Inspection on 20/09/06 for Gunters Grove Farm

This inspection was carried out on 20th September 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Gunters Grove Farm Gunters Grove Farm Shurton Stogursey Bridgwater Somerset TA5 1QH Lead Inspector Lesley Jones Unannounced Inspection 20th September 2006 14:00 Gunters Grove Farm DS0000066962.V312099.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 Gunters Grove Farm DS0000066962.V312099.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. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gunters Grove Farm Address 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) Gunters Grove Farm Shurton Stogursey Bridgwater Somerset TA5 1QH 01278 653751 Mrs Tracey Morgan Mrs Tracey Morgan Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Gunters Grove is registered with the Commission for Social Care Inspection to provide personal care for one adult who has a learning difficulty. Mr and Mrs Morgan own the home. There is a connecting door from Mr and Mrs Morgan’s own home to Gunters Grove. Mr and Mrs Morgan also own another two bed homes for people with a learning disability called The Bungalow. Both homes provide a service for people who in addition to their learning disability have behaviour, which is challenging to manage. Although Mr and Mrs Morgan have no specific qualification in managing challenging behaviour, they have developed expertise in this area, based on many years experience. Mr Morgan works mainly with the resident who lives at Gunters Groves, and provides cover at The Bungalow when needed. Other staff work across both homes. Mrs Morgan is the Registered manager for both homes. Both homes share the same policies and procedures. The homes are approximately five minutes drive away from each other. Gunter Grove is set in a quiet location near the village of Stogusey. Shops, public houses and a post office are within approximately fifteen minutes walk away. Accommodation is set on the ground floor and first floor and therefore only accessible to service users with good degrees of physical mobility. There is a large bedroom, office and bathroom/toilet upstairs, and a separate kitchen and lounge/dinning areas downstairs. Gunters Grove is in a rural setting, with views of open country. It provides quite and peaceful accommodation . Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector would like to thank the manager residents and staff for their welcome and help throughout the inspection. The majority of inspections carried out by the CSCI are unannounced. This inspection was announced (four hours notice) in order to cause minimal distress to the resident at Gunters Grove, who finds change difficult and can present behaviours, which are challenging to manage. I spent two hours at Gunters Grove. During this time, I was able to talk to the manager, the resident, inspect the premises, and look at some of the records, including medication. Both Gunters Grove and the Bungalow, share the same policies and procedure and the same staff group work across both homes. During the inspection of The Bungalow on 25th September, I was able to talk to members of the staff team and review policies, procedures and care plans. The visit to Gunters Grove took place over two hours. Most of the Key Standards were inspected over the visits to both homes. The only standards not accessed were staff records, and these were found to be in good order at the last inspection in February this year. The Manager and joint proprietor Mrs Morgan was present throughout the inspection. Given the inter related nature of the service, and to protect the privacy of residents, some of the information in this report refers both homes. What the service does well: Gunters Grove provides very individual care in a domestic setting. Due to the size and nature of the home there is excellent ongoing consultation with the service user about the day-to-day running of the home. There is a comprehensive care plan for the service user, which is well written. Daily records giving further information about the service user. The service user stated that any changes to the care plan are fully discussed. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 6 The resident has an activity programme. Activities cover a range of leisure and training opportunities both in the home and in the local community. The home assists the resident to maintain contact with friends and family outside the home. Staff are well motivated and appeared competent in their roles. Staffing levels are determined by the individual need of the resident. What has improved since the last inspection? What they could do better: The Manager was advised that POVA checked must be taken on all new staff in keeping with the Guidance from the Criminal Records Bureau available at www.disclosure.gov.uk. Some staff need updates in food hygiene training. All staff must receive training in manual handling. The Manager was advised to consider seeking physical intervention training for herself and staff, specifically ‘blocking and breakaway techniques’ from an accredited trainer. General support for providers of services for people with a learning disability as well Information about available training can be obtained from www arcuk.org.uk. The manager was advised to look at additional ways of ensuring that service users guides are accessible to residents. The use of symbols and video was discussed. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 7 The manager was asked to develop a homely remedies list in conjunction with residents GPs. This ensure that any homely remedy administered does not conflict with prescribed medication. It is recommended that as part of a quality assurance programme, the proprietor seeks formal feedback (perhaps through the use of questionnaires) from staff, outside agencies, parents or carers, and service users (where appropriate), on the quality of the service. 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. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 8 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 Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 9 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): 1,2,4,5, Quality outcomes in this area are good. The service user has a service user guide giving them information about the home and their financial responsibilities. EVIDENCE: Service users in both homes have a service user guide, which is personalised to them. One service user showed the inspector their guide. The manager is currently working on personalising the service user guide for the newest resident at the Bungalow., Service users guides are updated each year. The service user guide is clearly written and sets out the rights and responsibilities of each party and details of what is included in the basic fee. It is a recommendation of this report that where appropriate, service user guides are provided which include Total Communication symbols, and that a video guide is developed . Service users in both homes are assisted with their fees by their local authority. Financial contracts are between the home and the local authority and not with the service user. The current resident previously lived at The Bungalow. His stay at Gunters Grove was initially on a trial basis so that an assessment could be made. He has been a permanent resident since March 2006. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 10 Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 11 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, Quality outcomes in this area are good. The Service user is consulted with about all day-to-day decisions within the home. Care plans are comprehensive and give clear information about the resident’s needs and wishes. EVIDENCE: The inspector viewed the care plan of the service users currently living in both homes. The care plan covered all areas of care and gave details of all activities undertaken, including risk assessments. Service users are encouraged to keep a copy of their care plan in their room wherever possible . There is a formal annual review of service user needs and the inspector saw evidence that elements of the care plan are updated throughout the year to ensure that they continue to reflect up to date needs and wishes. Service users in both homes are aware of their care plan and stated that they were involved in decisions about any changes. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 12 The plan of care contained a skills assessment from which guidelines for staff to assist and support the person to gain further independence were outlined. Daily records are maintained outlining significant events, meals eaten, appointments, activities and behaviour. Daily records seen, were comprehensive. Residents spoken to in both homes felt that they were involved in all day to day decisions in the house and were able to express their opinion freely. The nature of both homes means that service users are able to relate to staff on a one to one basis. Service user stated that they are able to plan their own activity programme with their key worker. Informal meetings to discuss issues affecting daily life take place . Minutes are not kept of these informal discussions. Records relating to individual service users were appropriately stored. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 13 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): 11,13 14, 16, 17 Quality outcomes in this area are good. Service users in both homes have a comprehensive activity programme that covers leisure activities, accessing community facilities and developing independent living skills. Service users in both homes are assisted to maintain relationships with friends and family members. EVIDENCE: Service users in both homes have comprehensive weekly activity programmes, which cover activities at the home and in the local community. Activities undertaken on a regular basis include horse riding, swimming, walking, bowling and going to the gym. Care plans give details of how staff assist with each activity and the level of staffing required in each case. A chart of activities is displayed in the individual’s room at Gunters Grove and in his care plan. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 14 Service users in both homes stated that they were responsible for cleaning and tidying their rooms and helping to keep communal areas comfortable. There are no set menus in the homes and service users are able to choose what they wish to eat each day. Residents In both homes have a training day were they are responsible for shopping and cooking the main meal of the day. There is unrestricted access to the kitchen and drinks and snacks are available at all times. Meals eaten are recorded in the daily log. Service users in both homes retain contact with their families and the staff assist people to keep in touch by phone, letter and visits. The home is able to provide transport and staffing for visits and stays with family. Service users spoken to stated that there are no set times to get up or go to bed but that times were dependant on activities being undertaken. It was observed that the service user at Gunters Grove on the day of the inspection had unrestricted access to all communal areas and their personal room. The service user stated that they liked to spend some time on their own and that staff always knocked on the bedroom door and waited for a response before entering. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 15 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, Quality outcomes in this area are good. Staff assist service users with personal care in a way that respects their privacy and dignity. EVIDENCE: Service users in both homes are registered with local GPs and other healthcare professionals appropriate to their individual needs. Staff assist residents to attend appointments outside the home. Care plans give details of how service users like to be assisted with their personal care and the level of support that they require. All personal care is carried out in private, one person has an en suite bathroom and there is a communal bathroom. No service users currently living in either home administer their own medication. Some gaps were noted on the Medication Administration Record in Gunters grove. This must be addressed. There is appropriate storage for medication. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 16 It is a recommendation of this report that the manager develops a homely remedies list in conjunction with residents GPs. This ensure that any homely remedy administered does not conflict with prescribed medication. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 17 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): 22,23, Quality outcomes in this area are good. Service users are able to discuss worries or concerns with a member of staff or with family members outside the home. Reasonable steps have been taken to minimise the risk of abuse to service users. EVIDENCE: Each service user guide contains a copy of the home’s complaints procedure. Service users in both homes stated that they would be comfortable to approach the manager or a member of staff if they were unhappy with any aspect of their care. Due to the size and nature of the home changes in mood or behaviour, which may be indicative of a problem, would be quickly noticed by the small staff team. Service users are aware of any restrictions on freedom that were documented in the care plan. As previously stated service users have unrestricted access to their personal rooms and to all communal areas. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 18 All staff currently working at the home have undergone an enhanced Criminal Records Bureau check and some have covered issues of vulnerability and abuse in their National Vocational Qualification training. The most recently appointed member of staff had not been checked through POVA. This must be addressed. It is a requirement of this report that POVA checked must be taken on all new staff in keeping with the Guidance from the Criminal Records Bureau available at www.disclosure.gov.uk. Professionals outside the home review all care annually and both service users have regular access to family members if there was any issue that they felt unable to discuss within the home. The manager was seen to interact with the service user in a friendly and respectful manner. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 19 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): 24,26,27,28,29,30, Quality outcomes in this area are good. Gunters Grove provides domestic style accommodation for service users. EVIDENCE: Gunter Grove is set in a quiet location near the village of Stogusey. Shops, public houses and a post office are within approximately fifteen minutes walk away. Accommodation is set on the ground floor and first floor and therefore only accessible to service users with good degrees of physical mobility. The resident at Gunters Grove has a large bedroom on the first floor, which he has personalised. There is a combined toilet and bathroom on this floor and an office. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 20 There is a comfortable lounge/diner downstairs and a separate kitchen with good facilities. . There is also a downstairs toilet and a small utility area next to the kitchen. Gunters Grove was built as a separate unit to the main house, but is in fact an extension to in. The two houses connect through a door at the side of the kitchen. Sleeping in cover is provided from the main house and the resident confirmed that he could ask for help during the night and what he needed to do to summon either Mr or Mrs Morgan. The home was clean and fresh smelling. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 21 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, Quality outcomes in this area are good. Service users are supported by a well-motivated staff team in numbers appropriate to the needs of the individual service users. EVIDENCE: Six care staff are employed to work across both homes . They are responsible for all care and domestic tasks within the home. One member of staff is currently on maternity leave, and her shifts have been covered within the existing staff team. Three of the six staff have a National Vocational Qualification in care at level 2 or above. Some staff need updates in food hygiene training. All staff must receive training in manual handling. The Manager was advised to consider seeking physical intervention training for herself and staff, specifically ‘blocking and breakaway techniques’ from an accredited trainer. General support for providers of services for people with a Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 22 learning disability as well as Information about available training can be obtained from www arcuk.org.uk. Staffing levels are maintained in line with the individual needs of the service users. Overnight there are no waking night staff but Mr and Mrs Morgan are next door and can be called if required. In their absence a senior member of staff takes their place . One new member of staff has started work at the home since the last inspection. Service users meet all prospective members of staff before a position is offered. The members of staff observed at the Bungalow, and interviewed during this inspection appeared competent and well motivated. They stated that all care staff work as a team and that communication is very good. Staff feel that Mrs Morgan provides good behaviour management programmes and, as the team work well together and have a consistent approach, success can be achieved more quickly. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 23 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): 37,39,42, Quality outcomes in this area are good. The home is effectively managed giving consideration to the views of staff and service users. EVIDENCE: The registered manager and joint provider is Mrs Tracy Morgan. Mrs Morgan works alongside care staff offering advice and support and ensuring a high standard of care is maintained. She has an HND in management studies and is currently completing NVQ level 4 in care. Staff stated that they are comfortable to discuss any issues or seek advice from the manager at any time. The manager of the home was available throughout the inspection and was co operative and welcoming. Staff and service users stated that the manager was open and approachable. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 24 There are regular formal staff and informal service user meetings, which are an opportunity to share ideas and make suggestions about the running of the home. The manager acts as an appointee for both service users and is currently looking into the best way to open a bank account for each service user. Small amounts of personal allowance money is kept on the premises. Reasonable steps have been taken to ensure the health, safety and welfare of service users whilst encouraging people to learn and develop new skills and interests. Risk assessments are in place for individual activities. The house is fitted with smoke and heat detectors. Records viewed by the inspector showed that a member of staff tests these weekly. There is no hard wiring certificate for the home and a qualified electrician has not checked the electrical portable appliances, although staff carry out visual checks. Recommendations were made in respect of this at the last inspection. I understand that there are plans to have the Bungalow rewired. This leaves outstanding checks by a qualified electrician on portable equipment in both houses. All records seen were well maintained, up to date and appropriately stored. Service users are able to request access to their personal records at any time. It is recommended that as part of a quality assurance programme, the proprietor seeks formal feedback (perhaps through the use of questionnaires) from staff, outside agencies, parents or carers, and service users (where appropriate), on the quality of the service. Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 x 4 3 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 x 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 x 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 x x 3 2 x Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 26 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 YA42 Regulation 13(4) Requirement The manager must ensure that the Bungalow is rewired as advised following the visit of a qualified electrician and that all portable appliances are tested, in both homes. A copy of the safety certificate must be forwarded to the CSCI It is a requirement of this report that POVA checks must be taken on all new staff in keeping with the Guidance from the Criminal Records Bureau available at www.disclosure.gov.uk. The manager must arrange for staff to have updates in food hygiene training. All staff must receive training in manual handling. Timescale for action 01/04/07 2 YA23 19 (Schedule 2) 01/10/06 3 YA32 18© (1) 01/04/07 Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 27 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 YA32 Good Practice Recommendations The Manager was advised to consider seeking physical intervention training for herself and staff, specifically ‘blocking and breakaway techniques’ from an accredited trainer. General support for providers of services for people with a learning disability as well Information about available training can be obtained from www arcuk.org.uk. The manager was advised to look at additional ways of ensuring that service users guides are accessible to residents. The use of symbols and video was discussed. The manager was asked to develop a homely remedies list in conjunction with residents GPs. This ensure that any homely remedy administered does not conflict with prescribed medication. It is recommended that as part of a quality assurance programme, the proprietor seeks formal feedback (perhaps through the use of questionnaires) from staff, outside agencies, parents or carers, and service users (where appropriate), on the quality of the service. 2 YA32 3 YA20 4 YA37 Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Gunters Grove Farm DS0000066962.V312099.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!