Inspection on 08/03/07 for Houghtons

This inspection was carried out on 8th March 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Houghtons 04/01/06

Houghtons 11/05/05

Houghtons 26/10/04

Houghtons 08/05/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Houghtons 6 Sandy Road Bedford Bedfordshire MK41 9TH Lead Inspector Elaine Boismier Unannounced Inspection 8th March 2007 13:10 Houghtons DS0000014918.V331520.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 Houghtons DS0000014918.V331520.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. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Houghtons Address 6 Sandy Road Bedford Bedfordshire MK41 9TH 01234 351248 F/P 01234 351248 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) www.aldwyck.co.uk Aldwyck Housing Association Ms Margaret McNally Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Houghtons is a purpose-built detached bungalow located in a residential area of Bedford. The home provides long term care for adults between 18 years of age and over 65 years of age with learning disabilities and physical disabilities. The home is owned by the Aldwyck Housing Association who also employ and manage the staff who work there. The purpose built home is close to a bus route on the A428, and there are shops, pubs, churches and leisure facilities within easy reach. The building has six single bedrooms, one for each person living there. All areas of the home are accessible for people requiring the assistance of a wheelchair. There are a number of other rooms that everyone can use; these include a lounge, snozelan, kitchen/diner, shower room, bathroom and toilet. The home has a large garden area, with summerhouse. At the time of the inspection work was underway to improve the garden for the benefit of residents. People who live at the home use a number of social and leisure activities. Current fees are £1036.28 each week. Additional costs include those for meals out, hairdressing and aromatherapy. A copy of the inspection report is available at the home or via the CSCI website. The current certificate of registration is to be updated by the Commission for Social Care Inspection, the current registration authority, to reflect the change of name from the former registration authority, National Care Standards Commission. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The staff of home were informed 24 hours before that an inspection was taking place and in essence the inspection is considered as “unannounced”. The inspection was carried out by two Inspectors between 13:10 and 17:10 and took 4 hours to complete. On the day of the inspection there were 5 residents living at the home and two of these people were spoken to including residents guests that were visiting the home at the time of the inspection. A tour of the premises was made and documentation was examined. The Registered Manager, Deputy Manager and members of staff were spoken to as part of the inspection process. Six residents surveys were sent out prior to the inspection although none of these were completed due to the complex communication difficulties of the residents. The Registered Manager completed information prior to the inspection and this will also be referred to in the body of this report. The Commission for Social Care Inspection acknowledges that the inspection was carried out during an unsettled period of the home, due to ongoing decoration and a change in the occupancy of the residents due to a recent bereavement. We would like to express our gratitude for the co-operation and openness shown to us during the inspection despite such an unsettled period. Houghtons currently provides an adequate service that could become a good one should action be taken in response to any requirements and recommendations made in this report and any improvements made are sustained. What the service does well: Residents live in a homely, friendly and welcoming place and are able to integrate, with the support of staff, into the community. This includes visits to the local shops, pubs and restaurants and activities also include horse riding. There is an ongoing refurbishment programme to ensure that the home is well maintained, comfortable and pleasing for residents to live in. Staff receive a good standard of supervision and attend training in health and safety and training in topics such as caring for the person with a learning disability and heart condition. The home is managed in an open and inclusive way to involve both residents and their families in the way that care is provided. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 6 Comments made by residents’ guests were very positive about the home including “The staff give 110 and are terrific with him” (i.e. the resident). “ I have no problems whatever.” “My son is very happy here.” What has improved since the last inspection? What they could do better: Medication that is considered as controlled medication must be stored appropriately. A requirement has been made about this. Controlled medication must be recorded by following the guidance of the Royal Pharmaceutical Society. A requirement has been made about this. Medication must be stored according to the manufacturers’ advice. A requirement has been made about this. Assessment of temperatures where medication is stored should be recorded. A recommendation has been made about this. The garden area must be safe for residents, and their guests, to visit. A requirement has been made about this. 50 of care staff should be working at the home. A recommendation has been made about this. Full and satisfactory information must be obtained about staff before the start to work at the home. A requirement has been made about this. The Registered Manager should have the Registered Managers Award. A recommendation has been made about this. Staff rosters should include the full name of the staff working at the home. Fire alarm checks must be carried out on a weekly basis. A requirement has been made about this. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Houghtons DS0000014918.V331520.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 Houghtons DS0000014918.V331520.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 &4 Quality in this outcome area is good. There is a good standard of information to assist residents in their decision where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the Service User’s Guide was available by the front entrance of the home. This provided information, including pictures, of what the home offers. A copy of the most recent inspection report was included in the Service User’s Guide. The Manager explained that the age range and personalities of current residents would be taken in to account when carrying out assessments of prospective residents. Since the last inspection of January 2006 the home has had no person admitted to the home to live. Discussion with a guest to the home indicated that their relative had been assessed by the home during trial visits that included the resident staying at the home to have their meals. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. Residents’ needs and choices are met and respected within a framework of managed risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with a relative of a resident indicated that the home actively consults the resident’s representative about the changing needs of their relative. Examination of 2 residents’ care files indicated that records of the assessed needs of the residents were of a good standard that provided the reader sufficient information of how to care for the person. Reviews were carried out every 6 months and a resident’s relative confirmed that the family and other involved agencies (e.g. social services and district nurses) were included in the review process. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 11 Observation of staff interacting with residents indicated that residents were offered choices of how they wished to carry out their day, including going out of the home to have lunch or visit the local supermarket. Both care plans that were examined indicated that residents were allowed to take part in activities based on risk assessments and this was seen to be the case during the inspection. Residents were free to come and go with the support of staff, in a managed framework of risk. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, 15,16 & 17 Quality in this outcome area is good. Residents live a good quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No resident living at the home currently attends further educational courses or work due to the complex needs of the current residents. This standard is therefore not currently applicable. The home is located in a residential part of Bedford. At the time of the inspection a number of residents, supported by care staff, were out having their lunch. Later in the day another resident, with their guest, was taken out to the local supermarket with the support of a member of care staff. Discussion with a relative of a resident indicated that residents are given the opportunities to attend a range of social activities including horse riding, visits to the family home and trips out. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 13 Discussion with relatives of residents and observation of staff interacting with the relatives indicated that families are actively involved and included in the residents’ daily routines and can visit them where and when they chose to do so. Relatives demonstrated that they were aware of the residents’ choices of visiting, including times and duration of the visits. Resident were observed to be engaging in activities with other residents and were supported by staff in doing so although not all residents were included in these activities according to their wishes. These activities included going out of the home, playing ball and watching the preparation of supper. Staff were observed to interact with residents in a respectful way. At the time of the inspection a member of care staff, observed by 2 residents, was preparing supper. Food that was used included fresh vegetables and fresh fruit was available also. Staff stated that special diets were made according to the special needs of residents. The menu was on display and this included a range and variety of meals. According to the Manager one member of staff is designated to be responsible for buying of food and menu planning. When shopping for food the Manager stated that staff take residents with them to the shops. Currently no resident is able to assist in meal preparation or meal planning due to their complex communication and physical needs. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. The storage and recording of medication poses risks to residents’ health who otherwise receive a good standard of health and personal care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents were noted to be wearing individual styles of clothes. Individual bedrooms were provided with special equipment including electrically operated beds to maximise the comfort and support of the residents. Discussion with the Manager, a relative and examination of 2 residents’ care files indicated that residents are well supported by a range of community and hospital based staff. Medication administration sheets were examined and these were recorded as according to the home’s medication policy with two members of care staff Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 15 signing. According to the Manager and Deputy Manager all staff have attended training in management of medication. The medication is stored in a room that has no ventilation. A thermometer, placed inside the medication cupboard was reading over 25 degrees centigrade. This is in excess of manufactures advice for the safe storage of medication. A requirement has been made about this. There were no records of assessments of temperatures. A recommendation has been made about this. Records and discussion with the Manager and Deputy Manager indicated that the home has controlled medication that is kept in the home. This is currently kept in a locked box that was easily removed from the cupboard, as it was not secured to any permanent fixture. Although the legislation does not at present include care homes, such as Houghtons, the National Minimum Standards make this standard apply to every care home. Houghtons should invest in a controlled drug cupboard when they regularly hold supplies of controlled drugs that fall into the category of ‘secure storage’ for their residents. A recommendation has been made about this. The controlled medication was recorded on sheets of paper that do not follow the Royal Pharmaceutical Society’s guidance for recording of controlled medication as ‘a bound book or register with numbered pages’. A requirement has been made about this. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Residents are safe from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: According to information provided by the Manager before and during the inspection the home has received no complaints about the home and the Commission has no record of any complaints made. Discussion with a relative of a resident indicated that the person had a clear understanding of how to make a complaint although they were very satisfied with the standard of the service provided by the home. Examination of 2 staff interview notes indicated candidates are questioned about their awareness of adult abuse. Examination of staff training records and discussion with the Manager indicated that staff have and are attending training in adult protection procedures and this was also supported by information provided by the Manager before the inspection. A policy document for adult protection procedures was available and staff had signed to confirm that they had read this. Information provided before and during the inspection by the Manager indicated that no resident had been subject to an adult protection investigation. Personal monies of 2 residents that are kept by the home were counted and balances of these monies were the same as the records. Relatives were complimentary about the staff and how they cared for the residents. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25,28 & 30 Quality in this outcome area is adequate. Residents live in an adequately maintained home that could be improved upon with particular regard to the back garden. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Houghtons is a purpose built bungalow that is accessible for people who require the assistance of a wheelchair. To the rear of the building there is a large garden area that currently is being improved upon. However, according to the Manager, residents are not able to access this area without support from staff, due to uneven surfaces. Furthermore in hot weather residents would not be able to sit in any shaded areas, as none are currently available. A requirement has been made about this. At the time of the inspection the home was being decorated. During the tour of the premises it was noted that bedrooms were furnished and decorated in an Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 18 individual way. The Manager explained that colours of bedrooms were chosen based on staff knowledge of the resident and some assumption of what the person would prefer. The Manager stated that during the stage of choosing colours for bedrooms residents were shown the options for colours. The home offers a range of communal areas including a sensory room and comfortable lounge area where residents were relaxing and playing ball. On the day of the inspection the home was clean and free of any offensive odours. Laundry services are located a distance away from the kitchen area. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. Residents receive care from adequately recruited and adequately trained staff that are well supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although according to the Manager there is a number of care staff working towards achieving an NVQ level 2 in care, currently the home has 6 of 16 care staff with this NVQ qualification or above i.e. 37.5 . A recommendation has been made for the home to have 50 of care staff with this qualification. The Manager confirmed that due to staff sickness and staff vacancies agency staff have been used. Information provided by the Manager before the inspection notes that agency staff has supplied 566 hours of care during an eight-week period. Although this may be considered a large number of hours it was noted during examination of the staff roster that the home was supplied with the same agency staff for continuity of care for residents. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 20 Examination of 2 staff files indicated that the majority of required, full and satisfactory information was available with the exception of a reference. The Manager and we considered that this written reference was brief in detail and did not offer any information about the person. A requirement has been made about this. Information provided by the Manager before the inspection notes that staff have attended a range of training sessions including those for special conditions such as learning disabilities and heart conditions. Examination of staff training files and discussion with a member of staff indicated that staff are provided with training opportunities to be able to meet the complex and changing needs of the residents. Two staff files that were examined indicated that staff receive 1:1 supervision every 2 months. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has a diploma in Social Work and has worked at the home since the project was first opened over 10 years ago. He was appointed to her present position approximately 4.5 to 5 years ago. She intends to commence studying for the Registered Managers Award in September 2007.A recommendation has been made for the Manager to have the registered Manager’s Award. Copies of Regulation 37 notifications have been submitted to the Commission for Social Care Inspection although some of these have not been sent in a Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 22 timely manner. Both Manager and Deputy Manager confirmed that this to be the case. The regulation states that this information must be sent “without delay”. However, according to both Manager and Deputy Manager the Commission was notified of a recent death of a resident shortly after the person died. On this occasion we, the Commission, will not make a requirement about this finding as it is expected the management team will act on the advice provided by us during the inspection and findings contained in this report. Discussion with a relative of a resident and observation of interaction of the Manager and staff with residents and the Inspectors indicates that the home is managed in an open and transparent way. It is acknowledged that during the week of the inspection that the home had experienced some unsettled period although the management and staff team demonstrated co-operative and welcoming attitude towards the inspection process. According to the Manager, and telephone discussion with her manager prior to the inspection, the home is visited at least once per month and copies of reports of these visits are made and sent to the Commission. Records of residents’ personal allowances showed that an external person had checked these. Information provided by the Manager before the inspection notes also that policies and procedures are reviewed as necessary. During the examination of the staff roster it was noted that names of staff were of their first name only. A recommendation has been made about this. Information provided by the Manager before the inspection notes service checks have been carried out to include gas and water checks. Records were examined for checks of temperatures of hot water, emergency lights, fire drill practices and staff training in fire safety and moving and handling. All of these were satisfactory. Food that had been opened was covered and labelled with the date of opening. Records for fire alarm checks however were unsatisfactory as according to the home policy and discussion with the Manager these fire alarm checks are to be carried out each week. Records indicated that fire alarm checks were carried out on 17/12/06 followed by 29/12/06 (12 days) followed by 28/01/07 (30 days) and followed by 11/02/07 (13 days). A requirement has been made about this. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 N/A 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 3 3 x 2 2 x Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement Timescale for action 22/03/07 2. YA20 3. YA24 4. YA34 5. YA42 The Registered Person must ensure that medication must be stored at temperatures as advised by the manufacturer. 13(2) The Registered Person must 17(1)a ensure that records for Schedule 3 controlled medication must be maintained according to specific guidance and associated regulations. 23(2)(a) The Registered Person must ensure that all areas of the home are accessible and safe for people to visit with particular regard to the back garden. 19 The Registered Person must Schedule 2 ensure that full and satisfactory information is obtained before a person works at the home. 23(4)(c)(v) The Registered Person must ensure that fire alarm checks are carried out at least every week i.e. 7 day intervals. 22/03/07 01/10/07 22/03/07 22/03/07 Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA20 YA20 YA32 YA37 YA41 Good Practice Recommendations The Registered Person should consider ways to store controlled medication in lines of good practice. The Registered Person should consider ways to record temperatures taken where medication is stored. The Registered Person should consider ways for 50 of care staff to be working at the home. A person with the Registered Managers Award should manage the home. The Registered Person should consider ways to record the full names of staff on the staff roster. Houghtons DS0000014918.V331520.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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