Inspection on 02/08/06 for Glanmor

This inspection was carried out on 2nd August 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glanmor 05/07/07

Glanmor 05/01/06

Glanmor 18/07/05

Glanmor 01/03/05

Glanmor 07/10/04

Glanmor 17/03/04

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

CARE HOME ADULTS 18-65 Glanmor Bath Road Chippenham Wiltshire SN15 2AD Lead Inspector Alyson Fairweather Key Inspection 2 August 2006 10:30 nd Glanmor DS0000028637.V294702.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 Glanmor DS0000028637.V294702.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. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glanmor Address Bath Road Chippenham Wiltshire SN15 2AD 01249 651336 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) ABLE (Action for a Better Life) Maricka Elke Hamblin Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: Glanmor is a large, detached house converted from two semi- detached homes. It is situated within walking distance of Chippenham town centre and provides a service for seven residents who have or are recovering from mental illness. The home has a close support network with the local community psychiatric team. Glanmor is managed by ABLE (Action for a Better Life) and Sarsen Housing Association owns the property. There is a large secluded garden surrounding the home, with a paved patio area, and a car park at the rear. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in August 2006. Five residents, the manager and several care staff were present and spoken to. Written comments about the home have been received from five residents, two Community Psychiatric Nurses who have clients living in Glanmor, and a GP whom some of the residents visit. The current fees charged by Glanmor are £565 per week, although these are subject to review. The manager of Glanmor has been registered with the Commission for Social Care Inspection since 2005, and has a number of years experience of working with people with mental health needs. Glanmor is one of two registered premises managed by ABLE, who also are responsible for two other accommodations for more independent living. The inspector walked round the premises and examined several records, including care plans, risk assessments, health and safety and staff training. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: A great deal of work had been done on residents’ care plans. They contained information about people’s likes and dislikes and how their needs could best be met, as well as detailed information about their physical and mental health, their activities, their family contacts and any personal care needs. These care plans are reviewed on a regular basis and signed by the keyworker and the resident. One resident said “staff treat me well” and another said “staff listen, and act on what I say”. Two CPNs and a GP said that “specialist advice given to the home was incorporated into residents’ care plans”. Staff support residents to manage their own medication whenever they can. The medication records examined were in good order. The home has a policy in place for all medication, and all staff have medication training. The CPNs and the GP all said that medication was handled appropriately in the home. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glanmor DS0000028637.V294702.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 Glanmor DS0000028637.V294702.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): 2 Prospective residents would have their needs, hopes and goals assessed and recorded before they move in to the home. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Although there has been no new resident for some time at Glanmor, the staff team would ask for considerable information from the referring mental health team if a new resident is planning to move in. Information would be received from medical teams and from various other professionals. Each new resident would be offered a series of trial visits, in order to give them time to get to know the home, the other residents, and the staff. Staff would try to find out what they would like to do with their daily routine before they move in. The referring mental health teams would provide a copy of the most recent Care Programme Approach (CPA) plan, which gives details of how the potential resident can best be supported with their mental health needs. The home also has a service user guide which tells any potential resident about the service they provide. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Residents know that their needs and goals are reflected in their care plans, and they are encouraged and assisted to make their own decisions. They are supported to take risks as part of an independent lifestyle. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: A great deal of work has been done by staff in relation to compiling care plans for service users. Each plan now has an index page which quickly shows where to find specific care plans. Care plans include information on communication, accommodation, literary skills, health and social activities, as well as individual’s Care Programme Approach reports (CPA’s). Care plans have been reviewed regularly every six months, but are also done so when the situation has changed. A system of daily records is also in place. One file examined showed that a CPA done in January 2006 was recorded as due again in June 2006. This meeting had not taken place. The manager said that this resident had monthly meeting with her CPN and staff from Glanmor, and that was Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 10 probably why there had been no CPA. However, there was no record of these monthly meetings, and no evidence that this was an alternative to having a CPA. This means that the care needs which may be identified at these meetings is not recorded on the care plans for staff to follow, and the manager has been asked to ensure that all care plans contain accurate, up-to-date information. Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have family involvement and other support. Glanmor has recently been encouraging residents to use the local bank more, and this has had a positive effect on their independence. They have also started to use individual money boxes for their own use, instead of staff having to hand out money to them each time. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. There were now risk assessments in place for several residents, some of which had recently been reviewed. In discussion with the staff, it was clear that they was aware of the ways in which residents could be at risk, and that staff were taking measures to avoid these. Some risk assessments were kept alongside the medication records, and some were on the resident’s file. The ones on file were clearly linked to the resident’s care plans, and it is recommended that they are all stored in this way. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents have as much or as little contact with family and friends as they wish, and are encouraged and supported by staff. Residents’ rights are respected and responsibilities recognised in their daily lives. They are offered a healthy diet and enjoy their meals and mealtimes. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. One resident had gone out to day services on the day of the inspection, but five were at home. Activities include going to a workshop, shopping, visiting relatives and friends, gardening, arts and crafts Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 12 and attending industrial rehabilitation. The home has recently introduced a video night and one night when the residents have a take-away meal together, Residents have as much or as little contact with family and friends as they want. One person often stays with a friend for a few days, and another had just come back from a few days holiday in Scotland. One had been to town that morning to meet a relative for coffee. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door and wait for response. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. No resident has an advocacy worker, although one does have a befriender. When the annual questionnaire was issued to residents, all sis people who responded said that they felt it was important to help out around the house by doing small tasks. The menu supplied in the home is varied and nutritious, and residents decide on a daily basis what the main meal will be. There was a good supply of fresh fruit and vegetables, and juices and yoghurts were also available. Staff have records of the food likes and dislikes of all residents, and healthy eating options are encouraged. Vegetarian options are available at all meals. There is a small kitchen which residents can use to prepare light snacks and this is equipped with a fridge, a microwave and a toaster. There is also a larger kitchen in which staff prepare main meals, helped by residents when they are able to do so. The dining room is light and airy and comfortably furnished, so people can enjoy mealtimes together. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents receive personal care in the way they need and prefer, and their physical and emotional health needs are met. Residents are encouraged to self-administer medication wherever possible, and there are policies and procedures in place in relation to medication support. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Although Glanmor is registered for people with mental health needs, some of the residents develop healthcare problems too, and at such times would require personal support. Many of the residents require prompting, guidance and support in relation to personal support, although some direct physical care is sometimes be needed. Personal care is offered in a sensitive and careful manner, with detailed care plans in place, outlining individuals’ preferences, and how their personal care is managed. People receive support from staff to maintain their health care needs and there was evidence of further support from GP’s and community mental health teams. The care plans recorded input from community psychiatric nurses, Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 14 psychiatrists, GP’s, optician and dentist. People who have diabetes have routine blood sugar monitoring. One resident spoken is extremely anxious about attending the dentist, so is able to have some PRN medication and be accompanied. Medication records examined were in good order. The home has a policy in place for all medication, including homely remedies, and all staff have medication training. When PRN medication was given, it was seen to be recorded both in the communication book and in the diary sheet. The home now has PRN protocols in place, and it was agreed that these can be discussed and agreed either by the person’s CPN or at the next CPA. There were good, robust systems in place, and regular stock checks are done, when all medication is counted Some residents are being supported with self-medication. One person looks after all their own medication, and takes their dossette box with them when they visit friends. Another is gradually increasing the number of days they do so. Staff were observed supporting this resident to fill the dossette box so that they can keep it in their room. . Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents’ views are listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Weekly resident meetings are held, and people are encouraged to voice any concerns they may have. There is also a complaints book and a suggestions book available for residents. The home has a formal complaints procedure which outlines the steps to take if there are any complaints. This also gives details of how service users and families can contact the Commission for Social Care Inspection (CSCI). A copy of this procedure was recently sent to all resident and their families alongside the quality assurance questionnaire. No complaints had been received either by the home or the CSCI. The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff have had training in Working with are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff. Two recent incidents had been referred to the Vulnerable Adults team by the home, and the matters dealt with appropriately. Glanmor DS0000028637.V294702.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 and 30 Residents live in a safe environment, which is clean and hygienic, although the re-decoration of two of the communal rooms would make it more homely and comfortable. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Glanmor is a detached house converted from two semi- detached homes. It is a comfortably furnished home with large airy rooms. Residents’ bedrooms were homely and each contained individual personal items. One resident had recently acquired a new bookcase, and had a play-station so that he could enjoy playing computer games. Most residents have television and stereos in their room. Residents who have small bedrooms have the benefit of another room which can be used as a sitting room. There is a smoking room available, and the main lounge is non-smoking. There is a large secluded garden to the rear of the house, with a patio area and a car park. Residents are encouraged to help with household tasks, although a cleaner is also employed. There have been instances recently where leaks from pipes and tanks have occurred, Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 17 although staff have dealt with this promptly and are in negotiation with the housing agency about how to prevent this happening again. However, both the downstairs lounge and the smoking room had badly stained walls and ceilings, and the lampshades were dirty, making this a very dingy environment for residents. The manager has been asked to ensure that the lounge and the smoking-room downstairs are re-decorated so that residents can live in a clean, comfortable environment. Glanmor DS0000028637.V294702.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, 34 and 35 Residents’ individual and joint needs are met by staff who have had induction and some specialist training, and are undertaking NVQ. Residents are supported by competent and qualified staff, and by the home’s recruitment policy and practices, although evidence of enhanced CRB and POVA checks must be made available. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Three members of staff have NVQ Level 2 and one has NVQ Level 3. Staff meetings are held weekly, and a fixed agenda ensures that important issues are discussed, including resident needs and staff training. There was no obvious way to find out at a glance who had completed NVQ, and it is recommended that an up to date index of this is kept at the front of the training file. There was evidence that new staff have induction training when they start to work at Glanmor. One new staff member spoken to confirmed that she had had induction training, and examination of her staff file showed this to be the case. Other staff training includes food hygiene, safe handling of medication, fire safety and diet and nutrition. There is a staff file in place which contains Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 19 records of training and any certificates received. These included infection control, mental health awareness, emergency first aid, interpersonal communication and listening skills. The staff team and the inspector discussed the possibility of residents joining in some of the in-house training planned, e.g. basic food hygiene, and it was agreed that this would be discussed with the manager. All prospective staff are invited to visit the home prior to being interviewed, in order to get a feel of the home and to enable staff to receive feedback from residents. The person is then interviewed and two references are obtained. Staff sign a declaration of criminal convictions prior to the completion of a CRB and POVA check. All staff receive a copy of the code of conduct and terms and conditions, and have a three-month probationary period. There were no CRB certificates on staff files. Although each person had a CRB number, this did not show whether this had been done at the correct, enhanced, level, or whether a POVA check had been done. The manager was sure that this was the case for everyone, and that the details of the CRB check are held in ABLE head office. The law states that the information on these certificates must be kept ready for inspection, and this can be done by either keeping them on the staff member’s file or by having the office send all the pertinent details to be kept on file. The manager has therefore been asked to ensure that this is done. Glanmor DS0000028637.V294702.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, 39 and 42 Residents benefit from a well run home, and residents’ views underpin all selfmonitoring and development in the home. The training, policies and procedures in place promote and safeguard the health, safety and welfare of the people using the service. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: The manager was registered with CSCI in 2005. She has completed her Registered Manager’s Award since then, and is currently studying for NVQ Level 4 in Care. She has also had training in supervision skills and Protection of Vulnerable Adults. She has had experience of working with people with mental ill health and with older people. Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 21 There are regular meetings which discuss service provision, including staff meetings, and psychiatric reviews about individual residents. Residents meetings were also held on a weekly basis. An annual questionnaire is issued to residents, families and outside agencies, seeking their views on the service and asking how it might be improved. All six residents responded, and the manager collated their answers and replied to them. When asked if their quality of life had improved by living at Glanmor, one replied that they were not sure and the other five said yes. One person said “At one time, if you told me that I would have everything I have now, I would have thought that you jested”. The home has good policies and procedures in place to ensure safe working practices. There is a first aid box in the kitchen, as well as a fire blanket. The fridge and freezer temperatures are tested daily, Fire alarms are tested weekly, and emergency lights monthly. There is a contract to service fire extinguishers annually, and this was done in December 2005. Fire drills are conducted every 3 months. One drill had recorded some initials of the people who attended, but another did not. The manager should ensure that this is done every time. This should also include the names of anyone who refuses to participate. The bathroom upstairs had a dirty, cloth hand towel in place, although individuals can use their own personal towels from their room. The manager has been asked to ensure that paper towels are used in bathrooms and toilets in order to prevent any potential cross infection. Glanmor DS0000028637.V294702.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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 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 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA6 YA24 Regulation 15 23 (2) (d) Requirement All care plans must contain accurate, up-to-date information. The lounge and the smokingroom downstairs must be redecorated so that residents can live in a clean, comfortable environment All staff must have evidence on file that they have an enhanced CRB and that all new staff have been POVA checked. Paper towels must be used in bathrooms and toilets in order to prevent any potential cross infection. Timescale for action 02/09/06 02/11/06 3 YA34 17 Schedule 2 13 (3) 02/09/06 4 YA42 02/09/06 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 YA9 Good Practice Recommendations Risk assessments should be stored alongside their related care plans. DS0000028637.V294702.R01.S.doc Version 5.1 Page 24 Glanmor 2 YA32 An up-to-date index of those staff who have completed NVQ should be kept at the front of the training file. The initials of all those who take part in fire drills should be recorded. This should also include the initials of anyone who refuses to participate. 3 YA42 Glanmor DS0000028637.V294702.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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