Inspection on 30/08/07 for Graywood

This inspection was carried out on 30th August 2007.

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

Other inspections for this house

Graywood 21/07/08

Graywood 03/10/06

Graywood 17/11/05

Graywood 09/05/05

Graywood 09/11/04

Graywood 06/04/04

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

CARE HOME ADULTS 18-65 Graywood 10 Northdown Avenue Cliftonville Margate Kent CT9 2NL Lead Inspector Joseph Harris Key Unannounced Inspection 30th August 2007 10:00 Graywood DS0000037757.V345351.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 Graywood DS0000037757.V345351.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. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Graywood Address 10 Northdown Avenue Cliftonville Margate Kent CT9 2NL 01843 220797 F/P 01843 220797 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) Mrs Rassoolbie Haq Post Vacant Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2006 Brief Description of the Service: Graywood is registered to provide accommodation and personal care to a group of thirteen adults who are under the age of 65 years on admission to the home. The residents have all had experience of mental health problems and require ongoing support. The home is located in a residential area of Margate, near to shops, local amenities and the sea front. There is good access to public transport. Close to the home there is a large park and gardens. The home is of a good size and arranged over 3 floors. All of the bedrooms are single occupancy and there is an adequate range of communal space available for the service users. To the rear of the property there is a large, attractive and accessible garden. The current fees for the service at the time of the visit range from £315.13 to £378.75 per week. Information on the Home services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 30th August 2007. During the course of the visit a tour of the premises was undertaken and discussions were held with the home owners, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The home also returned the Annual Quality Assurance Assessment (AQAA), which provides information to inform the inspection process. What the service does well: What has improved since the last inspection? What they could do better: 5 requirements and 11 recommendations have been made as a result of this inspection. 2 requirements have been made in respect of developing and reviewing care planning and risk assessment processes. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 6 A further requirement focuses on developing the range of activities in respect of promoting independence and activities of daily living in particular. More emphasis should be placed on offering a wider variety of pastimes. The storage and quality of food needs to be monitored more closely as some food stuffs were out of date and there was a relatively low amount of fresh fruit and vegetables. The home needs to also appoint a registered manager. Recommendations were made covering topics including improving participation in the home by service users and supporting residents in the community. Fire safety logs and the staffing rota need to be maintained. Quality assurance processes and a more robust complaints process should be developed. The home should review the service user’s guide and contract of residency. Healthcare records should be kept up to date and include outcomes. The home is also advised to introduce competency assessments for staff surrounding topics such as medication. Residents should be provided with a key to the front door unless otherwise assessed. 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. The summary of this inspection report can be made available in other formats on request. Graywood DS0000037757.V345351.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 Graywood DS0000037757.V345351.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is adequate. Prospective service users are provided with adequate information about the home and facilities. There are satisfactory assessment processes in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and service users guide in place covering all required information. The home owners were advised to review the service user guide, which is a lengthy document, to improve accessibility for prospective service users with the aim of reducing the amount of jargonistic terms, the inclusion of pictures and concentrating on information that individuals want and need to know. Refer to recommendation 1. The home has assessment processes in place for service users referred. It was reported that information is requested from care managers and professional care teams prior to admission and that the home conducts it’s own assessment, which includes trial visits to the home. There have been no new admissions since the last inspection; therefore it was not fully possible to evidence these processes being applied in practice. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 9 The home has a contract covering terms and conditions of residency in place, which is provided to all service users and/or their representatives. Signed copies are kept on file by the home. Some minor changes to this were advised including where increases in fees are made that service users and their representatives are given sufficient notification in order that an informed choice can be made. Refer to recommendation 2. Graywood DS0000037757.V345351.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is adequate. Service users have a plan of care and are able to make decisions about their lives. The home could develop levels of participation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home develops an individual plan of care for each resident. Three examples of these were examined. The plans viewed set out areas of need, but showed areas of potential for improvement. The plans should clearly detail issues surrounding mental health needs and occupation and activities, which were not fully addressed. Each area of need should also provide clear and accessible instructions to inform staff how to consistently meet the identified areas of need. The action plans viewed were somewhat vague and lacking in detail. Additionally the daily recorded notes provide minimal information and concentrate on routine issues for each shift. These should provide a narrative Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 11 summary of each resident’s day in conjunction with the care plan. Although plans show evidence of review, it was evident that some care plans had not been altered or updated in the past 3 years. The individual files were rather disorganised and contained information that could be archived. The home should also ensure that plans of care reflect all areas of assessed need in conjunction with CPA documentation and on going assessments. Refer to requirement 1. The home owners act as an appointee for a number of service users. The personal allowances and other finances are paid into a dedicated clients account and withdrawn on receipt. This account is not linked to the business and statements are maintained and audited by the home on a regular basis. Residents spoken confirmed that they receive their personal allowance weekly or as defined within care plans. Some service users like to take part in tasks around the house such as setting the table and some light cleaning. However, there should be a stronger emphasis on enabling residents to participate in the maintenance and running of the home. This involvement should aim to complement activities of daily living and promote independence as part of a planned programme of support. Residents meetings are held on a regular basis and it was suggested that these should be facilitated by a range of different staff with clear outcomes recorded where issues have been raised. Refer to recommendation 3. Risk assessments are in place relating to each service user, but these need to be reviewed and updated. Emphasis should be placed on the actions to inform staff and residents how to minimise perceived risks and should be linked to CPA documentation and the home’s own on-going assessments of need. Some of the risk management plans examined showed no evidence of being changed or updated in the past 3 years, although dates of review were recorded. Refer to requirement 2. Graywood DS0000037757.V345351.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. Service users have some lifestyle choices, but more emphasis should be placed on developing a range of meaningful and recreational activities with greater staff interaction. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It is understood that a balance needs to be struck with regard to the level and intensity of activities in the home due to the needs of service users. However, throughout the course of the site visit, little structured and planned activity was observed. The owners and staff reported that activities are available such as playing board games and film nights. Staff also go out on a 1:1 basis with service users at times. There is minimal evidence that such events occur because activity records have not been completed and generally not recorded in the daily notes for each individual. Staff appear to concentrate on routine Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 13 issues such as mealtimes, cleaning and medication rather than spend planned or informal time interacting with service users. Care plans reflect little in the way of pastimes and social or therapeutic activities. Two residents access external activities, one who goes to college and a bowling club each week and another person attends church daily. Refer to requirement 3. A number of residents go out independently on a regular basis, however some also require support in this regard. Efforts should be made to provide planned and supported time for residents, particularly those who require assistance out of the home, to go out into the local community on a regular basis. Refer to recommendation 4. It was reported that visitors are welcomed into the home at all reasonable times, which was confirmed by a number of residents spoken to. No visitors attended the home at the time of the site visit. Residents are allowed flexibility within the daily routine of the home to choose how they spend their time. Residents stated that they can choose what time they get up and go to bed. Individuals have keys to their own rooms, but generally not for the front door. Refer to recommendation 5. The home maintains menu records and there is a 4-week rolling menu. It was reported that residents have had some input into the planning of meals. Varying observations were made by service users regarding the quality of food in the home. One person said, “the food is good” and another individual stated, “The food is not great”. There is scope to improve the level of input from service users in the planning, preparation and tidying at mealtimes. The home has achieved a high standard of cleanliness following the last environmental health officer’s visit. Food stocks were adequate, however there was a limited amount of fresh fruit and vegetables and an over-reliance on tinned, frozen and value goods. The home needs to ensure that all food stuffs are appropriately stored according to manufacturers instructions, as some goods were found to be out-of-date or stored inappropriately. Refer to requirement 4. Graywood DS0000037757.V345351.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. Service users receive personal support as they prefer and health and medication needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents reported that the staff are respectful and provide assistance with personal support as desired. As previously mentioned, the home should develop care plans to ensure that preferences and personal choices are clearly recorded and the nature and level of staff input is clearly defined. All service users are registered with a local GP and receive support from the Community Mental health Team. Access is available to complimentary professionals such as dentists, opticians and chiropodists. The home retains letters of appointment and keeps a record of healthcare visits and consultations, although attention should be given to this to ensure outcomes from any visits are recorded and reflected within individual plans of care. Refer to recommendation 6. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 15 The home manages medication satisfactorily with Medication Administration records clear and well-kept. There are suitable storage facilities and appropriate policies and procedures in place. Staff undergo medication training prior to administering medication. The home is advised to develop a competency assessment questionnaire relating to medication for staff to underpin knowledge and promote good practice. Refer to recommendation 7. Graywood DS0000037757.V345351.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. There is a complaints process in place and service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a suitable complaints process in place meeting all required elements. Most service users stated that they felt comfortable about raising concerns with staff and management, although one person said that they feel their concerns are not always taken seriously and they felt nervous about ‘making a fuss’. A complaints book is in place, but there have been no recorded complaints since the last inspection and only 2 complaints recorded since 2004. The home is advised to record complaints and concerns from service users, relatives and others on a more consistent basis regardless of the nature and perceived seriousness of the concern. The complaints record should clearly demonstrate how the issue has been resolved. Refer to recommendation 8. Satisfactory policies and procedures are in place relating to adult protection issues. All staff have participated in Adult Protection training and demonstrated a reasonable working knowledge of the principles of protection and abuse awareness. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The environment is well-maintained, fit and suitable for purpose. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises demonstrated that the home is clean, well-lit, airy and comfortable. There are two large communal rooms comprising of a lounge/diner and additional lounge. All bedrooms are single occupancy. There is a domestic style kitchen with necessary equipment. The last EHO inspection commended the cleanliness of the kitchen area. A separate laundry area is located to the side of the building, which has been recently refurbished. One service user agreed to show me their bedroom and stated that he was happy with his room. Other residents confirmed the same. No health and safety issues were apparent during the tour of the home. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 18 There is a good-sized garden to the rear of the home with garden furniture sheds and a badminton net. The home is located in a residential road with ample parking nearby. The house is a relatively short walk from the area of Margate called Cliftonville with public transport links. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. Service users are supported by a staff team with a range of experience and training. The home’s recruitment practices protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Graywood is a family run home with 5 of the staff members from the Haq family working in managerial, caring and administrative roles. There is a minimum of 2 staff on duty at all times throughout the day and 1 waking and 1 sleep-in night staff. At the time of inspection 9 residents lived in the home and the staffing levels were satisfactory commensurate with the numbers and needs of residents. The staff rota needs to be redesigned to ensure that full dates are entered, full staff names and their designation is included. The rota should be written in ink and staffing changes made as and when required on the master copy. Refer to recommendation 9. Staff members are encouraged and supported to achieve National Vocational Qualifications and currently over 50 of the staff team have achieved NVQ Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 20 level 2 or above. Staff spoken with demonstrated a reasonable understanding of the needs of service users and wider aims of the home. 3 staff personnel files were examined including the newest employee. The recruitment checks are completed satisfactorily and all relevant information was retained on file including references, proof of identity. Records were examined relating to staff training and certificates crossreferenced. All staff are offered an induction programme and the Common Induction Standards have been introduced for all new employees alongside the home’s own induction plan. Mandatory training courses are provided to all staff and records demonstrated that staff training is up to date. Courses are booked for the future and there is evidence to suggest that training remains an ongoing concern. Staff have been provided with mental health awareness training and the owners were advised to continue to develop knowledge in this area. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is adequate. There is no registered manager. Quality monitoring process should be further developed. Records are maintained regarding health and safety issues. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently managed in a temporary capacity by the owner, Mrs Haq, which has been a relatively long-term arrangement. The owners stated that they plan to appoint one of their sons as manager in the near future and put him forward for registration with the Commission for Social Care Inspection. He is currently working towards the completion of his NVQ 4. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 22 A large proportion of the staff team consists of the owner’s family and a discussion took place regarding the maintenance of supervision, applying disciplinary action and overall probity in this respect. The owners were advised to consider perceptions of non-family staff and the need to maintain professional boundaries within the work setting. The owners said that they accepted the observations, but felt that these boundaries are clear. A concern had been raised through an anonymous source prior to the site visit that ‘people feel intimidated when the family are there (Graywood)’. The owners were made aware of this concern. Service users stated that they feel comfortable living in the home and no-one spoken to suggested that they felt intimidated or unable to raise concerns. The home has sent out service user and relative questionnaires to feedback on the quality of the service. There is also evidence that resident and staff meetings take place regularly. However, further work should be completed in the area of quality monitoring. The home is advised to send satisfaction surveys to staff and health and social care professionals involved in the home. The information from all surveys should be collated into a report format and where issues/concerns are identified a clear plan of action and outcomes should be recorded. Some audits take place with regard to medication and health and safety; records should be maintained of these and additional areas audited such as financial records and individual service user plans. Refer to recommendation 10. The majority of health and safety records were up to date and in place. The fire safety log was complete with the exception of the recording of visual monthly checks on fire extinguishers and the documentation of fire drills. Refer to recommendation 11. All service certificates were examined and were up to date. Accident records are maintained. The home needs to ensure that close monitoring is maintained of food storage, as some out of date goods were in use. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 23 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 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 2 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 2 2 X X 2 X Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15(1) Requirement To review and update all individual service user plans ensuring that information is clearly stated and pertinent to individual needs, short and longterm goals and aspirations. To review and update all risk assessments for individual service users ensuring that clear guidance is provided and perceived risks are linked to CPA and other assessment information. To support service users to take part and engage in a range of meaningful activities in and out of the home promoting independence. To ensure that a healthy and balanced diet is provided at all times ensuring adequate food storage and personal choice. The home is to appoint a fulltime manager and apply for registered manager status with the Commission. (Previous requirement – timescale 01/12/07. Timescale extended.) Timescale for action 01/11/07 2. YA9 13(4) 01/11/07 3. YA12 16(2) 01/11/07 4. YA17 16(2) 01/11/07 5. YA37 8,9 01/11/07 Graywood DS0000037757.V345351.R01.S.doc Version 5.2 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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Refer to Standard YA1 YA2 YA8 YA13 YA16 YA19 YA20 YA22 YA33 YA39 YA42 Good Practice Recommendations To review the service user’s guide and improve accessibility for prospective service users. To review the contract of residency and update as required. To encourage and assist service users to develop activities of daily living and independent living skills through planned support. To support and enable service users to access the local community with staff support on a planned and regular basis. To provide all service users, unless otherwise assessed through the multi-disciplinary team, with a front door key. To ensure healthcare records are clearly maintained including outcomes of any visits. To develop competency assessments relating to medication issues for staff. To record all complaints and concerns raised by service users and significant others providing actions and outcomes from any issues raised. To review staff rota ensuring all information is accurately recorded. To continue to develop quality assurance systems. To ensure fire safety logs are fully maintained and up to date. Graywood DS0000037757.V345351.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Graywood DS0000037757.V345351.R01.S.doc Version 5.2 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. 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!