Inspection on 27/04/05 for Haslewood Avenue (1)

This inspection was carried out on 27th April 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Haslewood Avenue (1) 22/08/07

Haslewood Avenue (1) 30/08/06

Haslewood Avenue (1) 19/10/05

Haslewood Avenue (1) 21/12/04

Haslewood Avenue (1) 10/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Haslewood Avenue 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT Lead Inspector Jan Sheppard Unannounced 10:00 27 April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 1 Haslewood Avenue Address 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT 01992 479 171 01992 479 171 none Hightown Praetorian & Churches Housing Assocation vacant Care Home 8 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of LD Learning Disability 8 registration, with number LD(E) Learning Disability over 65 8 of places PH Physical Disability 8 Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate people with a physical disability (only when associated with a mental handicap) Date of last inspection 21 December 2004 Brief Description of the Service: Haslewood Avenue is a purpose designed bungalow in the centre of Hoddesdon built in 1995 to accommodate 8 adults with learning disabilities who had formally lived together in a hospital. It is an attractive, compact building, surrounded by a small garden that provides eight single bedrooms, two assisted bathrooms, three wheelchair accessible WCs, a laundry, lounge, kitchen and dining room and an office and storage areas. The home has a very homely appearance and feel. The facilities of the local town are easily accessible by foot from the home, as are the local transport services.The home, which is run by Hightown Praetorian Housing Association, a voluntary organisation, provides full care services in an intregrated and safe environment for its residents who all have learning and physical disabilities and who present a moderate degree of challenging behaviour. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day during when all the residents were seen and consulted with in the best manner possible considering their abilities. Visitors and staff were also spoken with. Discussions were held with the visiting service manager and with all the staff who came on duty throughout the day. Time was spent looking at care plans and other records maintained by the home. A tour was made of the building and of the garden areas. This was a positive inspection, the inspector was welcomed into the home by the residents many of whom remembered her and by all the staff who each made time to have their own personal discussion. Since the last inspection a number of improvements and changes have been made to the building including works of renovation and the replacement of a number of pieces of equipment this to ensure that the smooth running of the home is maintained. Most of the requirements made during the last inspection have either been met or have work in progress, two remain outstanding. What the service does well: The home offers a warm secure and homely environment for its residents with facilities and equipment that are appropriate for their physical and emotional needs. All the residents appeared to be relaxed and happy and to be very much “ at home “ in their own personal spaces. They were observed to be making their likes and dislikes clearly known to the staff and one resident also expressed his wishes very clearly to the inspector during this visit. The home is fortunate in having retained a core group of staff who are experienced and well trained carers, who understand the needs of the residents very thoroughly and are skilled at meeting these needs in a relaxed and spontaneous manner. The changing needs of the residents were being sensitively dealt with and appropriate medical referrals and treatment were seen to be in place to meet these changing needs. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 6 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. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4 and 5 Appropriate information is available for the service users and their families concerning how the home operates and what procedures are in place to meet their care needs. Service users care needs are being met in a caring and understanding manner by staff who clearly knew them very well. EVIDENCE: The contract Statement of Terms and Conditions given to every service user gives details of their room, the fees payable, the care and services that they will receive and the terms and conditions of their occupancy including their rights and obligations in the event of any breach of contract. The Statement of Purpose and Service Users Guide needs does not accurately reflect recent staffing changes in the home. The home has a thorough pre-admission policy and assessment procedure. All the present group of residents except one have lived in the home since it opened in 1995, when they transferred from a long stay hospital, which was to close. Records indicate that at that time an assessment of their care needs was made and service users and their relatives, if any, were able to visit and assess the suitability of the home before admission. For the one service user who was admitted in 2003, the records evidence that the assessment process concerning his admission was spread over several weeks and included staff from Haslewood visiting him in his then home to talk with him and his carers Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 9 as to his care needs before inviting him to visit Haslewood. Following this a number of visits were arranged over several weeks and these included day and over night staying visits. The records also show that once admitted to Haslewood the new resident settled in very quickly and during this inspection he told the inspector that he remains very happy in the home and that it was much better than his previous home. Evidence gathered from the service users current care plans and from the inspectors observations during this inspection demonstrated that their needs and aspirations are kept under review and that the manner in which their care is delivered is altered to meet their changing needs. The atmosphere in the home on the day of this inspection was found to be relaxed. The inspector was welcomed into the home by both the residents and the staff. Without exception the staff were seen to be carrying out their caring duties towards the residents in a calm and kindly way and it was seen that they adopted a mannerism that encouraged each resident to do as much for them selves as they wished and that was safely possible for them to do. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Personal care and assistance offered to the service users is of a high standard and is given in a manner that maintains their dignity and respect. Comprehensive and imaginative care plans are kept and these are subject to review so that changes to health and social care needs are recognised and met. Risk assessments are kept for all service users and these reflect how the potential risks for some individual residents could best be avoided. EVIDENCE: Care staff are experienced and well trained and several have worked with the service users for many years and know them and understand how to meet their care needs very thoroughly. Staff were seen to be offering their services in a sensitive and unobtrusive manner which whilst enhancing the abilities of the individuals also ensured that any sudden changes and wishes they had were accommodated smoothly and without fuss. The care plans examined were found to be comprehensive with good detail as to how each individual service users expressed their wants and wishes and with instructions as to how these care needs should best be met. Where it was possible the service users were found to have signed these plans. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 11 The plans were seen to be subject to review but the regularity of these reviews was not consistent and some were found to be overdue. The service manager explained that this had arisen due to the recent shortage of permanent staff but that this should soon be rectified with the commencement of several new permanent carers over the next few weeks. The staff examined how the residents are consulted about their wishes and the processes concerning the running of their home. Most regular consultation occurs informally around the dining table often at meal times. During this inspection a group of service users sharing their lunch were heard to be discussing their summer holiday plans with the staff. Staff have compiled a folder containing pictures of the service users favourite meals and this folder is used to enable all the service users to participate in the compiling and choice of the weekly menus. Staff were heard to be offering the residents a choice of dishes at lunchtime, which were then cooked individually for them. Several residents were seen to choose a piece of fruit to end their lunch meal. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 All the service users enjoy a day care activity programme, which is designed and delivered to them individually by the Guideposts Day Activity programme workers. This gives them the opportunity for individual development through a variety of leisure and learning activities as well as the opportunity to make frequent visits to leisure facilities in the local community. For those service users with relatives good liaison with the home is maintained including a regular visiting pattern. A nutritious and varied menu chosen by the residents and supervised by a visiting dietician is offered with fresh ingredients and home cooking being provided on a daily basis. EVIDENCE: The records demonstrated that all the service users have their individual day activity programmes led by the Guide Posts staff covering varied activities to meet their individual needs during the five week days and at the weekends two of the homes staff lead activities and outings for groups and individuals planned again to meet their wishes and needs. One service user told the inspector that he wanted a more varied activity programme and this request was discussed with the service manager. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 13 Throughout the day of this inspection the service users were seen to be departing or returning from their particular activities in very good spirits. Staff explained that the duration of their activities are planned to meet their individual requirements for some of the older residents activities lasting half a day or just a couple of hours are long enough. Outings in the homes bus and for individuals in staff members cars remain popular. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Personal care and Health care offered to the residents is of a high standard and meets their individual requirements. Many of the staff have worked with these residents for several years and have an in depth understanding of their care needs and of their varying moods and can interpret their wishes as to how these needs should best be met on any particular day. The home benefits from having well established professional working relationships with their local GPs, the community nursing team and with the specialist Consultant at the local hospital this ensuring that the residents changing health needs are properly met. The home has a robust medication administration and storage system. EVIDENCE: Individual personal care practice observed was commendable. The needs of the residents were seen to be being individually met. One resident who arrived in his wheelchair wanting to have his bath was quickly assisted into the bathroom where he was offered just sufficient help to enable him to then manage his own bathing process as far as it was safely possible for him to do without assistance. The staff member waited outside of the bathroom by the door until summoned inside by him for further assistance. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 15 Residents were observed to be relaxed and appeared happy. The atmosphere over the lunch table where three residents chose to share their lunch together was one of serious eating mixed with spontaneous laughter. Several of the residents greeted the inspector in a very happy and spontaneous manner. One insisted on showing off her room another introduced her pet cat whilst a third bought a plate of chocolate biscuits, which she told the inspector she had made! The home continues to use the MDS, monitored dosage medication system, which is supplied by a local chemist. The pharmacist makes regular visits to the home to check this system and offers advice and assistance whenever needed. The MAR sheets were found to be accurately recorded and all staff who administer medication have been trained to do so. The service manager discussed with the inspector the plans that he has to relocate the position of the medication storage cupboards away from their present crowded location to a quieter and more spacious area. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has a thorough complaints policy and procedure. There have been no complaints since the last inspection. The home has Policies and procedures concerning Adult Protection and Whistle Blowing, which ensure that residents are protected from abuse, neglect and self-harm. EVIDENCE: The homes complaints policy and procedure which is in written format has also been produced in a pictorial format and this has been shown to all the residents and a copy placed in their care plans. There have been no complaints nor any incidents concerning Adult abuse since the last inspection. Following a whistle blowing alert from a member of staff an incident that occurred during the previous year was seen to have been properly handled by the home with appropriate disciplinary and legal action being taken against the worker who can no longer work in the care field. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30. The home and its surroundings offer environment for its service users. The maintenance programme. Not all of the the last inspection had been fully met but met over the next few months. EVIDENCE: The home, which was purpose, designed and built in the mid 1990s to be fully wheelchair accessible provides a homely environment for its residents. Their single bedrooms are all very well personalised and are decorated and furnished with colours and furnishings of their choice. All the residents have specialist equipment supplied following an OT assessment to meet their particular needs. On the day of this unannounced inspection the home was found to be very clean and tidy with no unpleasant smells. The toilets and bathrooms are all fully wheelchair accessible and are provided with suitable equipment to enable the residents, who are able, to contribute to their own bathing routines as far as it is safely possible for them to do so. a pleasant, comfortable and safe home is clean and has a routine maintenance requirements made at plans were in hand for them all to be Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 18 One bathroom is about to be fully refurbished with a new rise and fall bath, which will give better safety to the staff, new flooring wall tiles and storage areas. The lounge and dining areas are well furnished with comfortable seating and an appropriate range of tables around which several of the residents were seen to gather on various occasions throughout the inspection. The home is surrounded by small attractive gardens that include a greenhouse and potting shed and a patio area where BBQs are held during the summer months. The service manager told the inspector that he had arranged for a water feature to be fitted in the front garden to further enhance this area. The requirement made at the last inspection for hold open devices to be fitted to two residents bedroom doors remains outstanding. These residents sleep with their bedroom doors open which in an event of a fire without these devices could leave them at risk. Plans have been made for the complete redecoration of the home over the summer months and this work will include the refurbishment works to the entrance hallway and corridors, which are outstanding requirements from the previous inspection. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35and 36 The home is run by a dedicated and long standing staff team who have been led for the past few months by the visiting service manager. Staff work very well together as a team, are experienced and undertake training on an ongoing basis. All staff have job descriptions and clearly identified roles and responsibilities within the home. EVIDENCE: Since the last inspection both the manager and deputy manager have left the home and new managers who have been appointed to replace them have not yet commenced their duties (planned to commence mid May and mid June). Staff told the inspector that over recent months they had been well supported by the service manager who visits the home on several days each week to offer leadership, support and management organisation. This service manager had very good knowledge of the residents several of whom he had cared for as a nurse working in the hospital where they were resident for many years before the Home opened in the mid 1990s. This knowledge enabled him to direct very good continuity of care for these residents who clearly had a good rapport with him. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 20 The staff said that during recent months they had kept the meeting of the needs of the service users as their top priority and that by working more closely together as a team they had achieved this with minimal disruption to the service users routine. The staff were enthusiastic and appeared to take great pride in their work. Without exception they said that they had been well supported by the service manager receiving regular supervision and could call him for help when ever it was needed. The homes records however did not evidence that regular formal supervision meetings had been taking place although all staff had had an appraisal over recent months. The homes records did indicate that adequate staffing levels had been maintained in the home through out this period and that proper recruitment procedures had been followed for the new staff recently appointed. The service manager explained that the delay in some appointments had been caused partially by the length of time CRB checks were now taking. Staff confirmed to the inspector that they had continued to attend their individual pre arranged training programmes and that several were booked to commence their NVQ 2 studies in the autumn. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home is well run by experienced and well trained staff who are enthusiastic about meeting the care needs of this very vulnerable group of have given residents. The managing company, Hightown Praetorian appropriate management help and support so as to enable the smooth running of the home to continue despite the absence of its managers over the past several months. EVIDENCE: All the staff spoken with were complimentary about the recent help and support they had received from the company during the past difficult months and said that they were now looking forward to working with a new management team. Regular staff meetings have been held and the records of these demonstrated that they are well attended with many staff making positive contributions to the subjects discussed. From these minutes the reoccurring theme of providing the best care for the service users was very evident. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 22 The homes records evidenced that the highest priority is given by all staff to health and safety issues and this contributes to the warm caring environment of the home in which the service users appeared to be relaxed and happy. Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Haslewood Avenue Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 24 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 24 Regulation 23(2)(b) Timescale for action Works to refurbish the ground by 31st floor bathroom are required. This June 2005 is an outstanding requirement from the previous inspection. Works of redecoration and repair by by 31st to the homes entrance lobby and June 2005. hallways are completed. This is an outstanding requirement from the previous inspection. Hold open devices linked to the by 31st fire alarm system are fitted to June 2005 the two bedroom doors where the residents sleep with them open This is an outstanding requirement from the last inspection. The Statement of Purpose and by 31st May Service Users Guide must be 2005 revised to reflect the current situation in the home. Staff must have regular by 31st supervision. The NMS state at June 2005 least six meetings per year with records kept as evidence. Care plans are regularly by 31st reviewed. June 2005 Requirement 2. 24 23(2)(b) 3. 24 13(4)(a)& (c) 23(4)(c) (iii) 4. 1 6(a)and (b) 18(2) 5. 36 6. 6 15(2)(b) Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Haslewood Avenue I52 s19407 haslewood avenue v223861 270405 stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden Cithy AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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