Inspection on 03/08/06 for Housemartins

This inspection was carried out on 3rd August 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Housemartins 03/05/07

Housemartins 07/12/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Housemartins Housemartins Colebrook Lane Cullompton Devon EX15 1PB Lead Inspector Belinda Heginworth Key Unannounced Inspection 3rd August 2006 09:00 Housemartins DS0000063698.V300089.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 Housemartins DS0000063698.V300089.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. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Housemartins Address Housemartins Colebrook Lane Cullompton Devon EX15 1PB 01884 35443 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) Jason Stuart Collins Mrs Anne Morey Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A person meeting the criteria for registration as a manager under the Care Standards Act 2000, as described in Standard 37 of the National Minimum Standards for Care Homes for Adults (18-65) and Regulation 9 of the Care Home Regulations 2001, must be appointed at all times. 7th December 2005 Date of last inspection Brief Description of the Service: The home provides support and personal care for 5 people with a learning disability. The home is owned by Mr Jason Collins who also owns Forge House, another home for people with a learning disability, in Cullompton. Housemartins is a detached two-storey property on the edge of the town of Cullompton, which is within walking distance. There are five single bedrooms with a bathroom on both floors. On the first floor there is a bedroom, office, kitchen with a dining area and a lounge. To the front of the property there is an enclosed garden. At the rear of the property there is a larger garden, which includes a patio area with garden furniture. Information received from the home prior to the inspection indicated that current fees range from £500 - £700 per week. Additional costs are charged for transport, holidays, chiropodists and personal items. CSCI reports are pinned to the notice board in the kitchen and are discussed with the staff team and service users as appropriate. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours with the manager being present throughout. Some service users have limited communication skills and were therefore unable to fully contribute to the inspection process. Time was spent with all service users and observations were made throughout the inspection. Two service users were consulted fully and their views on the home discussed. The inspector also spoke with two members of staff and the manager. The inspector looked around parts of the building and some records were inspected. Prior to the inspection the manager completes a questionnaire, which provides information about service users, staffing, fees and confirms that necessary policies and procedures are in place. Surveys were sent to service users and staff prior to the inspection. Comment cards were also sent to professionals who are connected to the home and a questionnaire was sent to relatives. One service user survey was returned, one comment card and two staff surveys were returned. All comments received were very positive about the home and the services. What the service does well: The atmosphere in the home is warm, friendly and fun. Service users appeared to have good relationships with the staff and were relaxed and happy. Staff were observed being kind and caring, offering choices to services users and encouraging independent living skills. The manager ensures the home has enough information about service users prior to admission to establish if the home can meet that person’s needs. Once a service user is admitted the manager provides good written plans of care that take into account service users’ needs, risks, wishes and goals. This ensures staff are provided with information that helps them meet service users’ needs safely and consistently. The staff team are committed, caring and respectful at all times, this was confirmed by service users and observed throughout the inspection. Service users use the local and surrounding areas to attend a wide variety of activities, educational and leisure pursuits. Service users are also supported to maintain good family contact and visits. A wide, varied and healthy diet is offered to service users, which they help to shop for and prepare. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 6 Staff, on the whole are recruited appropriately and receive training appropriate to meet service users needs and protect their safety and welfare. The home is well managed and run in the best interests of service users. The manager monitors the quality of care regularly and seeks the views of service users, relatives and outside professionals to ensure the home is being run in the best interests of service users. 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. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 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 the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The manager gathers enough information to ensure the home is able to meet service users’ needs prior to admission. EVIDENCE: The home has a Statement of Purpose that provides relatives and professionals with information about the home. The manager has also produced a Service User Guide that provides similar information but in formats suitable for the communication needs of service users with a learning disability, for example, in larger print and audiotape. The majority of service users living at the home have done so for a number of years. One service user was admitted within the last 2 years. A detailed assessment was carried out prior to admission. This enabled the home to establish whether they were able to meet the service user’s needs. One service user was able to confirm visits to the home before admission. Relatives said they were involved in the process and had received good information about the home. Carers confirmed that there was good information about service users to help them understand their needs. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are provided with good information to meet service users’ needs and goals safely and consistently. EVIDENCE: Service users’ care plans provide accessible information and guidance about assessed needs and risks, and set individual goals. Information includes service users’ preferences, behavioural guidance, assessments of risks and health care needs. This ensures service users’ needs are met safely and consistently. Relatives, other professionals and the staff team advocate on behalf of the service users and work hard to identify any changes in assessed needs. Staff demonstrated a good knowledge and understanding of the plans. Daily records, on the whole, reflected that care plan goals were being respected and met. Some service users talked about how staff respected their choices on day-today issues. They knew about their care plans and said they attended reviews. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 10 Staff were observed being caring, offering choices to service users and having fun. Staff were observed trying to encourage some service users with independent living skills, for example, making their own drinks, shopping for lunch and helping to prepare food. During the inspection a service user asked to go to the shop independently to buy some crisps, this was encouraged and supported. Good assessments were completed for all areas of risk for each service user. This ensures that service users are enabled to take some risks but clear action is described to keep the risks to a minimum. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from accessing the local community and taking part in appropriate activities. Service users rights are respected at all times. Although the overall quality rating is excellent, improvements are needed in relation to information provided about costs of holidays. Service users benefit from a varied diet. EVIDENCE: Some service users talked about the busy and varied lives they lead. This ranged from attending college, going out on trips to pubs, cafes, cinema, boat trips, adventure parks, swimming, walks, picnics, shopping and many more. Photographs of activities and trips out were seen throughout the home. Service users confirmed that staff were always kind, caring and respectful. This was observed throughout the inspection. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 12 Relatives provided some very positive feedback about the care their relatives’ received, for example, “happy atmosphere, like a second home”, “staff always polite and helpful”, “always kept informed”. A social worker said “staff were very helpful and the service user was doing really well”. Staff in the home support service users to maintain regular contact with their families through telephone calls, letters and visits home. Daily records and a record of activities provided good information about what service users did each day, in and out of the house. Goals from care plans were recorded in daily records the majority of the time, although some improvements were needed. Service users talked about going on holiday soon. Three service users were very excited about going to Euro Disney. They said they had requested to go there and helped to choose the accommodation. Three staff will be escorting and supporting them during this holiday. The cost of the holiday is met jointly between the provider and service users. The provider meets the cost of staffs’ time, all food and transport during the stay. Each service user is paying, in this instance, for the cost of staying at the resort for themselves and a staff member. Although service users appeared happy with meeting this extra cost, they do not fully understand financial matters, therefore it is recommended that the manager discuss and agree this issue with relatives and care managers. This will ensure the home is being open and transparent about how service users’ monies are being spent. Service users who were able spoke about how much they enjoyed the food and confirmed they were offered choices each day. This was observed during the inspection. A menu board is available with typed information of the main meal of the day. However, none of the service users could easily read so asked what it said. Pictures were used to describe activities of the day and were pinned on the notice board. One service user was able to talk about each of these pictures and activities. The manager intends to use the same picture format for menus in the future. This will ensure service users can clearly see what the main meal is each day without having to ask. Daily records are kept of foods eaten; these confirmed that a varied and healthy diet is provided. Fresh fruit was seen to be freely available. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ health needs are well met. A small improvement is needed to a medication practice in relation to over the counter medicines. Service users’ dignity and privacy is respected. EVIDENCE: Service users said they were happy with how staff supported them with personal care. Staff had a good knowledge of how service users preferred to receive personal care. Care plans provide staff with information on personal care and how much support is necessary. There were good records of service users’ health care needs and how they are monitored. Service users said they are supported to attend medical appointments. Medication storage and administration records were on the whole accurate. However, medicines bought “over the counter”, did not have a “Homely Remedy Policy” agreed with a pharmacy or GP. This means that medicines that are not prescribed, for example, pain and cold relief medication have not been Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 14 approved by appropriate professionals. This could lead to unsafe and inappropriate medicines been given to service users. All staff that administer medication have received appropriate training and their competencies are assessed by the manager to ensure they understand the training they have received and remain safe to administer medication. These assessments are completed six-monthly. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Relatives and service users are assured they are listened to and complaints are dealt with appropriately. Service users are fully protected from abuse. EVIDENCE: The home has a complaints procedure in a number of formats, including an audiotape. This ensures that service users’ communication needs are considered and helps service users to understand how to raise concerns or complaints. Relatives confirmed that they would raise issues of concern with the home and felt confident it would be dealt with appropriately. Some service users said they would talk to staff if they were unhappy about anything. Some service users also attend a group called “people first”. This is run by people with a learning disability. They support other people with a learning disability to speak up for themselves. Service users’ meetings take place regularly giving service users another opportunity to raise concerns and discuss any issues relating to the home or their care. All staff have received training in the protection of vulnerable adults. Staff demonstrated a good awareness of types of abuse and knew what to do if they suspected any. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 16 Service users’ finances are managed well. Service users said they had their own bank accounts where benefits are paid and a standing order is set up to pay their contribution towards the home’s fees. All financial records were accurate. Housemartins DS0000063698.V300089.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean and homely environment. EVIDENCE: The accommodation is homely, domestic in style, bright and cheerful. On the day of the inspection the home was clean. Service users said they take turns at cleaning parts of the home. This was observed during the inspection. There is an ongoing maintenance programme to replace and improve the home as part of the home’s quality assurance and development audit. For example, in the coming months some bedroom carpets are due to be replaced, repairs are to be made to the kitchen floor where water damage occurred, some general decoration will take place as necessary and repairs to broken locks in some bedroom doors will be completed. A large area of the garden that was used for growing vegetables has now been replaced with a lawn, making the garden more useable to service users and staff. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by enough caring and trained staff to meet their needs. Some improvements are needed in relation to formal supervision. Service users are protected by robust recruitment procedures but improvements are needed in relation to some checks. EVIDENCE: Service users said they felt the two staff provided per day was enough to meet their needs. During the inspection service users went out with staff and were supported in all aspects of their needs in the home. Service users also said that staff support them to attend all activities including activities in the evening. Examples of this were when service user requested to see a film, staff would stay on duty to accommodate this request. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 19 It has been highlighted at previous inspections that the home’s shift system did not take into account the social needs of residents in the evening. Staff work 12.5 hour day shift patterns that end at 8.30pm when one night carer comes on duty; this prevents ad hoc evening activities. However, the inspector felt by talking to service users, reading care plans, daily records and activity records that service users’ social needs during the day and evening were being met. This is mainly through the staff’s commitment to ensuring that service users don’t “miss out” because of the shift patterns. Recruitment practices of the home are generally good. Three staff files were inspected. One staff had recently been employed. All appropriate checks had been completed ensuring service users are fully protected from potential abuse. Two other staff files had worked at another home that the same provider owns. All staff files were transferred across. The manager thought that new police checks (CRB) would not be necessary because they were employed by the same provider. It was explained that, when those CRB were completed it was under a different provider, the two homes are registered separately and all new staff must be checked against the Protection of Vulnerable Adults list, the only way to complete this is to apply for an enhanced CRB check. The staff were well know to the manager and had worked for her for a number of years, therefore it was felt there was minimum risk. The manager intended to apply for these checks to be completed immediately. Staff demonstrated a good understanding of service users’ needs, health & safety issues and were able to describe training they had received and what they had learnt from it. Examples were adult protection, epilepsy, care planning and recording information appropriately, fire training, first aid and many more. This means that service users needs and welfare are met and protected by appropriately trained staff. In addition to this training, over 50 of care staff had obtained NVQ qualifications level 2 and above. The manager supervises and advises staff daily and holds staff meetings to update them on care issues. However, formal recorded supervision has not taken place yet. This would provide staff with the time and opportunity to identify training issues, look at care practices in more depth and have individual and confidential time with the manager. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being run in the best interests of service users. Systems to review, develop and improve the home need further development in terms of the provider’s quality audits. Service users’ safety and welfare are well protected. EVIDENCE: The manager has many years of experience in working in learning disability services and as a registered manager. She has obtained management qualifications and is the process of completing qualifications in care. Staff and service users spoke highly of the manager saying she was very supportive and service user focused. The also said she provided good advice and training. This was also confirmed by relatives and feedback from a social worker. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 21 The home has good systems in place to audit the quality of services delivered in the home. These include service users’ and relatives’ satisfaction questionnaires. The manager has responded to any issues raised from these surveys. A six-monthly newsletter has started to update relatives, services users and other interested parties of any issues relating to the home or care. Feedback received by the Commission from relatives was positive and said they felt included in decisions about their relatives’ lives. Care plan reviews take place regularly, service users and staff meetings are times of reviewing the services and ensuring the home is being run in service users’ best interests. The provider visits regularly to audit the service and ensure the home is being run appropriately. However, these visits have not been formalised and recorded. This should be completed as stated under Regulation 26 of the Care Home Regulation. The fire logbook was found to be up to date and accurate. Fire risk assessments and most staff training were completed, therefore protecting service users safety and welfare. The CSCI obtains information prior to inspections. The information includes conformation that all necessary policies and procedures are in place and are up to date. These are not inspected on the day but the information is used to help form a judgement as to whether the home has the correct policies to keep service users and staff safe. In this instance policies and procedures were in place. These along with risk assessments have been recently reviewed and up dated where necessary, to ensure they are appropriate and reduce risks to staff and service users. Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 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 3 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 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 4 13 4 14 2 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement The registered person shall not employ a person to work at the care home unlessb) subject to paragraph (6) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of Schedule 2. (This refers to completing CRB checks for all staff) The registered provider must visit the home in accordance with regulation 26 and complete reports according to regulation 26 (4) (a) and supply a copy to the Commission. Timescale for action 06/09/06 2 YA39 26 30/09/06 Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 24 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 YA14 Good Practice Recommendations The manager should ensure that costs of holidays are discussed and agreed with relatives and service users’ representatives such as care managers to ensure the decision to pay for staff on such holidays are agreed. The manager should ensure there is a Homely Remedy Policy agreed with a pharmacist or GP to ensure service users receive over the counter medicines appropriately. All staff should receive formal, recorded supervision at least six times a year, covering topics listed in standard 36 of the National Minimum Standards for Adults 18 –65. 2. 3. YA20 YA36 Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Housemartins DS0000063698.V300089.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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