Inspection on 26/09/06 for Grove House & Grove Lodge

This inspection was carried out on 26th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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

Grove House & Grove Lodge 15/05/07

Grove House & Grove Lodge 08/02/06

Grove House & Grove Lodge 11/10/05

Grove House & Grove Lodge 23/11/04

Grove House & Grove Lodge 29/07/04

Grove House & Grove Lodge 24/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Grove House/Grove Lodge 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW Lead Inspector Pat House Unannounced Inspection 26 September 2006 10:40 Grove House/Grove Lodge DS0000019398.V306585.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 Grove House/Grove Lodge DS0000019398.V306585.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. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove House/Grove Lodge Address 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW 0208 953 6443 0208 953 6443 H 3071@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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) Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Grove House and Grove Lodge, known as numbers 13 and 14 Norton Close, are a pair of semi-detached houses situated at the end of a cul-de-sac in a residential area about one mile from Borehamwood town centre. Each House is self-contained with its own kitchen, dining room, lounge and bathroom but is jointly managed by staff whose office is in Grove house. The home has a shared garden to the rear of the building, accessible via a ramp and which includes raised decking, a patio area with a barbeque and some grass and borders. There are parking bays to the front of the buildings. Grove House accommodates six service users and Grove Lodge accommodates three service users who each have their own single room. The service users residing in the Lodge are more independent than those in the House. However, all current service users are able to make decisions about the running of the home and able to use the transport and leisure facilities available nearby. Although the charity Mencap provides the care services in the home, the building is owned and rented from a Housing Association. The Statement of Purpose for the home is kept in the office and is available on request. Current fees for the home range from £359.87 to £412.80 per week. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day with one inspector. This was a “key” inspection, when all the main areas of care provision were checked. A member of the existing staff has recently been appointed as Manager of the home but was not on duty during the visit. The support worker on duty was able to assist with almost all aspects of the inspection and areas not checked on this occasion will be assessed at the next visit. The home is currently full, and three of the nine residents were at home and were spoken with during the inspection. Comment cards had previously been sent to relatives of the residents, by the CSCI and responses are included in this report. Both houses and the garden were seen and the residents had lunch during the visit. Some records, documents and the procedures for administering medication were checked and proposed changes to staffing numbers were discussed both with the staff member and the residents. What the service does well: What has improved since the last inspection? The home now has a new Manager in post, who was praised by the residents spoken with. The Manager has been updating the care plan recording and the new format is excellent with meaningful links to risk assessments. The plans are user-friendly and have clear evidence that care staff are aware of the contents and that residents have been involved in producing them. Requirements made at the last inspection have all been actioned and safeguards have been implemented where residents administer their own medication. A full assessment has taken place of the resident who has limited vision and adaptations have been made and new equipment provided around the home, which the resident was clearly pleased with. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 6 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. Grove House/Grove Lodge DS0000019398.V306585.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 Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Some of the written information about the home needs updating so that prospective service users and families can make informed decisions. Written service user contracts also need to be signed so that everyone is clear about their roles and responsibilities. However, thorough needs assessments are completed in all cases, to ensure that the care provision in the home can meet all service user needs. EVIDENCE: The home’s Statement of Purpose was displayed on the wall in the office, where it could be accessed if required. However, this document is now out of date and needs to be updated. Service user records mostly contain signed copies of their tenancy agreement with the Housing Association which owns the buildings but each resident must also have a signed contract with the provider of services, which lists all parties’ roles and responsibilities regarding care provision. Requirements have been made about these two shortfalls in this report. The comment cards, received by the CSCI from relatives, also show that families are not clear, or have forgotten about the Complaints Procedure in the home, although this needs to be summarised in the Service User’s Guide. It is therefore suggested that the Guide for the home is reviewed and copies sent out to relatives. Copies of the Guide, in appropriate formats are given to all service users. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 9 Some service user records were checked during the visit, and all contained written assessments from referring agencies, with risk assessments attached to the more recent referrals. There are also written assessments in place completed by staff from the home, which contain all relevant details. In all cases, care plans have been completed, using the original details and these have been updated and changed as appropriate. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. All service user plans are detailed and individual and reflect individual wishes and aspirations enabling staff to provide appropriate support. Service users are empowered to make their own decisions about their lives and are always supported by care staff to take and manage risks, wherever possible. EVIDENCE: Written care plans in the home are currently being streamlined and new files are being used alongside older records. The new format for the main “care/support plan” is excellent and highlights and links in to risk assessments and plans are signed by care staff that they have seen and also reviewed the plan. There is also clear evidence of service user involvement in the care planning and changes to care provision. The residents spoken with during the visit made it clear that they made the decisions about their own lives and also about the running of the home. Outcomes from the minutes of service user meetings have been seen at previous inspection visits and clearly demonstrate that the residents wishes for the home are listened to and actioned where possible. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 11 Residents spoken with also said they managed their own personal allowances, with assistance, and that documentation of money spent was always completed. There were a wide variety of written risk assessments in the care plan records, showing how individual risks were managed, and evidence that staff help to train service users about going out on their own and interacting with the wider community. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users in the home are enabled to make all their own choices about their daily lives and have their rights respected at all times. All service users are supported to take part in their choice of leisure activities and to use local services and individual activity programmes provide opportunities for personal development. Family involvement is supported where appropriate so that meaningful contact is maintained. Service users are involved in and enjoy their food and mealtimes although regular visits from the dietician must continue to ensure that good health is maintained. EVIDENCE: Currently none of the residents have any paid employment but one service user is a volunteer worker in a local care home. All residents have activity and college programmes, which are individually designed to meet individual interests and skills. The residents spoken with said they make regular use of local facilities. They quoted the bus numbers used to get to various places and said they went to the nearby shopping centre and twice-weekly street market. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 13 Service users also said that the neighbours in the road were friendly and that the home shared some events with other Mencap homes. Currently, more staff are being recruited for the day shifts in the home, and this will enable the service users who need escorts, to go out more. The service users’ bedrooms seen were full of personal items, including music centres, computers and Sky television. One service user has an organ in her room and the care worker said that this resident has professional music tutoring in the home twice each week. This resident is also a keen swimmer and the medals on display demonstrate a real level of participation and skill. A recent holiday in Bournemouth had been attended by the majority of residents and family members had also taken part. Service users said that visitors were made welcome in the home at all times and one resident goes home every weekend. The three bedrooms in the Lodge, where all the residents were out, were all locked and the support worker said that all service users hold their own door keys. Service users spoken with confirmed that they were treated with respect at all times and that they opened their own mail and made their own choices about whether to take part in activities or not. One resident said that she had decided, after going to a day centre for 16 years, that she no longer wanted to do this and “had now retired”. Service user rotas for cooking and cleaning duties were displayed in the home and one resident was busy with her tasks during the inspection. All residents are responsible for their own bedrooms and two made it clear that theirs were “messy” out of choice. The home has a resident cat, who was introduced and was clearly loved by the residents and staff. There is a “no smoking” rule in the home, but currently none of the residents smoke. Service users spoken with said they planned their own meals each week and participated in the shopping and cooking for these. In the Lodge, the menu was seen displayed. It appeared that there has been no recent visit to the home from the dietician, and the Manager should ensure these visits are again made, especially to check the balance of the menus and to speak to service users about maintaining healthy eating habits. However there were good levels of food stocks and several bowls of fresh fruit available in both houses. During the inspection the three ladies in the House prepared and ate their own lunch, unaided and clearly enjoyed this meal at their leisure having a discussion about life in general at the same time. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Regular health checks and on-going monitoring ensure that service users have their health needs met and service users are also reassured that their wishes are respected as their preferences are followed regarding the staff who provide their personal care. Service users are supported by staff to self-medicate, if they wish and medication systems generally safeguard the residents’ health. EVIDENCE: Service users spoken with confirmed that assistance with personal care is provided in an appropriate manner and that all residents have their own key worker. One service user said that she had agreed with the Manager that the new staff being recruited would meet the residents and that the residents would be involved in who was appointed. The service user said it had also been agreed that the residents who needed help with personal care, who were all ladies, would have female care workers to give them assistance. The records examined showed that residents received regular and appropriate input from a variety of Health professionals and that staff work with district nurses to monitor the needs of the one diabetic service user. Regular health checks were recorded on individual care plans. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 15 One of the service users living in the Lodge has had recent epileptic attacks and details were all recorded. The support worker felt that any hazards connected to these attacks had been considered and dealt with. It was felt however, that a specific written risk assessment should be completed to ensure that this was the case, especially as the Lodge does not have staff in situ. A recommendation has been made for this. There is an intercom phone, which connects the two buildings and the bedrooms in the Lodge have alarms, which sound in the House if activated. One resident who has limited vision has now had a full assessment from the Sensory Team. As a result this lady’s bedroom now has specialist lighting for the nighttime and illuminated light switches and door. There are also special freestanding lights in place around the home so that the resident can continue with all normal activities. The system for administering medication was checked and was sound. Most drugs are in blister packs and are stored appropriately with the storage temperature recorded. Two residents self-medicate and records were being appropriately kept for this. Non-prescribed medication is kept separately and is recorded when used. It is, however a Recommendation here that the Medication Policy for the home should be updated in line with current guidelines. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s policies and procedures ensure that service users are protected from abuse and service users are confident that their views will always be listened to and taken seriously. EVIDENCE: The home’s Complaints Policy is displayed on the corridor wall in the home in both written and pictorial form. Service users spoken with said they would not hesitate to voice a concern if they had one. The residents are clearly aware of the complaints procedure, as there are several complaints recorded in the Complaints book, all from residents. These were all fairly small issues but all were dealt with formally. There have been no complaints from other agencies or relatives. The home has written policies on Adult Protection and Whistle Blowing and staff have demonstrated understanding of these issues in the past. Grove House/Grove Lodge DS0000019398.V306585.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is generally well maintained and service users clearly find it comfortable and homely. Hygiene standards are good and promote the well being of the residents. EVIDENCE: All areas of the two buildings were visited during the inspection, with the exception of the locked bedrooms in the Lodge. Generally the home was clean and it is clear that service users feel comfortable in their surroundings and keen to maintain the environment as their own home. Furniture is attractive and the decking area outside was being well maintained. The carpet in the entrance hallway was quite stained and should be cleaned or replaced but there were no unpleasant odours apparent in any areas. Bedrooms were very personalised and there is a water machine and phone in the hall for general use. Routine maintenance work was being carried out during the visit and this work is on going and part of a regular provision from Mencap. There are areas needing more repairs and the maintenance worker said they would be dealt with. However, the garden was in need of some attention and looked quite overgrown and the door to the outside gas meter cupboard was broken off. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 18 A requirement is therefore made in this report that the outside area be improved. The Lodge has its own washing machine in the kitchen and there is a laundry sited between the two houses, outside the main door. There are two tumble-dryers here but one is broken, and should be repaired or removed. The support worker confirmed that red alginate bags are used for dealing with incontinent laundry. Evidence was seen of an on-going assessment taking place for continence support for two service users from a district nurse. Grove House/Grove Lodge DS0000019398.V306585.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Procedures in the home for recruiting and training staff ensure that service users are protected and plans for more staff training will ensure that all individual service user care needs can be met in a professional way. EVIDENCE: Only one new staff member had been appointed to the home since the last inspection, when recruitment files were examined and contained all appropriate evidence of recruitment checks. The new staff file had a CRB clearance and other evidence, but the application form and references were locked away for security and will be seen at the next inspection. As indicated by service users spoken with, new care staff are being recruited at the moment and the staff complement will be increased during the day when the process is complete. The newest support worker had thorough induction training and records of this training were seen. Certificates were also seen of recent training courses, provided for staff and more courses are being set up. A staff training overview is currently being prepared by an outside company who are planning more courses and results will be available by the next inspection. Currently only one support worker has achieved an NVQ qualification, but three care workers are due to start this training soon. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 20 The Recommendation that more staff complete NVQ training is carried forward here from the last inspection report. Grove House/Grove Lodge DS0000019398.V306585.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Service users are happy with the management in the home, which is well run and they are confident that their wishes and views will continue to direct the services provided. Generally, procedures in the home help to protect service users and promote their welfare. EVIDENCE: Service users who were spoken with, said that the newly appointed Manager was very competent and supported their wishes and requests in an appropriate manner. The support worker said she felt confident that the home was being well run. The Manager is currently undertaking professional training and will be applying to register with the CSCI in the near future. There are Quality Assurance systems in place, linked to Head Office systems and this area will be pursued further with the Manager at the next inspection. Records of fire checks and evacuations were seen and were well documented, with details of who took part in the fire drills and the outcomes. Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 22 However, in the Lodge, there were two fire doors wedged open and it appeared that the Door Guard on one of these was not working. A Requirement has been made that fire doors must not be wedged open. Grove House/Grove Lodge DS0000019398.V306585.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 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 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 3 x 3 x x 2 x Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 6(a)&(b) Requirement The Registered Provider must review and update the home’s Statement of Purpose and service User’s Guide and provide a copy for the CSCI. The Registered Provider must produce for each service user a written contract/terms and conditions. Timescale for action 01/11/06 2 YA5 5(1)(b)&(c) 01/12/06 3 YA24 23(2)(o) 4 YA42 The Registered Provider must ensure that the grounds are well maintained and that the broken door to the gas meter cupboard is repaired. 23(4)(a)&(c)(v) The Registered Provider must ensure that fire doors in the home are not wedged open. 01/11/06 26/09/06 Grove House/Grove Lodge DS0000019398.V306585.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. Refer to Standard YA19 Good Practice Recommendations The Registered Provider should produce a written risk assessment to identify and control the possible hazards attached to the living arrangements of the service user with epilepsy. The Registered Provider should produce a written medication policy for the home using current professional guidelines. The Registered Provider should ensure that at least 50 of the care staff in the home achieve an NVQ level 2 in care or above. THIS RECOMMENDATION HAS BEEN CARRIED FORWARD FROM THE LAST INSPECTION REPORT AND IS ON-GOING. 2 3 YA20 YA32 Grove House/Grove Lodge DS0000019398.V306585.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Grove House/Grove Lodge DS0000019398.V306585.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. 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