inspection by a variety of means both prior to and during the visits to the home. The CSCI request information from the home routinely and the home manager provided all the information requested in the pre-inspection questionnaire prior to the inspection visit. Comment cards were sent before the inspection visit, to the people living in Gate House (service users), relatives, health care professionals, care managers and GPs. Completed comments cards were received from service uses, relatives and visiting professionals. All ticked yes/good in the boxes and those containing comments about the home were positive. The people living in Gate House have communication difficulties. The inspector spoke a little to them. Mostly judgements around individual views have been made in this inspection based on observations of communication between the people living in Gate House and staff that they know. Discussions were also held with staff and various written plans and records were viewed and discussed. All key standards were assessed at this inspection. The 2 requirements made at the previous inspection have been met. 2 requirements made that are ongoing have been given extended timescales for completion and three recommendations were made as a result of this inspection. What the service does well: Assisting service users to communicate is considered very important to individual wellbeing. Staff work hard with the community speech and language therapist to provide the most useful aids and teaching methods to enable all the people living in Gate house to communicate and make their wishes known. A good range of activities is being provided to make individuals lifestyle interesting and varied. Activities are also designed to develop personal skills towards more independence. The home is spacious and provides a good comfortable environment. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 6 The current management structure works well. Staff demonstrated positive attitudes. The service is well resourced and maintained. 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. Gate House DS0000064755.V308088.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 Gate House DS0000064755.V308088.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users needs and aspirations are assessed by a person who has the skills, knowledge and insight to ensure that that the homes will be suitable and be able to meet the needs of the service users. Not all service user contracts gave clear information around the fees and what is included in the service. EVIDENCE: There have been two new admissions since the last inspection. The assessments and information contained in the service user plans were viewed and discussed. There was some good clear information and also the assessment included visiting professional input. The admission and assessment process was also discussed with staff. They confirmed that they are involved, once a person has had an initial assessment to determine the service’s suitability. Staff also explained that prospective service users have a series of trial visits and they observed their interactions with other service users and this is taken into account as the final decision as to whether the placement is suitable is agreed. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 9 Service user plans were viewed and some contracts were in place but no all. There were no fees included and no clarity about what is provided in the service. The revised regulation requires that there is clear information included in the contract about fees and that this forms part of the service user guide. A requirement has been made to revise the contents of the contract and make sure it complies with this regulation. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. Service users are supported and provided with appropriate communication aids to be able to influence decisions about their own lives. Risks are identified, recorded and minimised ensuring that service users are protected and kept as safe as possible. EVIDENCE: A sample of service user plans were viewed and discussed with the team leader. Staff working practice was observed and they demonstrated that they followed the guidelines for support written in the plan. There were good records of care and support. As with other homes in the company there are several different places to keep records and the overall recording system for service users needs to be reviewed to see if it the most efficient way. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 11 One person was being reassessed as there was a change in behaviour that was indicating a change in support needed. This part of the file was therefore out of date and the team leader was advised to make a note in the file about the current situation and how the guidelines were being re-written. It is also advised that there should be some interim guidelines for staff to provide consistent support whilst reassessment is ongoing. A recommendation has been made for this. The staff demonstrated their commitment to positive behaviour support. There were a variety of communication aids around the home. Each service user has been assessed and they each have an appropriate communication aid. Service users were seen using the aids and gaining a positive response from them. There has been some progress with providing external support including potential advocacy for one individual as discussed at previous inspections. A sample of risk assessments were viewed in the service user plans. Risk assessments for one individual need to be updated along with the rest of the service user plan and this is covered by the previous recommendation. Overall, there was a good range of risk assessments for all areas of each individual’s lifestyle. Guidelines for staff were clear and they were updated and signed when reviewed Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are benefiting from good support with their communication skills and a varied range of occupational activities. Service users rights are respected and upheld where this does not compromise their safety or the safety of others. Service users benefit from the development of menus that offer a healthy and varied diet in keeping with their preferences, and supports weight reduction plans. EVIDENCE: A sample of activity programmes was viewed. Different individuals participate in different activities depending on their interests and assessed needs. Service users were participating in an active day during the inspection visit. Examples of some of these were: One service user was out with their key worker in the town shopping and having a coffee. Three service users went out during the afternoon to the occupational therapy unit for sensory therapy. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 13 Many of the families are in close contact with service users and are involved with their care and support. Contact details are kept in the service user plan folder. The service users are able to access all parts of the home. All bedrooms are single and have ensuite showers or bathrooms. Bedroom areas are considered private. The environment has been risk assessed. The kitchen is open. Where risk assessments have indicated a need measures have been taken to protect the safety of individuals. An example is that sharp knives are locked away separately and care is taken to account for them when they are in use. Mealtimes are flexible around individual activities and preferences. Some service users eat in the dining room and some next to the kitchen so that everyone has sufficient space and are able to eat in a relaxed atmosphere. The menu is varied and service users are involved in choosing what they like. Alternatives are provided. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their wishes and preferences will be taken into account in how they are supported. Service users benefit from good health care support and are able to access community health care services. Medication procedures have improved and medication is stored and administered correctly and safely. EVIDENCE: Individuals have had the support of the occupational therapist and the speech and language therapist. Advice has been incorporated into the service user plan. Service users were observed using communication aids with success. Staff get to know individuals and are able to judge by responses and behaviour as well as the use of the communication aids to ascertain service users wishes and feelings. Service users are supported to access the local health care facilities. All are registered with a GP in the village. The community learning disability team provide support with personal health care needs. There are health care Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 15 support plans in the service user plans. The team leader explained that the staff are about to commence health action plans with individuals and the blank forms were available. The home uses the Boots MD system. Medication storage was viewed. All bottles of liquid medication were labelled and dated when opened. The storage cupboard was locked. It was clean and not over stocked. Boxes of medication not in blister packs were clearly labelled with original pharmacy label and administration directions. The team leader administers medication when on duty and audits at the same time. The registered manager carries out random audits and this is also audited by the line manager during the reg. 26 visits. The MAR sheets were completed accurately and countersignatures had been included for the medication that had been altered in between printed prescription dates. PRN guidelines were in place to give staff instructions on how and when to administer and it was clear if authorisation was needed first. There are currently no service users who require diazepam as part of epilepsy treatment. The previous requirement with regard to this is no longer relevant. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective complaints process. Service users are given the means to express their feelings. Service users are protected from harm by the policies and procedures in the home. Staff are knowledgeable about adult protection. EVIDENCE: A copy of the complaints procedure provided in widget is displayed in the home and accessible to service users. From feedback received, most relatives are aware of the complaints procedure. Generally service users could use their communication aids to say if they are unhappy with something in the immediate environment. 10 staff have attended adult protection training and the remaining staff are new and booked onto the next course available. Staff spoken to demonstrated an awareness of risks to individuals and what their role is. Care managers are informed of incidents and are involved in the reassessment of changes in need. There is community psychology involvement with service users who need behaviour intervention and support. The financial procedures have been reviewed again. Service users’ money is kept securely. There are records for income and expenditure. Two signatures Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 17 are written on financial records for all transactions. These are also audited by the team leader and are checked during the reg. 26 process. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is spacious and well designed to suit service users. It is clean and well maintained. EVIDENCE: A tour was carried out at the beginning of the inspection visit. The home was clean, spacious and warm. All bedrooms have been personalised. There is an open plan central lounge with a dining area and all other rooms go from here. The kitchen is in process of being redesigned due the new cooker blocking the dishwasher from opening properly. The worktop surface edging that was chipped and commented on at the last inspection has not been repaired due to the overall redesign but its repair is included in the refurbishment plan. Appropriate infection control measures are in place – flip top bins, liquid soap, paper towel dispensers and there are suitable waste disposal procedures in place. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 19 Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team have a strong commitment to enabling service users to develop their skills, including social, emotional, communication, and independent living skills. The recruitment process is satisfactory and effort is made to make sure that interaction with service users and their response is taken into account when deciding suitability. Service users benefit from an enthusiastic and supportive staff team. The NVQ training programme is underway. A good range of training is provided to meet individually assessed needs. EVIDENCE: The registered manager was not available during the site visit and the staff files were locked away. However, staff records were viewed thoroughly at both previous inspections and there have been no requirements regarding the recruitment procedure. Discussions with new staff indicated that correct procedures had been followed to protect service users. There was also some information provided by the registered manager in the pre-inspection Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 21 questionnaire regarding CRBs and staffing levels. The team leader discussed the recruitment procedure. She also explained how the service users’ feelings are taken into account by observing how they interact with new or prospective staff. The induction was discussed both with the team leader and new staff on duty. It was also later discussed with the registered manager over the telephone. On the first day staff go through the home policies and basic information. The team leader has put information relevant to supporting individuals in one file so that new staff are able to gain some insight into the care and support provided. Then they have the opportunity to discuss and ask questions and gain understanding. The induction training pack was viewed and discussed. It contains the standards recommended in Skills for Care in 2005 but has not been revised to contain the general induction elements that have been produced recently by Skills for Care to be introduced from now on. A recommendation has been made to incorporate these into the induction training. Attendance to mandatory training is organised by the team leader as courses are available. Courses are a mixture of external and some provided by the company training department. The records were viewed and there is ongoing provision keeping all staff up to date. Staff have a training development plan and the team leader explained that during supervision the staff have expressed an interest in training in particular areas. A recent example was the request for training in autism. This request was passed on to the training team and the training was provided this year. There have been staff changes recently and the team do not currently have 50 of the workforce trained in NVQ. 3 staff currently hold the NVQ level 2 and this includes the team leader who also has level 3. There is a NVQ programme which is being run in partnership with two training organisations. The team leader has qualified as an NVQ assessor. 2 staff are currently studying level 3. The programme is ongoing throughout the company. A recommendation has been made to continue to provide sufficient training to reach the workforce target. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well managed home. The quality assurance monitoring system needs to be further developed so that it can be relied upon to make sure that the home is meeting individual needs and striving for improvement. The home has a good record of meeting health and safety requirements. EVIDENCE: The management structure of the home is effective. All staff were clear in their roles. Gate House is one of a group of 5 homes on the same site that is overseen by the same registered manager. The registered manager has the required qualifications and experience to meet this standard. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 23 The current quality assurance process was discussed with the registered manager shortly after the site visit. The manager has set up a quality audit that includes health and safety, security, equipment and refurbishment of the home. This generates action points and discussions and plans to implement improvement. The team leader in Gate House has designed personal development plans for each individual living in Gate House. The team leader described these during the site visit but was unable to show them to the inspector because they had been given to the main head office to be checked and printed out. However, she was able to explain some of the contents to give sufficient evidence. The company has produced surveys that are sent out to relatives, visiting professionals and other interested people. Feedback is sought in a variety of ways from service users depending on their understanding and communication skills. From observations of service users in Gate House they are able to communicate with the use of aids, although responses and understanding are limited to what is happening in the immediate environment and physically affecting them at the time of asking. Other methods of information gathering to ascertain their views would also be needed. At present the company produces overall business plans for all homes including priorities for improvement. An individual report has not been produced for the home to bring the outcomes of quality monitoring together for Gate House. A development plan needs to be designed for this home so that everyone is working towards improvement of the home and the service provided to service users. A requirement to continue to create a quality assurance system for the home, produce an annual report and from that design a development plan has been made. Mandatory training is ongoing and all staff have completed relevant training. A variety of home records were viewed including the fire log and environmental risk assessments were discussed. These were relevant and kept in good order. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 25 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5 (1)(b-bd)(c) Requirement All service users should have a contract and these need to include the current fees and relevant information in line with this revised regulation. Create a quality assurance system for the home, produce an annual report of outcomes and from that design a service development plan. Timescale for action 15/01/07 2. YA39 24(1-5) 28/02/07 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. Refer to Standard YA6 YA32 YA35 Good Practice Recommendations Need interim guidelines for staff to support individuals when they are being reassessed for changing need, written in the service user plan. Need to continue to provide sufficient NVQ` training to reach the workforce target. The Skills for Care general induction elements need to be DS0000064755.V308088.R01.S.doc Version 5.2 Page 26 Gate House incorporated into the induction training. Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Gate House DS0000064755.V308088.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!