Inspection on 14/07/06 for Gaywood Street 24

This inspection was carried out on 14th July 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gaywood Street 24 16/07/08

Gaywood Street 24 27/07/07

Gaywood Street 24 19/01/06

Gaywood Street 24 23/09/05

Gaywood Street 24 04/01/05

Gaywood Street 24 05/10/04

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

CARE HOME ADULTS 18-65 Gaywood Street, 24 London SE16HG Lead Inspector Lynne Field Unannounced Inspection 14 & 21st July 2006 12:00 th Gaywood Street, 24 DS0000007090.V302951.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 Gaywood Street, 24 DS0000007090.V302951.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. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gaywood Street, 24 Address London SE16HG 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) 020 7261 9210 LINC Care Home 5 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 people with learning disabilities male or female, some of whom may be over 65 years old. 19th January 2006 Date of last inspection Brief Description of the Service: Gaywood Street is care home providing personal care and accommodation for up to 5 people with a learning disability some of whom may be over 65 years of age. Hyde Housing Association Limited owns the building but Choice Support manages this. The service is staffed and managed by PLUS support (Provident and Linc United Services), a voluntary organisation. The home is located in Elephant and Castle, close to shops, pubs, the post Office, underground and buses. The home consists of a two-storey building, and is designed to be wheelchair accessible, with passenger lift, and access to a patio area. All the home’s bedrooms are single. The deputy manager said the current range of fees is charged from £277-60p per week. Additional charges are made for things such as hairdressing and toiletries. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out over two days in July 2006. The manager was on holiday on both days but deputy manager was present and took part in the inspection process. There were five service users in residence on the day of the inspection. The inspector spoke to six care staff as well as meeting all the service users. Only one service user was able to give his views and he said he liked living at the home. The inspection included a tour of the home and examination of records on care plans, staff records and records relating to running the home. During the inspection staff interaction with service users was observed to be very kind and caring and conducted in a respectful manner. What the service does well: What has improved since the last inspection? What they could do better: The home must have better systems in place to ensure the service users are protected from possible abuse. Fire safety policies and procedures must be reviewed to give clearer advice on what to do in the event of a fire. The home kitchen and bathrooms need to be cleaned and updated. Flooring in the kitchen, stairs and hall need to be replaced. Service users care plans and needs assessments need to be kept up to date at all times. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 6 An agreement / contract of the ownership of the car needs to be agreed drawn up with the service users and advocates. 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. Gaywood Street, 24 DS0000007090.V302951.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 Gaywood Street, 24 DS0000007090.V302951.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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information in the Statement of Purpose and Service User Guide needs to be revised to include details of the new organisation. Service users have their needs assessed by senior staff before they move to the home and know that staff have decided that the home can meet their needs before they move there. Prospective service users and their relatives can come and look around the home and meet staff before they decide to move there. EVIDENCE: The home has recently been taken over by a new organisation. The inspector was shown the statement of purpose and service user guide. These need to be reviewed and updated to include all the information relating to the new organisation. One service user moved into the home in December 2005. The deputy manager told the inspector that the manager assessed the service user before they were accepted into the home and all adaptations were in place, such as handrails and a profiling bed, before they arrived to live at the home. The service user was able to visit the home before deciding to come to live there. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 9 The inspector looked at the service users file and noted there was a contract in place outlining the care they would receive and the service user, the care manager and the homes manager signed this. Gaywood Street, 24 DS0000007090.V302951.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): 6,7,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans, risk assessments and action plans need to be reviewed to describe the needs of the service users and how staff will meet the needs and manage or minimise risks. EVIDENCE: The inspector viewed three service users care plans. Files had all the information needed to meet this standard but would benefit from being more organised. Care plans and risk assessments were in place but needed to be reviewed. The deputy manager told the inspector they were in the process of changing all the paper work relating to the home to comply with the organisation that has recently taken over the management of the home and the new manager wanted to change how files were organised. The new manager, who had only recently come into post, was on holiday on the days of the inspection. The deputy manager said when she returned from holiday, they had planned to go through all the service user’s files to reorganise review and update the files. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 11 The third file viewed was of the service user most recently admitted to the home. This had copies of the six weekly review and risk assessments in place. At the previous inspection in January 2006 it was noted that staff have helped service users by writing down their life story, so that staff and other people can better understand what they need. Person centred planning has been started but this needs to be continually developed with service users. Service users have files with personal information kept safe and private at the home. All personal information that was displayed on cupboards in the kitchen has been removed. Gaywood Street, 24 DS0000007090.V302951.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): 12,13,14,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Meals are varied and enjoyed by service users. A healthy diet is provided and mealtimes are relaxed. Service users are restricted by staff constraints to be able to take part in activities in their local community. The new manager is to review this. Despite this, efforts are made to provide activities and access as many social events in the community as possible. EVIDENCE: Apart from one service user who is ambulant, all service user’s need assistance both to move around the home and staff to support them in most aspects of their daily lives. The inspector observed staff assisting service user’s in the home to make choices about what they wanted to eat and what they wanted to do with their time as well as assisting them with their personal care needs. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 13 All the service users apart from one are not able to communicate their needs verbally but staff were seen to be sensitive and know the service users well enough to be able to understand what they want through the service users facial gestures, sounds and body language. The inspector was shown a copy of the menu. The staff said most of the service users had lived at the home for a number of years and the staff were able to tell by their reaction whether they like the food they are given. The deputy manager told the inspector they had helped a service user organise a meal out for her birthday in a local restaurant that is accessible for wheelchairs. All the service users, with support from staff and her relatives were going. The deputy manager told the inspector that the home encourages service users and their relatives to keep in touch and invites them to any events the home is organising. One service user told the inspector they went on holiday with their friend from the home they had lived previously. The deputy manager said one of the difficulties with accessing the local community was because each service user has a wheelchair and each need a member of staff to take them and there were not always enough staff on duty to do this safely. The deputy manager told the inspector that the rota needs to reflect the needs of the service users rather than the needs of the staff. The inspector was told the new manager was dealing this with and staff were being consulted about changes to the rota. The home must make sure service users have the opportunity to go out into the community and access other activities other than activities in the home. There is an activities programme that the service users follow and one service user attends a day centre four days a week. The home has a sensory room, which was shown to the inspector. Three service users were using it with the help of a member of staff and from their faces it appeared they were enjoying the experience. Most of the service users activities were in the home. One service user owns a car that has been adapted to take a wheel chair and other service users have been using this. There has been an ongoing discussion in previous reports and within the organisation about whether this should happen and if it is agreed, what service users should pay towards the car. See Standard 23. Gaywood Street, 24 DS0000007090.V302951.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): 18,19.20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported safely, having their health needs met. The home does not assist the service users to assess community activities as much as it could. EVIDENCE: All the service users in the home need help with personal care. The inspector observed staff assisting service users move around the home and taking them to their bedrooms for personal care. Staff spoke to service users with respect and addressed service users by the name they preferred to be called by. There are procedures in place for night care, such as having a waking night carer and an alarm system for service users who have epilepsy and may have a seizure during the night. Staff told the inspector service users are checked hourly though out the night and assisted with personal care as necessary. The medication is kept in a locked cupboard in the kitchen. A member of staff helped the inspector check the medication, which was correct. They explained Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 15 that one service user was given their medication at a time and it was signed for at the time of it being given before going on to another service user. The label and dosage must be checked every time before administrating the medication to the service user. This was part of the homes policy and procedure. If a service user is prescribed a new medication this is recorded in the communication book as well as on the service users medication chart. The medication is audited weekly. None of the service users have the ability to be self-administrating. During a service users review it had been decided the service user should purchase a prepaid funeral package. The inspector questioned this as there were not many people at the review and the service user has not the ability to fully understand. The inspector was told the home had written to the service users’ social worker and they had agreed it would be acceptable to do this. If the organisation decides that this is something they want to have in place, they must make sure this is what the service user and their family would want and need to taken in to consideration cultural and religious needs of the service user. Gaywood Street, 24 DS0000007090.V302951.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. More needs to be done to protect service users from abuse and measures need to be put in place to address this. EVIDENCE: The home has a complaints policy, a copy of which is in the service users’ guide. The inspector saw the complaints book. There was one complaint recorded since the last inspection by a service user and this was dealt with under a “Safeguarding Adults Meeting” chaired by a Southwark SSD senior practitioner. The outcome was the allegation was unfounded and there were recommendations that came out of the meeting which the home are to follow. The allegation was reported by a service user to a visiting professional, who in turn reported it to the home. The home did not report this allegation to CSCI which came to the inspector’s attention through social services. The inspector was told one service user owned the car but several service users have been allowed to use this. This has been an ongoing concern that the home has been asked to address in previous inspection reports and requirements that have been left. Service users don’t have written agreements about the use of the vehicle owned by the one service user, and currently used by the others informally. The organisation must look at the transport arrangements for the service users in the home and consider how this could be managed more fairly for all the service users. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 17 The inspector checked three service users financial accounts with the deputy manager and found them all to be correct. Staff must bring back a receipt for all service users money spent and a running total is kept in the service users cash account books. Each service user has their own bank account and three senior managers are signatories on the accounts. Gaywood Street, 24 DS0000007090.V302951.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): 24,25,26,27,28,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in comfortable accessible accommodation but areas of the home have been allowed to become shabby, for example worn flooring in the kitchen, landing and stairs. EVIDENCE: The inspector was given a tour of the home, which is spacious and homely. The living room and kitchen are a good size but the kitchen is dated and the tiles on the floor are broken and need to be replaced. There are adequate bathrooms and toilets with specialist equipment for staff to use to assist the service users safely with their personal care but the tiles in the bathrooms were dirty and need to be cleaned. The hall and stair carpet is worn in places and should be replaced. The service users bedrooms are spacious and they are decorated to reflect the service users personalities. There is a garden leading from the kitchen, which is accessible and well used by service users. During the tour of the home the inspector noticed the laundry door was propped open. A fire door guard should be used for this door or the door kept shut. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 19 The deputy told the inspector manager there had been problems with the lift and it had been out of action for several days, several months ago. Service users had been unable to get down stairs. The contractors managed to get it working but it needs major maintenance to be carried out on it. This has been authorised and a time slot has been allocated to do this. The inspector was shown the action plan and risk assessment in the event the lift should be out of action again before the planned maintenance has been completed. There were a number of wheel chairs in one service user’s bedroom. The deputy manager said they belonged to the service user. Two were in a poor state of repair and are not used. The home needs to make arrangements to have them repaired or removed. One service user is ambulant who has moved to the home recently but unsteady on their feet. A handrail has been installed to help them move around the home independently. Gaywood Street, 24 DS0000007090.V302951.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): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are supported by an effective staff team that know the service users well. Staff are having appropriate training to meet the needs of the service users and to keep them safe. EVIDENCE: The inspector examined three staff files. The home operates a good recruitment process, which includes formal interview, taking up two references, CRB checks and POVA checks prior to appointment. All staff has an employment contract, which include details of their terms and conditions of employment and has been signed by them. The home protects service users by obtaining references, CRB checks, and obtains employment histories. The inspector spoke to six staff over the two days of the inspection. Staff told the inspector they enjoyed working at the home. One told the inspector they had transferred to the home to be with the new service user to help them settle in the home and to have someone they knew. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 21 Two members of staff told the inspector they had supervision at least every two months or more often if it was needed. The records shown to the inspector confirmed this and the manger and member of staff signed them. Staff told the inspector they felt supported by the management of the home and they were approachable. The inspector observed staff working with service users and noted they treated them with respect and were caring when assisting them in daily living. Staff spoken to said they had fire training. The home keeps training files separate from the main staff files. The inspector checked the training records of the three staff files and these confirmed staff had training in Adult Protection, Fire training as part of the health and safety course and Medication refresher course. The inspector was told three care staff had completed NVQs level 2 and 3 and one staff was on a management training course. The deputy manager showed the inspector the training plan for the staff and explained staff were booked in advance into courses over the year to make sure they attended all the relevant mandatory courses. Gaywood Street, 24 DS0000007090.V302951.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. The manager has clear expectations of staff and the ethos and approach staff at the home should take. Service users know the home is well managed and run. Working practices and associated records ensure that the service users health and safety are promoted and protected. EVIDENCE: Although on the day of the inspection the manager was on holiday, the deputy manager told the inspector the new manager had a clear idea’s of how she wants the service to develop and this would benefit the service user’s. Although she has only recently come to work at the home, she has been with the organisation for some time in another home. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 23 Records indicated that all fire and electrical systems and equipment in the home are serviced and inspected appropriately and that all internal checks are conducted at appropriate intervals. The inspector looked at the fire policy and procedure. It was not clear from this if in the event of a fire staff should leave service users in their rooms till the fire service came to rescue them or if staff should start to move them out to the fire assembly point. The registered provider needs to contact the local fire service or their own in house fire office and review the policy and procedure. The registered provider must to conduct monthly, unannounced visits to review the service and send copies of the reports to CSCI to evidence the provider’s monitoring of the service. Gaywood Street, 24 DS0000007090.V302951.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 2 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 X 2 X X 3 x Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 25 Yes 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 YA1 Regulation Sch 4 Requirement The registered person must produce an up to date statement of purpose and service user’s guide for the home to incorporate all the information required to meet this standard. The registered person must ensure that all service users care plans are regularly reviewed and up dated on time. The registered provider must ensure service users are able to engage in local, social and community activities. The registered person must ensure that service users are supported to express their wishes and feelings and make a decision regarding death and dying, taking any action necessary in consultation with the purchasing authority and other stakeholders. The registered person must ensure they review the transport arrangements of DS0000007090.V302951.R01.S.doc Timescale for action 30/10/06 2. YA6 15 30/10/06 3 YA12 YA13 YA14 2(m) (n) 30/10/06 4 YA21 12(2)(3) 30/10/06 5 YA23 13(6) 30/10/06 Gaywood Street, 24 Version 5.2 Page 26 6 YA24 13(4)(a) 7 YA24 23(4) 8 YA30 23(2)(d) 9 YA39 Reg 26 the service users and how this is paid for by the service users to protect them from possible financial abuse. The registered provider must ensure the kitchen floor, hall and stair covering is free of hazards. The registered person must take adequate precautions to protect the home from fire by keeping the laundry room door closed or fitting it with a fire door guard. The registered person must ensure the bathroom and toilet walls are cleaned to maintain satisfactory standards of hygiene within the home. The registered person must ensure Regulation 26 monthly visits are conducted and copies of the reports are sent to CSCI in Southwark. 30/10/06 30/10/06 30/10/06 30/10/06 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 YA29 Good Practice Recommendations The registered person should maintain or dispose of the surplus wheelchairs. Gaywood Street, 24 DS0000007090.V302951.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Gaywood Street, 24 DS0000007090.V302951.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!