Inspection on 25/04/06 for Grove Road (107-109)

This inspection was carried out on 25th April 2006.

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

The inspector found 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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grove Road (107-109) 24/05/07

Grove Road (107-109) 08/12/06

Grove Road (107-109) 18/10/05

Grove Road (107-109) 05/05/05

Grove Road (107-109) 05/01/05

Grove Road (107-109) 04/08/04

Grove Road (107-109) 16/02/04

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

CARE HOME ADULTS 18-65 Grove Road (107-109) 107- 109 Grove Road Walthamstow London E17 9BU Lead Inspector Rob Cole Unannounced Inspection 25th April 2006 10:00 Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Grove Road (107-109) Address 107- 109 Grove Road Walthamstow London E17 9BU 020 8520 6435 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) bagano98@aol.com Mrs Conchita Damaguen Pooten Mrs Conchita Damaguen Pooten Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: The home is registered to provide accommodation and support to nine service users with mental health needs. It consists of three homes that have been converted into one. The home is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, and is close to shops and other local amenities, including transport networks. The home is indistinguishable from other homes in the area. The home is privately run. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 25/4/06 and was unannounced. The inspector had the opportunity of speaking with service users, staff and the homes manager was present throughout the inspection. Service users gave generally positive feedback about the care and support they receive. There are however a number of issues that must be addressed, as highlighted within the report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 6 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 Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 7 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): 1,4 and 5 The inspector was satisfied that service users are provided with sufficient information about the home to help them make an informed choice about the home. This information is provided through written documentation and the opportunity of visiting the home. However, the home must ensure that service users are only admitted to the home in line with its admissions procedure. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place, both documents are written in plain English. The Statement includes the aims and objectives of the home, facilities and services provided and details of the staff team and the organization. The Service User Guide includes details of the environment and the homes complaints procedure. Since the last inspection the Guide now also includes details of fees payable. However, neither document is dated and there is no indication of when the next review is due, and this must be addressed. All service users are provided with a written contract/statement of terms and conditions. These have been signed by the service user and the homes manager, and are in line with NMS. The service user is issued with a copy of the contract, and since the last inspection the home now also has a copy. There have been no new admissions to the home since the previous inspection. However, at the last inspection a requirement was set that the home only admits service users to the home in line with its admissions procedure. This Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 8 states that service users will initially move in on a trial basis, after which a placement review meeting will be held. It was found that for the most recent admission to the home there had been no placement review meeting. This requirement is repeated in this inspection. The admissions procedure states that service users will be given the opportunity of visiting the home before making a decision a to move in or not, and service users spoken to confirmed that this was indeed the case. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 It is the inspector’s judgement that service users are able to make choices and have control over their daily lives. Risk assessments and care plans are of a satisfactory standard, and service users are consulted over the running of the home. EVIDENCE: Clear and comprehensive care plans are in place for all service users. These are drawn up with the involvement of the homes manager and service users. Plans cover needs associated with medication, mobility, cultural, religious and social and leisure needs. There was evidence that plans are regularly reviewed, and daily logs are also maintained. Risk assessments are also in place for all service users. These have been developed since the last inspection and now are of a satisfactory standard. Assessments cover risks associated with self harm, neglect, violence and aggression and accessing the community. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. For example, service users were able to get up and go to bed and eat at a time of their choosing. Service users are able to come and go as they choose from the home, and Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 10 have keys to the front door and their bedrooms. The manager informed the inspector that service users are routinely consulted over the running of the home, for instance over menus and activities. Since the previous inspection formal arrangements have been introduced to seek service users views, in the form of regular service user meetings. These are minuted, and included discussions on holidays and general house issues. The home has a confidentiality policy in place. This makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests of service users and others. Confidential records were stored securely, staff and service users can access them as appropriate. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15 and 17 The inspector was satisfied that service users are supported to live valued and fulfilling lives. Service users have regular access to the community, and food was of a good standard. EVIDENCE: Service users have regular access to the local community. Service users visit local cafes, parks, shops banks and the post office. Service users access public transport, including buses and tube trains. One service user is employed at a local café, while others attend day services and adult education classes, for instance to study maths and IT skills. Another service user has a weekly guitar lesson arranged in house. The inspector was impressed by the efforts the home has made to support service users with their spiritual needs. One service user attends a local mosque, one service user attends a catholic church, one a Baptist church and another a Greek orthodox church. A gospel music group also visits the home twice a week, service users informed the inspector that this was something that they enjoyed. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 12 Service users have access to a variety of social and leisure activities both in house and in the community. In house service users have access to TV, video, DVD, music, cards, board games, and the home organizes BBQ’s and parties, for instance to celebrate birthdays. In the community service users go to the cinema, theatre and day trips, recently service users went to Margate for the day. All service users are offered an annual holiday, it is planned that later this year service users will get a weeks holiday in Kent. Service users spoken to informed the inspector that they helped to choose this holiday, and that they were very much looking forward to it. Service users are able to maintain contact with family and friends, including visiting their families in their homes for overnight stays. Service users are able to receive visitors in the home at a time of their choosing, and can see them in private if they so wish. Service users have access to a telephone, and are given their own mail to open. Records are kept of menus, these evidenced that service users are offered a varied, balanced and nutritious diet. Service users have a large degree of choice over meals. On the day of inspection service users had a choice of corn beef hash, vegetable curry, a fish dish or chicken stew. Service users are involved in food preparation, including buying the food. One service user prefers a Halal diet, and this is catered for. The kitchen was clean and tidy. Records are kept of the temperatures for the homes fridge and one of two freezers, but not for the second one and this must be addressed. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 It is the inspector’s view that service users receive appropriate personal care. However, more must be done in regard to their health care needs, for example all service users must have access to regular dental care, and medications must be appropriately administered and recorded. EVIDENCE: Service users are able to manage their own personal care, although the home will give encouragement and advice on clothing appropriate for the weather. The manager informed the inspector that service users would be able to remain in the home with a terminal illness, so long as the home could meet their medical needs. Service users wishes in the event of their death have been sought and are recorded on their care plans. All service users are registered with a GP. Records are maintained of medical appointments, including details of any follow up action required. Records indicated that service users have had access to various health professionals, including CPN’s psychiatrists, opticians and district nurses. However, as at the last inspection the home was unable to evidence that all service users have access to regular dental care, and it is a repeat requirement that service users have access to health care professionals as appropriate. The home makes use Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 14 of the Continence Advisory Service, and used continence products were disposed of appropriately. The home has a comprehensive medication policy, and all staff receive training before they administer mediations. Records are maintained of mediations entering the home, and of those that are retuned to the pharmacist. Seven of the nine current service users self medicate, and there are appropriate risk assessments and checks in place around this. Medications are stored in locked cabinets inside individual bedrooms. However, the Medication Administration Record (MAR) charts for one of the service users who are supported to take their medication by staff had not been filled in appropriately for the two weeks prior to the inspection. The MAR charts merely stated “self medicates”, but both the service user and the homes manager confirmed that this was not the case. It is required that all medications are appropriately administered and recorded. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 It is the view of the inspector that the home could be doing more to ensure that service users are protected from the risk of abuse. The homes adult protection procedures must be in line with current legislation, and staff need to be aware of their responsibilities with regard to adult protection. EVIDENCE: The home has a clear complaints procedure. This was prominently displayed within the home, and included timescales for responding to any complaints made and contact details of the CSCI. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home also maintains a complaints log, although the manager informed the inspector that no complaints have been received in the past year. The home has a copy of the Local Authority adult protection procedures and also its own policy on adult protection. However, this was not in line with current legislation, for example it did not make clear the homes responsibility to notify the Local Authority and the CSCI of any suspected abuse, and must be amended accordingly. This is a repeat requirement. The manager informed the inspector that all staff have now undertaken training in adult protection issues. However, staff spoken to on the day of inspection demonstrated a poor understanding of their roles and responsibilities with regard to adult protection, and this must be addressed. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 The inspector was satisfied that the home is suitable to meet its sated purpose with regard to the physical environment. Service users are provided with adequate communal and private space, and the home was generally well maintained. EVIDENCE: The home consists of three houses converted into one, and is situated in the Walthamstow area of the London Borough of Waltham Forest. The home is in keeping with other homes in the vicinity, close to shops, transport links and other local amenities. All service users have their own bedrooms, five of these are ensuite and the others all have hand basins fitted. All bedrooms had adequate natural light and ventilation, and bedding, carpets and curtains were well maintained. Service users have been able to personalise their rooms, for example with family photographs, and bedrooms meet National Minimum Standards on size requirements. In addition to the five ensuite bedrooms, the home has one toilet/shower room, one toilet bathroom and one toilet on its own. Bathrooms were clean, tidy and free from offensive odours. Since the last inspection a lock with an emergency override device has been fitted to the downstairs toilet. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 17 The communal areas of the home consists of three lounges, (one a designated smoking room), two kitchen/dining areas and a garden with appropriate garden furniture. Furniture and fittings around the home were generally well maintained and domestic in character. The home has recently had new carpets fitted, which service users helped to choose. The home has suitable measures in place to help prevent the spread of infection, for example protective clothing is available to staff, and COSHH products were stored securely. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 The inspector was satisfied that the home is staffed in sufficient numbers to meet service users needs, and that staff have a good understanding of service users individual and collective needs. EVIDENCE: The home provides 24-hour support, including an emergency on-call procedure. The home had a staffing rota on display, this accurately reflected the staffing situation on the day of inspection. Since the last inspection the home now holds regular staff meetings. All staff can contribute to the agenda, and records evidenced discussions on service user issues and health and safety. All staff receive a copy of their job description, and a staff handbook, which includes the homes policies and procedures and terms and conditions. All staff have been given a copy of the General Social Care Council codes of conduct. Through observation there was evidence that staff have built up good relations with service users, and a good ability to communicate with service users. The home has policies in place on equal opportunities and recruitment and selection. As there have been no new staff recruited to the home since the last inspection, requirements made around staff recruitment at previous inspections are repeated in this report. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 19 Staff informed the inspector that they receive a structured induction on commencing work at the home, this includes health and safety and service user issues. Records are maintained of staff training, these indicated that staff have undertaken recent training in understanding mental health, challenging behaviour, food hygiene and manual handling. Of the seven care staff employed at the home the manager informed the inspector that two have achieved a relevant care qualification, and that a further four staff are currently working towards such a qualification. It is required that at least 50 of the staff team have a relevant qualification in care. The inspector was pleased to note that since the last inspection the home has introduced a system of formal supervision for all staff, undertaken by the homes manager. Records of supervision evidenced discussions on performance and training. However, supervision is as yet infrequent, for example several staff have had only one supervision since October 2005. It is required that all staff receive regular formal supervision, at last six times a year. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 and 43 It is the view of the inspector that the homes manager is suitably qualified and experienced to carry pout their duties, although greater attention needs to be paid to health and safety issues. EVIDENCE: The homes manager is a Registered Mental Health Nurse with over thirty years experience of working with adults with mental health issues, including twenty five years experience of working in a managerial capacity. The manager informed the inspector that they are now working towards the Registered Managers Award. Staff and service users informed the inspector that they found the manager to be approachable and accessible, and on the day of inspection staff were observed to interact with the manager in a relaxed manner. The home has a quality assurance system in place, and copies of previous inspection reports were available to view in the home. The home issues questionnaires to service users and relatives to gain their feedback on the Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 21 running of the home. Care plan reviews, staff meetings and service user meetings also contribute to the quality assurance within the home. The home has various health and safety policies in place, including infection control and fire safety. Staff undertake health and safety training, such as on food hygiene and first aid. Fire fighting equipment was situated throughout the home and last serviced on the 28/2/06. Fire exits were clearly signed and free from obstruction. Fire alarms were last serviced on the 6/3/06. However, fire alarms had not been tested for the past five weeks, although the manager informed the inspector that they are supposed to be checked weekly. Further, there was no evidence of any fire drills taking place at the home since May 2006. Since the last inspection the home now tests hot water temperatures, however, records indicated that the water temperature in one of the baths was between 66 and 74 degrees centigrade. It is required that hot water is maintained at 43 degrees centigrade for all water outlets used in personal care. The home had in date certificates for gas safety, PAT testing and electrical installation. The home had in date employer’s liability insurance cover. Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 X 3 X 4 2 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 3 3 3 3 X X 2 3 Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 23 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 YA19 Regulation 13 Requirement The registered person must ensure that all service users are registered with a dentist and offered dental care as appropriate. (Timescale 31/1/06 not met) The registered person must ensure that they obtain all information listed in Schedule 2 of the Care Homes Regulations 2001 for all staff working in the home. (Timescale 31/1/06 not met) The registered person must ensure that all water temperatures used for personal care are checked weekly, and ensure that temperatures do not exceed 43 degrees centigrade. (Timescale 31/1/06 not met) The registered person must ensure that the home has a policy in place on adult protection which is in line with current legislation. (Timescale 31/1/06 not met) The registered person must ensure that all service users are admitted to the home in line with the homes admission DS0000007245.V290345.R01.S.doc Timescale for action 31/08/06 2 YA34 19 31/08/06 3 YA42 13 31/08/06 4 YA23 13 31/08/06 5 YA4 14 31/08/06 Grove Road (107-109) Version 5.1 Page 24 6 YA36 18 7 YA1 6 8 YA17 13 9 YA20 13 10 YA23 23 11 YA32 18 12 YA42 13 and 23 13 YA42 13 and 23 procedures. (Timescale 31/1/06 not met) The registered person must ensure that all staff receive regular formal supervision at least six times a year, and that records are kept of supervisions, and staff receive a copy of the minutes. (Timescale 31/1/06 not met) The registered person must ensure that the homes Statement of Purpose and Service User Guide are both dated and subject to periodic review. (Timescale 31/1/06 not met) The registered person must ensure that the home tests and records all fridge and freezer temperatures on a daily basis. The registered person must ensure that all medications are appropriately administered and recorded. The registered person must ensure that all staff have a good understanding of their roles and responsibilities with regard to adult protection issues. The registered person must ensure that at least 50 of the care staff employed at the home have a relevant care qualification, NVQ level 2 or equivalent. The registered person must ensure that fire alarms in the home are checked at least weekly. The registered person must ensure that the home holds regular fire drills, at least four times a year. 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Grove Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Road (107-109) DS0000007245.V290345.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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