Inspection on 23/02/06 for 428-430 Gillott Road

This inspection was carried out on 23rd February 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 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 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

428-430 Gillott Road 28/12/06

428-430 Gillott Road 28/09/05

428-430 Gillott Road 10/01/05

428-430 Gillott Road 08/09/04

428-430 Gillott Road 09/12/03

428-430 Gillott Road 26/08/03

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Tanglewood

88 Church Lane

Harmony Care Home

Olivet Christadelphian Care Homes

Sayer House

Beacon Centre For The Blind

60 Olive Lane

Bryndale Avenue, 41 Flats 13, 14 & 18

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

CARE HOME ADULTS 18-65 Gillott Road, 428/430 Edgbaston Birmingham West Midlands B16 9LP Lead Inspector Kerry Coulter Unannounced Inspection 23rd February 2006 11:00 Gillott Road, 428/430 DS0000016714.V284905.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 Gillott Road, 428/430 DS0000016714.V284905.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. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gillott Road, 428/430 Address Edgbaston Birmingham West Midlands B16 9LP 0121 454 5323 0121 455 8256 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) Sense West Ms Deborah Holt Care Home 8 Category(ies) of Learning disability (8), Sensory impairment (8) registration, with number of places Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 28th September 2005 Brief Description of the Service: 428-430 Gillott Road is registered to provide personal care and support to 8 adults with a visual impairment/ learning disability, who have been assessed as requiring full assistance with daily living tasks. The premises are divided into two homes, each with its own team of staff. Each has its own front door but is also internally interlinked. The home is staffed 24 hours a day including waking night and a sleeping in member of staff. Service users would be admitted to the home following a full assessment that would determine the level of support they require. A number of adaptations have taken place within the home in order to meet the assessed needs of the service users. Service users are encouraged and supported to maintain links with their families and the local community. The home is situated in Edgbaston, a residential area of Birmingham and has ready access to local amenities. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by one Inspector over five and a half hours. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from September 2005. Two managers manage the home, one based in 430, the other in 428, only one of the mangers is registered. Service users were unable to give a view of the home due to their communication needs. At this inspection time was spent observing care practices, interactions and support from staff. A tour of the home was made. Service user care plans, risk assessments and some Health and Safety records were inspected. The Inspector had the opportunity to talk with members of staff, the Registered Manager and Unregistered Manager. The Inspector did not have an opportunity to speak with relatives. What the service does well: What has improved since the last inspection? Some hard work has been undertaken to cross reference risk assessments with the care plans, so that the reader is naturally directed from one to the other. The Registered Manager has liaised with the GP and medication reviews have taken place or are in the process of being arranged. Previous requirements regarding medication administration systems have been met. It was identified at the last inspection that records on the use of physical intervention needed improvement. Records sampled at this inspection showed improvement and met the required standard. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 6 A greenhouse has recently been installed so that service users can become more involved in growing plants. A team building day was organised in December. Since the last inspection the Manager has been successful in her application to be registered with the CSCI. 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. Gillott Road, 428/430 DS0000016714.V284905.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 Gillott Road, 428/430 DS0000016714.V284905.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): N/A EVIDENCE: These standards were not fully assessed. It was previously required that consideration be given to providing the service user guide in alternative formats to include photographs, CD Rom, audio or video tape as suitable to individual need. The Manager said that the home now had access to a CD Rom format. Gillott Road, 428/430 DS0000016714.V284905.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): 8, 9 Service users are supported to make choices and decisions, but this is limited by their learning disabilities and communication support needs. Responsible risk taking is recognised as an essential component of promoting individual independence. However, risk assessing needs to be developed regarding identifying levels of risk. EVIDENCE: Care plans were not fully assessed at this inspection as they were observed to meet the required standard at the inspection in September 2005. The home has a wide range of service user risk assessments, these include swimming, rambling, ice skating and self-injurious behaviour. At the last inspection some assessments were not up to date. Sampled assessments at this inspection had been reviewed in the last six months. Additionally the Unregistered Manager was in the process of reviewing the risk assessments for one service user at the commencement of the inspection. Some hard work has also been undertaken to cross reference risk assessments with the care plans, so that the reader is naturally directed from one to the other. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 10 As highlighted at the previous inspection the level of risk was not always clear from the assessment. The home uses a Sense risk assessment format that does not guide staff about the inclusion of the level of risk. Discussion with the Registered Manager indicates that she is awaiting guidance from Sense before completing work on this. In this house, choices and decision-making are restricted to fairly mundane matters, (such as what to eat or whether to go out) because of people’s learning disabilities and limited communication. Staff have to use their knowledge of individuals’ mannerisms, body language and gestures to interpret their wishes. Staff were observed including service users in the routine of the house, for example one individual was supported to make a hot drink. Gillott Road, 428/430 DS0000016714.V284905.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): N/A EVIDENCE: These standards were not assessed. The inspection in September 2005 found the key standards to be met. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 12 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): 19, 20 Minor improvement of the homes healthcare monitoring systems were required so that the home can evidence that service users needs are properly monitored and kept under review. General practice in the handling and administration of medication affords protection to the service users but some improvements are needed to medication protocols for as required medication. EVIDENCE: There was evidence of service users receiving regular health checks. Records show that referrals are made to healthcare professionals to include the Speech and Language Therapist. At the last inspection it was not evident if all service users had regular medication reviews. The Registered Manager has now liaised with the GP and reviews have taken place or are in the process of being arranged. One service user has diabetes. Guidelines for staff instructed them that two tests per day for glucose levels were required. However monitoring records did not always record that two tests had been done. These were some blank spaces where staff had not recorded the outcome or any reason why the test had not been done. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 13 One service user has recently been unwell. Records sampled showed that action taken in response to this has been appropriate with the GP being consulted as necessary. Notifications to the CSCI show that one service user has had increased incidents of self injurious behaviour. Discussions with the Manager and sampling of records show that advice from health professionals has been sought. Medication and behaviour guidelines have been reviewed and recent weeks have shown a decrease in this behaviour. Some service users are at risk of constipation. Records sampled show that this is regularly monitored by staff. The ‘as required’ medication protocol guided staff to seek advice from the GP in extreme circumstances. As it is not unusual for this service user to not open their bowels for quite long periods clearer guidance is needed for staff. This should detail what are extreme circumstances and what signs do they need to watch out for regarding severe constipation. ‘As required’ medication protocols were observed to generally not be dated. These should be dated to evidence that they are regularly reviewed and are still current. Previous requirements regarding medication administration systems have been met. A copy of the prescription is now retained, so that staff checking in the medication can check the medication against the prescription. Controlled medication is now checked and signed for daily in a bound controlled drug register. A random audit of stocks held revealed no discrepancies, and there were no gaps on the administration record. It is good practice that clear descriptions have been completed on how service users prefer to take their medication. It was recommended previously that the location of the medication cabinet in the kitchen in 428 needs to be reviewed. It is quite high making it difficult for any staff who are smaller in height to easily see what is stored on the top shelves. The cabinet is also located behind a door. People entering the kitchen would not be able to tell if someone was behind the door using the medication cupboard. This poses a risk to staff and could also disrupt the safe administration of the medication. The Registered Manager said this has been considered but has not been feasible as other walls did not have the load bearing capacity. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 14 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): 23 General practice provides protection for service users from abuse, neglect and self-harm, but some CRB checks have still to be received and some staff require refresher training in physical intervention. EVIDENCE: It was identified at the last inspection that records on the use of physical intervention needed improvement. Records sampled at this inspection showed improvement and met the required standard. Staff receive training in the use of physical intervention and generally receive an annual refresher. Unfortunately the Registered Manager has not received refresher training since 2001, she said that this had occurred as she had given up her training places to enable new staff to attend. It is essential that staff receive annual refresher training to reduce the risk of injury to themselves and to service users. One member of staff spoken with demonstrated an adequate knowledge of the physical intervention guidelines in place for one service user. An incident occurred in the home regarding two service users; appropriate action was taken by the home. The incident was notified to the CSCI and the Social Worker as a potential adult protection issue. The incident was investigated by Sense and a report was produced with action points to prevent future occurrences. Evidence at this inspection shows that the Manager is working towards meeting all the agreed actions. It was identified at the last inspection that some staff did not have CRB checks. Evidence was available that checks have been applied for where required. CRB checks had been completed prior to new staff commencing work in the home. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 15 Agency personnel are used to cover staffing deficits. It is good practice that the home requests a profile of the staff used from the agency to ensure a CRB check has been obtained. Gillott Road, 428/430 DS0000016714.V284905.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, 26, 27 Several maintenance matters required attention to ensure the home presents as a homely and comfortable environment for the people who live there. EVIDENCE: Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 17 The home is decorated in bright contrasting colours to meet the needs of service users with a visual impairment. Around the home there are tactile indicators to indicate to service users where doors, stairs and other hazards are. The lounges, dining areas and kitchens also have tactile indicators. The safety systems are appropriate for people with visual and associated impairments. There are buzzers and flashing lights to alert service users. It was identified at the last inspection in September 2005 that one bedroom was without a wash hand basin, no evidence was provided that the provision of this facility would pose a risk. It was required that this must be reviewed and a wash hand basin provided if appropriate. The Manager said that she was in the process of trying to meet with health and social care professionals to seek their views on the provision of a wash hand basin. As observed previously, the refurbished wet-room has several areas where the walls require repainting. The Registered Manager said that this has not yet been done as there are some leaks from this room to the bathroom below. Once resolved the room will be repainted. Since the last inspection funding to provide a walk in shower for one service user has been agreed. The Registered Manager said that they are awaiting a date for the work to commence to provide showering facilities that are more suitable to this individuals needs. The rear garden is enclosed and well maintained. A greenhouse has recently been installed so that service users can become more involved in growing plants. The premises are not owned by Sense. On the day of the inspection a meeting took place between the Registered Manager and the representatives of the housing association who own the property. The registered Manager said that these meetings occur quarterly to discuss any issues regarding the premises. Gillott Road, 428/430 DS0000016714.V284905.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): 32, 33, 35, 36 Current staffing arrangements are at times failing to meet the needs of the service users. EVIDENCE: It was noted that both staff and service users appear comfortable in each other’s company, staff give support with warmth, friendliness and patience and treat people respectfully. The standard requires that 50 of staff achieved NVQ level 2 by 2005, discussion with the Registered Manager indicates the home has met this target. The home maintains the minimum agreed number of staff on duty to meet service user needs. However due to several long term staff absences and some staff vacancies there is regular use of agency staff. This is higher in house 428 than 430, where most shifts there is an agency member of staff on duty. The organisation needs to ensure the current use of agency staff is further reduced to ensure service users are supported by people they know well. During the inspection a member of staff phoned in unwell at 12:44, unable to attend their afternoon and sleep in shift. This gave the Registered Manager little time in which to organise a replacement. It is therefore recommended that the procedure guiding staff regarding phoning in sick is reviewed and the notice period extended regarding afternoon shifts. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 19 Staff files were sampled. Files for newly recruited staff contained all the required information to evidence that a robust recruitment process had been followed. However, for two staff who have worked at the home for some time Criminal Record Bureau checks have not been received, as stated earlier in this report. However, these have been applied for. Training records and discussion with the Registered Manager show that SENSE has a rolling programme of training but some training is outstanding. However booking forms show that arrangements have been made for staff to receive the training they need. The Registered Manager is due to take part in a pilot project using the ‘Kilpatrick Model’ to evaluate training undertaken by staff to see how beneficial it has been in regard to improving actual practice. Sampled minutes show that staff meetings are held on a regular basis. The frequency of formal supervision from managers was assessed for three staff. For two staff the frequency was regular but one staff had not had formal supervision for several months. The Manager said that the supervisions had been arranged but the member of staff had not been able to attend. One member of staff spoken with said they felt appropriately supported by the Manager. A team building day was also organised in December. Gillott Road, 428/430 DS0000016714.V284905.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, 42 EVIDENCE: Since the last inspection the Manager has been successful in her application to be registered with the CSCI. There are some concerns regarding the homes compliance with relevant Health and Safety legislation. There were some gaps in the records for testing of fire alarms and emergency lighting. This was identified at the previous inspection and has also been recorded on three previous reports of the visits made by the representative of Sense. The home needs to develop a system that reminds staff when the tests are due and the Registered Manager must check to ensure it has been done. Records observed show that the gas appliances have been tested as safe by an engineer. Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 21 At the last inspection the certificate for the hard wiring system recorded that some areas are unsatisfactory but evidence was not available to show that all the work required had been carried out. The Registered Manager said she had been assured the work has been done and she has requested a new certificate from the housing association. Records show that the electrical installations had been discussed at a meeting with the housing association. However, to date evidence has not been received to show the work has been done. Staff test the fridge and freezer temperatures regularly to make sure that food is being stored at the correct temperature. Staff test water temperatures weekly. Records of these showed that these are safe. Gillott Road, 428/430 DS0000016714.V284905.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 X 2 X 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 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 2 X 3 X X X X 1 X Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA9 YA19 Regulation 13(4) 12(1)(2) Requirement The risk assessment must clearly record the level of risk. Outstanding from 30/11/05. Ensure all health monitoring records are completed in line with written care plan, guidelines. Clearer guidelines are needed for staff regarding the risks of constipation for one service user. This should detail what are extreme circumstances and what signs do they need to watch out for regarding severe constipation. Ensure medication ‘as required’ protocols are regularly reviewed. Ensure all staff receive annual physical intervention refresher training. Attention is required to repainting of walls in the wet room. Outstanding from 30/11/05. The lack of a wash hand basin in one service users bedroom must be reviewed. One must be provided if appropriate. Outstanding from 30/12/05. The service user in ground floor DS0000016714.V284905.R01.S.doc Timescale for action 30/04/06 30/03/06 3. YA19YA20 12(1)(2) 13(2) 30/03/06 4. 5. 6. YA20 YA23YA35 YA24 13(2) 12(1) 13(6) 18(1)(c) 23(2)(b) 30/03/06 30/05/06 30/04/06 7. YA26 23(2)(j) 30/05/06 8. YA27 23(2)(j,n) 30/05/06 Page 24 Gillott Road, 428/430 Version 5.1 9. YA33 12(1) 18(1)(a) 10. YA34 13(6) 19 11. 12. YA36 YA42 18(2) 13(4) 13. YA42 13(4) 23 bedroom must be provided with showering facilities suitable to his assessed needs. Outstanding from 30/11/05. (Quotes for this work to be done have been obtained since the last inspection) The home needs to resolve the issues of staff who are absent form work and reduce the use of agency staff. Outstanding from 30/11/05. Criminal Record Bureau checks must be obtained for all staff working at the home. Outstanding requirement but checks have now been applied for. Ensure all staff receive formal supervision at least six times per year. Ensure evidence is available in the home to show that electrical repairs have been done, as required on the hard wiring certificate. Outstanding from 14/10/05. Ensure that the fire alarms and emergency lighting are tested weekly/monthly. Outstanding from 29/09/05. 30/04/06 30/04/06 30/04/06 30/03/06 22/02/06 Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The medication cabinet in the kitchen should be relocated to a more convenient location. Previous recommendation. Manager said this has been considered but has not been feasible. It is recommended that the procedure guiding staff regarding phoning in sick is reviewed and the notice period extended regarding afternoon shifts. 2. YA33 Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Gillott Road, 428/430 DS0000016714.V284905.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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