Inspection on 12/01/06 for Hampshire House

This inspection was carried out on 12th January 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 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hampshire House 14/01/10

Hampshire House 27/09/07

Hampshire House 01/06/06

Hampshire House 26/07/05

Hampshire House 23/02/05

Hampshire House 10/05/04

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

CARE HOME ADULTS 18-65 Hampshire House & Redsteps The National Society For Epilepsy Chesham Lane Chalfont St Peter Gerrards Cross Bucks SL9 ORJ Lead Inspector Mike Murphy Unannounced Inspection 12th January 2006 09:30 Hampshire House & Redsteps DS0000022975.V279003.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 Hampshire House & Redsteps DS0000022975.V279003.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. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hampshire House & Redsteps 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) The National Society For Epilepsy Chesham Lane Chalfont St Peter Gerrards Cross Bucks SL9 ORJ 01494 601427 01494 871927 martineau@epilepsynse.org.uk The National Society for Epilepsy Mr John Peter Windley Care Home 20 Category(ies) of Physical disability (0) registration, with number of places Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A total of 20 residents (14 in Hampshire and 6 in Redsteps) Date of last inspection Brief Description of the Service: Hampshire House and Redsteps provide a rehabilitation service for people with epilepsy. The service is based in two separate buildings located at the National Society for Epilepsy (NSE) centre in Chalfont St Peter, Buckinghamshire. Hampshire House is an older building which has been extended and provides 14 places in single rooms on two floors. Redsteps is a conversion of two buildings, two semi-detached former staff houses, on the periphery of the NSE site about 400 metres walk from Hampshire House. Together the service can accommodate up to 20 younger adults with epilepsy. The homes aims include the development of service users independence. The home is an integral part of the NSE and benefits from a wide range of support services provided by the organisation. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over two days in January 2006: a five hour day time visit to Hampshire House and a one and a half hour late afternoon visit to Redsteps a few days later. Hampshire House and Redsteps, although a single registered service, are different. Hampshire House has 14 residents, many of whom require a moderate to high level of staff support. Redsteps has six places (five residents at the time of this inspection) and the residents there are more independent and require less staff support. The inspection methodology included discussion with staff and residents, reading care plans and other documents, reviewing systems for the storage and administration of medicines, and a walk around each home. Significant themes in both houses were a degree of uncertainty and anxiety about the future following the recent failure of the NSE’s appeal against refusal of planning permission to develop the Chalfont site. Two homes had recently closed elsewhere on the site and there was a very real anxiety that Hampshire House or Redsteps would be next. The registered manager had moved on to a new job elsewhere in December 2005 and the post was vacant at the time of inspection. The deputy manager was covering the post pending a substantive appointment in the near future. This inspection finds that both Hampshire House and Redsteps provide good support to residents with a wide range of needs. There is a core group of experienced staff who provide stability and continuity at a time of anxiety and uncertainty for both residents and staff. Procedures for care planning and for meeting personal, healthcare and social needs appear satisfactory. The home must ensure, however, that amendments to care plans are properly signed and dated and that there is evidence of the resident’s participation and agreement to the care plan. The environment in both houses was generally satisfactory but the temperature of the hot water at three outlets, averaging 57 degrees Celsius, was higher than that recommended in areas to which residents have access. The home is required to address this. While both houses were generally clean, tidy and well maintained, and there were signs of improvements in both over the past year, the environment in Redsteps in particular is likely to require further attention in 2006 in order to maintain a pleasant home for residents and staff. The inspector would like to thank the residents and staff for their time and hospitality during the course of this inspection. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Ensure that the temperature of the hot water in the kitchens of Hampshire House and Redsteps and in the laundry room of Redsteps is at a level which is Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 7 safe for residents while being suitable for washing dishes and other domestic activities. Continue to invest in improving the environment of Redsteps in order to maintain a pleasant home for residents. 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. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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 Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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): Standards in this section were not fully assessed on this inspection. They were assessed and reported on in the announced inspection which was carried out in July 2005 EVIDENCE: Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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 Standards in this section were not fully assessed on this inspection. They were assessed and reported on in the announced inspection which was carried out in July 2005 Care plans are detailed and show evidence of assessing and endeavouring to meet resident’s needs. It is important, however, that all care plans show evidence of the resident’s participation and agreement to the plan and that amendments are dated, signed and again show evidence of the resident’s agreement. The home has begun to develop a ‘Person Centred’ approach to care planning which is a positive development. EVIDENCE: Five care plans were examined. Care plans are comprehensive and are based on an assessment process which includes detailed risk assessments. Hampshire House had started to pilot a Person Centred Approach to care planning (‘PCP’s’) and progress on this was described by the senior support worker leading the development. The PCP approach is to be introduced gradually. All care staff will be attending training on the subject and team leaders will be trained as facilitators. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 11 One care plan in Redsteps did not have the signature of the member of staff responsible for drawing it up. Pencil entries noting changes to the care plan were not signed or dated, and it was therefore, difficult to know on what authority the changes had been made. Two care plans did not have the signature of the resident indicating agreement to the plan. Care plans are drawn up by the key worker in liaison with the resident. The care plan includes a weekly activities timetable. Daily entries were good, recording the events which the resident participated in as well as other relevant information. Care plans showed evidence of being regularly reviewed and a more comprehensive multi-agency review (‘Life Plan’) is conducted annually. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15, 16, 17 The home facilitates residents participation in a range of social, educational and training activities. This provides residents with opportunities to develop skills and to engage in a variety of activities both within the NSE site and in the wider community. EVIDENCE: Care planning includes ascertaining resident’s wishes to participate in activities. Within the home residents participate in cooking, looking after their own rooms and planning their weekly timetable. Some attend church in Chalfont St Peter. A number of healthcare services are available on site – some on a sessional basis. These include a nurse and doctor on call, a specialist epilepsy nurse, a neurologist, a psychiatrist, and psychologist. The NSE employs a College Co-ordinator who liaises with residents and colleges on courses. Colleges attended by residents at the time of this Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 13 inspection included Amersham & Wycombe, Uxbridge, Hayes, Chesham, Gerrards Cross, and on occasions Dacorum. Subjects included life skills, maths and literacy, horticulture and animal husbandry. 12 of 14 residents go to college at some point in the week. Some also attend Chalfont Assembly and Processing (CAPS) on site or assist the gardeners in maintaining the grounds. The home is over a mile from the centre of Chalfont St Peter. Some residents shop at the larger shopping centres in Uxbridge or Slough. Around three residents occasionally go to the cinema in Gerrards Cross. Some go to a local pub. Some residents used to go to a local snooker club but because of recent changes there none were attending at the time of the inspection. All residents are registered to vote. All staff either have attended or will be attending training on the Disability Discrimination Act 1995 and associated issues. A factor which can have an affect on participation in social and recreational events in the wider community is the number of drivers on the staff team at any time. This can vary and a reduction can lead to some restriction in informal outings. In addition to the cinema, shopping and pub outings mentioned above residents may also participate in horse riding and in 2005 some attended drag racing in Nottingham. Each home has TV, video or DVD and music centres. Many residents in both Hampshire and Redsteps have their own home entertainment systems in their rooms. Hampshire House has a games room which includes a pool table and a darts board. One resident expressed dissatisfaction with the lighting around the darts board. Holidays in 2005 have included Pontypool, France, Centre Parcs, Haven Holiday Parks, Blackpool, Yarmouth and Andorra. The NSE Centre contributes £300 per person towards the cost of holidays. Some holidays are organised by a specialist agency which has been set up by former staff of the NSE and who have an understanding of any special needs. Most residents are in touch with their families and go home on occasions. The NSE has a policy governing personal relationships and one of the staff has undertaken special training in relationship counselling for male residents. It is expected that a female member of staff will follow a similar course and be in a position to offer relationship counselling to female residents. Residents in both homes have their own daily routines and each has a weekly diary which is drawn up with the help of a key worker. All participate in varying degrees in cooking. Breakfast consist of cereals, toast, fruit juices and tea or coffee. Lunch is usually a simple snack such as sandwiches and soup. The evening meal is the main meal of the day and is prepared by residents with staff support. Residents are weighed monthly and records maintained in the medical file. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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 Resident’s healthcare needs are assessed and recorded in the care plan and residents have access to healthcare services, both those provided by the NSE and by primary care and other healthcare providers in the community. This aims to ensure that individual healthcare needs are met. The home’s arrangements for the control and administration of medicines appear satisfactory and can accommodate a range individual needs. These range from administration of medication by staff, through a spectrum of staff support and supervision, to self-administration without staff supervision. This process supports resident’s who wish to manage their own medicines. EVIDENCE: The staff in Hampshire House know the residents well and have a good understanding of their needs and how they prefer to receive support. Many residents require a high level of support while others have a high level of independence and much less need for staff support. Residents in Redsteps are more independent. All residents have a key worker who negotiates care with the resident which is then recorded in a care plan. All residents are registered with a general practitioner. Many specialist services are available on site including neurology, psychiatry, psychology, a specialist epilepsy nurse, physiotherapy, and occupational therapy. A nurse and doctor Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 15 are on call. Residents are not currently offered an annual health check. Opticians are available in Chalfont St Peter. Audiology, chiropody, speech therapy and district nursing are accessed via referral. Medicines are prescribed by GPs or neurologists on two separate different coloured prescription and record charts. The home is required to conform to the policy and procedures governing the control and administration of medicines at NSE. These include provision for a spectrum of administration, from administration by staff, through varying degrees of supervised self-administration, to self-administration with minimal staff supervision. Each home has residents on different points along this spectrum. All team leaders have received in-house training at the basic level which staff are required to complete before administering medicines. A number of staff are now being trained to ‘level 2’ which has a higher theoretical component. Rectal diazepam is now usually given by a nurse. Staff accompanying residents on holiday receive training in the administration of rectal diazepam by a nurse. No one was prescribed a Controlled Drug at the time of this inspection and no stocks of such drugs were held in either house. Medicines are dispensed by the pharmacy which is on-site. Staff in Hampshire and Redsteps either make up or supervise the filling of individual ‘Nomad drug wallets’ for residents who administer their own medication. 11 of 14 residents on Hampshire were self-administering and five residents in Redsteps. Procedures are in place for recording the receipt and disposal of drugs and for reporting errors in administration The latter is subject to audit by the pharmacy, a report of which is issued periodically. Arrangements for the storage of medicines in both homes were satisfactory. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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): Standards in this section were not fully assessed on this inspection. They were assessed and reported on in the announced inspection which was carried out in July 2005 EVIDENCE: Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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 Standards in this section were not fully assessed on this inspection. They were assessed and reported on in the announced inspection which was carried out in July 2005 Both Hampshire House and Redsteps provide a comfortable environment which meets the needs of residents. The recent award of a silver rating by the environmental health department is a reflection of good practice in kitchen hygiene in Hampshire House. However, the temperature of the hot water in three outlets and the frosting of a freezer in Redsteps pose a risk to vulnerable residents and need to be effectively addressed by managers. EVIDENCE: Both Hampshire House and Redsteps were clean and tidy at the time of the inspection although some areas of Redsteps were showing signs of wear and tear. These will need attention in 2006 if the home is to continue to provide a comfortable environment for residents. A resident expressed satisfaction with his accommodation which had been personalised and which accommodated a tv, dvd and computer games. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 18 The self-catering arrangement which was introduced to Hampshire House over the past eighteen months appears to be working well The home had received a silver award from the Environmental Health Department following an inspection carried out in October 2005. The lounge in Hampshire House had been redecorated by staff and residents. Records are maintained of fridge, freezer and hot water temperatures. In Hampshire it was noted that the maximum temperature of the hot water which could be recorded was 50 degrees Celsius, this being the limit of the thermometer used. On testing the temperature was found to be 56.4 degrees. This is above the recommended ‘close to 43 degrees Celsius’ in areas to which residents have access. There are two reasons why the temperature at this particular outlet needs to be hotter than that. First of all the sink is used to do some of the washing up after meals and the water needs to be hot enouch to deal with greasy pans. Secondly, about half of the current group of residents may move on to more independent living in the future, to accommodation where the temperature of the hot water may not be regulated. Redsteps has a similar problem. The temperature of the hot water in the laundry room tap was tested at 59.2 degrees Celsius and at 57.3 degrees in the kitchen. The home needs to safeguard the welfare of all its residents and it now needs to do four things in relation to this matter: firstly, to use an electronic thermometer to obtain an accurate reading of the temperature; secondly, to obtain the opinion of the environmental health department on the maximum temperature recommended given the need to safeguard residents at risk while, at the same time, being hot enough for domestic tasks (such as washing up and laundry); thirdly, to regulate the temperature to that safe maximum; and, finally, to carry out a risk assessment for these particular outlets (all other outlets are regulated) appropriate to the needs of all residents in Hampshire House and Redsteps. Fridges and freezers were generally in order in both houses with the exception of a freezer in Redsteps which was heavily frosted and which could not have been working effectively. The inspector was informed that this is due to be replaced. A new shower had been installed in Redsteps. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 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): Standards in this section were not fully assessed on this inspection. They were assessed and reported on in the announced inspection which was carried out in July 2005 EVIDENCE: Hampshire House & Redsteps DS0000022975.V279003.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): 39 While the home does not have a formal plan for quality assurance activities it does have a systematic approach to care planning and review and for carrying out Regulation 26 visits. It also has procedures for recording and reporting seizures and for errors in the administration of medicines which are subject to audit and review. These benefit residents by creating a culture of selfmonitoring which supports improvements in service quality. EVIDENCE: The home does not have a formal development plan. Any future developments will be linked to the plans for the NSE site as a whole. These were unclear at the time of the inspection but the failure of the planning appeal had raised anxiety and uncertainty about the future. The home has systems of audit for seizure charts and medication errors and receives reports on the outcomes of these. It does not conduct a service user survey and a house meeting had not been held since august 2005. Staff meetings are held monthly. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 21 Care plans are reviewed three monthly and life plans reviewed annually. Families are invited to review meetings. Risk assessments are comprehensive. Accident records are maintained. Regulation 26 visits are regularly carried out (one took place on the day of the inspection) and reports sent to the CSCI. The homes comprehensive policy manual is available to staff and residents in the office. Policies are reviewed centrally by managers. Hampshire House & Redsteps DS0000022975.V279003.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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x X X 2 X X X x Hampshire House & Redsteps DS0000022975.V279003.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 YA42 Regulation 13 (4) Requirement The registered manager is required to ensure that the temperature of the hot water in areas to which residents have access is close to 43 degrees Celsius The registered manager is required to ensure that the thermometer used to check the water temperature if Hampshire House and Redsteps is suitable for that purpose. Timescale for action 28/02/06 2 YA42 13 (4) 31/01/06 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 YA36 Good Practice Recommendations It is recommended that the registered manager provide occasional support to Redsteps to enable it to hold staff meetings and establish a programme of personal supervision for staff. It is recommended that the registered manager review with residents the lighting around the darts board in Hampshire House DS0000022975.V279003.R01.S.doc Version 5.1 Page 24 2 YA14 Hampshire House & Redsteps 3 YA39 It is recommended that the registered manager reestablish regular meetings with residents and that notes taken and retained. Hampshire House & Redsteps DS0000022975.V279003.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Area Name Area Address 1 Area Address 2 Area Address 3 Area Address 4 Area Address 5 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. 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