Inspection on 18/07/05 for Greenfield Care Home

This inspection was carried out on 18th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greenfield Care Home 09/08/07

Greenfield Care Home 09/08/06

Greenfield Care Home 24/10/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Greenfield Care Homes, London Road Lodge 385/387 London Road Mitcham Surrey CR4 4BF Lead Inspector Jean Stuart Unannounced 18 July 2005 2.30pm 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 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 Stationary 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. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Greenfield Care Homes Address 395/387 London Road Mitcham Surrey CR4 4BF 020 8687 3131 020 7431 8618 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Greenfield Care Homes Ms Madrine Rugano-Wilson Care home only (PC) 6 Category(ies) of Learning disability (LD) registration, with number of places Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This is the first inspection under the CSCI Brief Description of the Service: London Road Lodge is a registered care home for six service users with a learning disability. The home is on two floors of a detached property and is situated within a residential area of Mitcham. Parking is to the front of the home. Public transport bus services and the tram line are within a short distance of the home. The home currently has two service users. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during late afternoon and early evening, 18th July05. A brief tour of the premises took place and care documentation was inspected. Two service users and two members of staff were spoken to individually. The inspection took six hours, the manager and the representative of the provider was present. This inspection highlighted several areas that need to be improved to enhance services for the people currenly residing at the home. What the service does well: What has improved since the last inspection? What they could do better: The manager and provider’s representative agreed with the areas identified by the inspector. They will move forward with amending the registration category, improving record keeping, and ensuring that policies and procedures are followed. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 6 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. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3. The Statement of Purpose fails to reflect the service provided, and to provide service users with the aims of the home. Service users and their families do not have the information they need to make a full assessment of the home. EVIDENCE: Prospective service users must have the information they need to make an informed choice. The Statement of Purpose is an important document setting out for service users and their family, the aims of the home and the facilities available. This document and other documents arising from it, such as the service users guide, require improvement. The home now has two residents with learning disabilities and a physical disability, this is not reflected in the Statement of Purpose. To ensure that service users can make the best possible choice with regard to the home they might be moving in to, the care provided by the home must be clearly stated in the home’s documentation. The provider and placing social workers have failed to demonstrate an understanding of the registration category of the home for people with a physical disability. New service users are admitted on the basis of a full assessment undertaken by the staff from the social services department, this identified physical needs. A copy of the assessment is supplied to the home and placed on the individuals file. London Road has not been developed as a home intending to provide care to people with a physical disability. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 9 A representative of the provider stated that recently a decision had been made that a service user with challenging behaviour should not move to the home, the individual’s behaviour would disturb the group. The decision not to admit this service user ensured the wellbeing of users was protected. The care needs of service users with a physical disability are set out by the local authority on admission. The manager reported that staff have received a training session from the company providing the hoist for a service user. Information provided from the placing authority includes information on the correct procedure for moving and handling. Appropriate manual handling training must be given to all staff. This protects the service user from harm. The home plans to use an advocacy scheme for service users, this will help service users to express their opinions. The means of communication used by the individual is explained in the passport (care plan). This indicates how service users who use very little , or no speech, express emotions, and indicate choice. By understanding the individual staff have more opportunities to provide quality care. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9. The home has failed to ensure that care documents are kept up to date, which are a measure of how service users are being looked after. Regular daily recording must take place, passports (care plans) must be kept up to date, risk assessments and resulting recording must reflect what is actually happening. EVIDENCE: Service users needs are reflected in their passport, this reflects individual personal planning for each person. The plan is generated from the social service assessment and covers all aspects of personal and social care support and health care needs. This plan is drawn up with the involvement of the service user together with their family. It is visual, providing graphic illustrations to help the service user to understand what is being discussed. Service users needs have not been fully covered by the passport. The passport sets out a daily routine for each service user. During discussion with the manager activities enjoyed by individuals, and promoted by the home were not a part of the plan. One service user attends a day centre but this was not recorded as a part of their routine, two services users go to church on Sunday, this spiritual need was not recorded. The home failed to record these events on either the passport or the daily report of service users activities. The passport Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 11 had not been updated to reflect changing need. The home reported in the daily record on the dull mood of an individual on returning from the day centre but not when this mood changed or any action taken to intervene. For the home to provide care that meets all the needs of service users, current issues must be recorded. By recording the information, service users wishes will not be overlooked by staff. Staff believe in the right of service users to make decisions and this is reflected in the information collected on their behalf. Differences were noted in food preferences, and activities. One service user stays up to 11pm or midnight watching films. For one individual the management of a risk while they are sleeping is to carry out checks every fifteen minutes. The reason why the checks are happening and a record of the individual’s well being when carried out the checks is not maintained. A risk taken by one service user is using the “dial a ride” bus service. The steps staff need to take to make sure the individual is safe, are documented. All moving and handling strategies are presented to the home on the admission of the service user staff must have manual handling training to ensure they can meet service users needs. The risk management strategy must cover all aspects of a service users care and promote the individual’s wellbeing. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,17. Service users use the local community and have contact with their family, however this must be recorded and care documentation kept up to date. A dietician is required to give nutritional advice, on a “reducing” diet. EVIDENCE: Service users attend day care four days a week, and have one day at home with carers. On the day of inspection, a Thursday, the manager reported that two service users had been out for a walk and had lunch before they returned home. (Service users do not attend the day centre on a Thursday). Two members of staff accompanied the service users. Service users eat out at local restaurants, and go to church. It was found that the level of recording at the home was not adequate to support the manager’s statements about these activities. The activities were not consistently recorded in the daily report and going to church did not appear on the individual’s passport. Service users participation in such activities must be recorded to reflect their use of the local community. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 13 Service users can maintain relationships outside the home. A service user receives emotional support by frequently staying with their family. Service users receive a varied diet. The manager keeps the required record of food served, this covers every meal and snacks. The manager reported that a service users was on a “reducing” diet. A dietician has not been consulted to assess the quality of this diet, this must be requested. The ability of service users to make meal choices are noted in the passport. The passport demonstrates to staff how service users indicate choice, thus ensuring service users have a meal they enjoy. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21. The manager reported that service users physical and emotional health needs are met. The inspector was not able to confirm this, appropriate records have not been maintained of the care given to service users. Staff require training in the handling of medication to ensure service users are protected from harm. EVIDENCE: Service users on the day of the inspection were dressed in different styles of clothing, thus ensuring that they maintain their individuality. The passport indicated that one service user had a particular interest in going shopping. The daily report demonstrates that one service user likes to go to bed after 11pm, their independence in doing so is possible due to staff support for their actions. A service user has a hoist that is needed to help transfer from their wheel chair to the bed. A professional assessment on how to complete this task was available to staff. A record of training in the use of the hoist had not been maintained, this record ensures that staff have the information to complete the task in a safe manner. Service users health care needs are noted in the passport and the daily report demonstrates when they have received medical treatment. Service users receive medication from the manager of the home. When the manager is not available a retired nurse gives medication. This person must be CRB checked Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 15 and their PIN number requested to ensure that their record of practice is upto-date. Medication must not be dispensed from bottles, to safeguard service users and staff medication must be dispensed from a blister pack/nomad system. The medication procedural statement must be amended to give all service user the right to self administer medication once a risk assessment has been completed. The manager reported that medication training for staff is to happen in the next three months. Accredited medication training for staff will ensure that medication is given safely and that the well being of service users is protected. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23. The home has a complaints procedure that needs a minor amendment. There is no record of staff attending training to protect service users from abuse. EVIDENCE: The service users do not find it easy to state their views. Staff reported that one resident clearly reports when they do not want to do something. Another service user indicated that the conversation with the inspector was acceptable, their body language was relaxed. The manager reported that the home has not received any complaints, indeed the family of one service user has phoned to praise the home for the good services given. There have been no complaints received by the home. This is a measure of the level of satisfaction felt by the service users, their families and the professional involved with service users care. The complaint procedure requires amendment to reflect the availability of the CSCI at any stage of the complaint procedure, reassuring people that there complaint can be taken to a body outside of the home. The homes policies and procedures regarding service users money ensure the safe storage of their money, making service user finances free from abuse from staff, and other people. Staff training in abuse is a part of the induction programme, the home has failed to retain a record of who has completed induction training. Nor have staff attended other training in the prevention and signs and symptoms of abuse. To safeguard service users from harm, training in abuse is required. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,29,30. The service users live in a homely, comfortable environment. The registration category of the home is not as originally stated. The adequacy of this environment for two people with a learning disability and a physical disability must be assessed by an occupational therapist. The registration must be amended if necessary. EVIDENCE: As a new build home providing care for two service users who are wheel chair users, the home must ensure all areas are accessible. The home has failed to do this, and has not included physical disability on the registration form, the home is registered only for service users with a learning disability and not for additional needs. On this inspection an immediate requirement was served on the home to ensure that the registration category was changed (a variation) and that the home has an appropriate environment and staffing for service users who have demanding physical needs. A list of equipment currently user by service users will enable the CSCI to assess how service users needs are currently being addressed. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 18 The provider is required to provide to the CSCI a report, from an occupational therapist, demonstrating that the home is suitable to meet the needs of people with a learning disability and where required, a physical disability. Furnishing and fittings are of a good quality and of a domestic nature. These will be included in the occupational therapists assessment. The home offers access to local amenities, local transport and support services to suit service users personal and lifestyle needs. The home is clean and hygienic. The facilities provide service users with a comfortable home. The home has two service users in total. Both service users have single bedrooms to a suitable size for wheel chair users, i.e. with at least 12 square metres of usable floor space. This excludes the ensuite, which provides a walk in shower and a toilet facility. Bedrooms are personalised by the service users with the help of staff, making the rooms individual to the service user. The two service users have accessible shared space and the lounge dining area is a combined area. A separate laundry room is available with domestic style washing facilities. A service user has specialist equipment they require to maximise their independence and a hoist has been provided. These areas will be accessed by the occupational therapist, to ensure that the needs of services users are addressed. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,36. The manager is to provide information on the competency and skills of the staff group, staff must be supervised and the recruitment procedure fully used to ensure that the home could act as an effective staff team. To ensure service users receive an appropriate standard of care the skills required by staff must be identified and staff with appropriate skills employed. EVIDENCE: A service user responded most positively when a member of staff started to speak with them. Staff demonstrated that they are accessible to, and comfortable with service users. To measure staff competences, a list of staff employed and their skills and qualifications must be submitted to the CSCI this will indicate that staff have the necessary skills to provide the service. For service users to be protected by the home’s recruitment procedure, the manager must use this procedure. The home has failed to ensure that references and criminal record bureau (CRB) checks are received prior to commencing work at the home. Service users would be protected from harm by these checks being completed, prior to the service user receiving care from a member of staff. For staff already employed reference checks must be completed and CRB forms submitted for checking. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 20 The manager reported that staff receive informal support from her. Formal, recorded supervision is not given, this must be carried out at least six times a year. Supervision provides the opportunity to explore the work that is being completed with service users, to monitor this work, and to identify training needs. It helps to ensure that service users receive good quality care. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,41. The health, safety and well being of service users is not protected and promoted by the management of the home. Record keeping, and the use of policies and procedures is not to a standard that safeguards the service users. EVIDENCE: The service provided at Greenfield failed to provide a well run home. The aims of the home were not clearly set out, the home does not have an appropriate registration certificate, and policies and procedures are not being followed. Greenfield’s manager is in her first post in a senior role with total control of the running of the home. It is also her first experience as a senior in the learning disability field. The manager must under take periodic training to TOPSS specification to maintain, update her knowledge, and develop the skills to manage the home, and provide a good service to service users. The registered provider must give support, to ensure that the necessary skills are developed and that national minimum standards are consistently achieved. Continuous self monitoring is one way of achieving this. The manager to date Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 22 had one supervision from the providers representative, six must be held a year, (the home has been open six months). The provider is yet to commence with the required monthly visit to the home to measure the provision of care. The home has failed to protect service users through positive use of the home’s record keeping policies and procedures. The passport (care plan) is not kept up to date, daily recording is not being consistently completed, and the recruitment procedure is not used. Such failures do not protect service users best interests. Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 2 x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 x 3 3 Standard No 11 12 13 14 15 16 17 x 3 2 x 2 x 2 Standard No 31 32 33 34 35 36 Score x 2 x 1 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenfield Care Homes London Road Lodge Score 3 2 2 2 Standard No 37 38 39 40 41 42 43 Score 1 x 2 x 1 x x G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 24 n/a 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 1 Regulation The Care Standards Act 2000 Section 11 4 schedule 1 13(5) Requirement The registered person must ensure that an application is made for a variation to amend the registration certificate . (this was an immediate requirement) The registered person must ensure that the Statement of Purpose reflects the service provision. The registered person must ensure that manual handling training is given to all staff and a record of training maintained. The registered person must ensure that the passport (care plan) is maintained as a current record, and daily recording completed to document how care is given. The registered person must ensure that any risk taken by service users is documented and a plan drawn up about how the risk is to be managed. The registered person must ensure that the advice of a dietician is sought. The registered person must ensure that medication is dispensed from a monitored Timescale for action immediate 18.7.05 2. 1, 20 31.8.05 3. 3,19 31.10.05 4. 6,13,15 15(1) (2) 31.8.05 5. 9 13 (4) (b) 31.8.05 6. 7. 17 20 13(b) 13(2) 31.10.05 31.8.05 Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 25 dosage system, not from bottles. 8. 20 13(2) The registered person must ensure that staff receive accredited medication training in the handling of medication. The registered person must ensure that the complaint procedure states that a complaint can be made at any stage to the CSCI. The registered person must ensure that abuse training is given to staff. The registered person must ensure that a list is drawn up of the equipment, aids and adaptations currently in use in the home. The registered person must ensure that an assessment of the premises and facilities, for people with learning disabilities some of whom have a physical disability, .is made by suitably qualified persons, including an occupational therapist. The registered person must ensure that a statement of staff skills, and qualifications is drawn up to assess their competencies. The registered person must ensure that the recruitment policy and procedure including all checks iereferences and CRBs , is followed in full. The registered person must ensure that staff receive formal supervsion six times a year. The registered person must ensure that monthly visits are completed by the registered provider and a written report produced on the conduct of the home. The registered person must ensure records required by regulation are mainatained. 31.10.05 9. 22 22(7) 30.9.05 10. 11. 23 24 13(6) 23 (c) 31.10.05 31.8.05 12. 24 23(2)(n) 31.8.05 13. 32,37 19(5) 31.8.05 14. 34 19(40 (5) 31.8.05 15. 16. 36 39 18(2) 26 30.9.05 31.8.05 17. 41 17 31.10.05 Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 26 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 Good Practice Recommendations Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Greenfield Care Homes London Road Lodge G54-G04 S61460 Greenfield V227987 180705 Stage 4.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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