Inspection on 27/07/06 for Huddleston Close (34-35)

This inspection was carried out on 27th July 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Huddleston Close (34-35) 10/12/07

Huddleston Close (34-35) 29/12/05

Huddleston Close (34-35) 29/06/05

Huddleston Close (34-35) 18/03/05

Huddleston Close (34-35) 18/10/04

Huddleston Close (34-35) 02/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Huddlestone Close (34-36) 34-36 Huddlestone Close Parmiter Street Bethnal Green London E2 9NR Lead Inspector Sarah Greaves Key Unannounced Inspection 27 July and 2nd August 2006 11:00 th Huddlestone Close (34-36) DS0000010298.V305437.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 Huddlestone Close (34-36) DS0000010298.V305437.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. Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Huddlestone Close (34-36) Address 34-36 Huddlestone Close Parmiter Street Bethnal Green London E2 9NR 0208 983 3515 0208 983 3484 h3m055sewell@mencap.org.uk 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) Mencap Miss Sophia Cheryl Sewell Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 2005 Brief Description of the Service: 34-36 Huddleston Close is a care home registered to provide care, support and accommodation for up to seven adults with a learning disability. The service is managed by MENCAP and the premises are leased from the Bethnal Green and Victoria Housing Association. The premises are three ordinary domestic properties located within a short walking distance of the shops, cafes and other amenities at Bethnal Green High Street. In addition to the underground and overground stations, frequent buses operate to East London districts and central London. The home contains one house, which is occupied by three service users, a house accommodating two service users and a flat for one service user. Each property has its own front door and separate rear garden. Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was conducted on Thursday 27th July 2006. The inspector met four service users and staff, toured the premises, checked upon the storage of medication and read four care plans. The inspection was continued on Wednesday 2nd August in order for the inspector to access confidential records (for example, staff training and supervision files) that were appropriately not previously available in the absence of the registered manager and deputy managers. What the service does well: What has improved since the last inspection? Three requirements were issued in the last inspection report in regard to ‘health and safety’ issues (water temperatures, monitoring of first aid boxes and labelling of opened refrigerated food items). All of these requirements had been satisfactorily met. The home had appointed a second deputy manager, which should impact upon improving the quality of life for service users and provide staff with additional guidance and support. Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 6 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. Huddlestone Close (34-36) DS0000010298.V305437.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 Huddlestone Close (34-36) DS0000010298.V305437.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): 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The needs of prospective service users were carefully assessed, including consultation with prospective service users to ascertain their views. The service needs to make a straightforward amendment to the existing contracts. EVIDENCE: The inspector read four care plans during this inspection. There was no new service users admitted to the home since the last inspection. Each care plan demonstrated that service users had received a multi-disciplinary assessment prior to admission, with information gathered from relevant parties such as social workers, psychologists, educational services, speech and language therapists and families. The care plans also evidenced that the home undertook its own assessments, which included observations of service users in order to establish their needs and wishes. The inspector was not able to view any recent evidence of how the home managed the admissions of new service users. Evidence gathered at previous inspections demonstrated that the home liaised well with external individuals and organisations, and offered prospective service users several visits and a trial stay prior to moving in as a permanent resident. The care plans contained pictorial contracts, which were satisfactorily presented but referred to a different MENCAP home (Vulcan Square). Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 9 Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The needs and required care for service users is well documented in the care plans and risk assessments. Service users are assured that confidential information about them is properly held. EVIDENCE: The inspector read four care plans during this inspection. The care plans and risk assessments were up-to-date; it was also noted that service users had received thorough reviews by the placing authority (Tower Hamlets Social Services) within the past twelve months. Each service user also possessed a ‘Person Centred Planning’ (PCP) file, which demonstrated one-to-one consultation with service users. At the time of this inspection, some of the PCP files were awaiting the inclusion of photographs and other pictorial information. The home promoted independent advocacy input for service users. The inspector noted that the home had sent quality assurance questionnaires to the independent advocates, which has highlighted the need for care staff to develop their skills in communicating with service users who do not posses Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 11 verbal communication. The home produced evidence of conducting service users meetings, which were known as ‘tenants’ meetings. The risk assessments within the four care plans viewed at this inspection were comprehensively written and corresponded with the identified needs and behaviour patterns of service users. Confidential information relating to service users was stored safely and securely in lockable offices. Staff guidance regarding confidentiality was provided through a MENCAP policy and staff training. Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are offered a range of fulfilling activities and opportunities to use community resources. More attention needs to be applied to ensuring that all service users can access healthy snacks, and that full details are recorded on menu plans. EVIDENCE: At the time of this inspection, arrangements had been made for service users to take their summer holidays; destinations included Paris, Euro Disney, Scotland and the Sherwood Forest Center Parc. Service users undertook a wide range of activities, which reflected their individual interests and abilities. Activities included music festivals, trampolining, picnics, restaurant trips, shopping, college courses, looking after plants, swimming and bingo. The inspector was informed that the home proposed to re-establish a sensory room within the premises, in accordance to guidance given by an external healthcare professional. The inspector noted that on the first day of this inspection, one of the service users had been taken to Lakeside shopping centre by staff (to buy holiday Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 13 clothes) and another service user informed the inspector that they had been out for lunch. Two service users returned from their regular daytime activities after 5pm. Via discussion with service users and staff, and through reading a sample of the care plans, the inspector established that service users were supported to use general community facilities such as health centres, parks, hairdressing salons, cafes and shops. The home offered flexible visiting hours for the relatives and friends of service users. Support was also provided for service users to visit their relatives. As previously stated in this report, service users were offered the services of independent advocates and they received monitoring by their placing authority. The rights of service users to make their own choices was supported, for example, a care plan documented that one of the service users went to the pub with their key worker in order to plan their holiday (which was confirmed via discussion with the service user). The inspector was not present during mealtimes. The menu plans indicated that service users received a varied and balanced diet, which included healthy options such as fruits, fresh vegetables and yoghurts. It was noted that the menu plans did not consistently state that service users received a dessert after their main meal, although discussion with staff indicated that this was an administrative error. The inspector observed that there was no fresh fruit available on the three bedded unit and was informed that this arrangement had been implemented in order to manage the overeating of one service user. The inspector suggested that the fruit and snacks for this unit could be stored on an adjoining unit (and discreetly made available to the two service users that do not require monitoring of their food intake). Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The personal care and health care needs of service users were identified and suitably met. Management of medication needs were generally well met; however, the maintenance of liquid medications needs to be more robust. EVIDENCE: The care plans contained a good level of detailed information relating to the personal care and health care needs of service users. Via discussion with one of the deputy managers, the inspector was informed that there were no current issues of concern regarding service users access to healthcare services. The inspector noted that a clinical psychologist was attending the next staff meeting in order to advise staff about the complex needs of one of the service users. The inspector checked the storage and recording of medication on one of the units. It was observed that liquid medication (lactulose, sodium valporate and ferrous fumarate) had dripped on to the exterior of the bottle, which could potentially damage or remove the prescription label. The inspector noted that the need to wipe medication bottles had been previously brought to staff attention in the unit’s communication book and staff meetings. Medication storage and recording was otherwise satisfactory. Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 15 Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home demonstrated good systems to protect service users, but must ensure that all staff attends Adult Protection training. EVIDENCE: The home possessed an appropriate Adult Protection procedure (inclusive of whistle-blowing). In addition to Adult Protection guidance issued by MENCAP, the home held a copy of the Tower Hamlets Social Services Adult Protection procedure. The inspector noted that one member of staff had not undertaken Adult Protection training; a requirement for the home to ensure that all staff access this training has been issued in this report. The home produced a satisfactory complaints procedure, which was available in a pictorial format. There were no issues of concern in regard to the home’s management of complaints. Huddlestone Close (34-36) DS0000010298.V305437.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): 24,25,26,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home was generally well maintained; however, there is a need to ensure that the environmental safety of service users is consistently maintained. Improvements to the garden areas have been suggested. EVIDENCE: The home was clean and free from any offensive odours. One of the service users took the inspector to look at their bedroom, which was pleasantly decorated and had been personalised in accordance to the service user’s preferences. The inspector was permitted by service users to view two other bedrooms, which were found to be of a similar good standard. The inspector observed that the gardens required some improvements. It was acknowledged that the home was not in a position to water the lawns due to the hosepipe ban, which had understandably impacted upon the gardens visual presentation. However, it was noted that a shed had not been locked as the lock was broken (it contained gardening equipment that could be hazardous to service users) and a plank of wood and a sharp gardening tool had been left unattended on the patio. The inspector was informed that the gardens were used for entertainments such as gardening and trampolining; it has therefore Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 18 been recommended for the service to undertake some development of this communal space to create a more pleasant and relaxing environment for service users. One of the deputy managers informed the inspector that the housing association were taking action in regard to a tree in a neighbouring property that was growing through the care home’s garden wall. The inspector observed that one of the service users chose to habitually remove the filling from their armchair in a communal lounge. The inspector advised that this could be potentially harmful to the service user (for example, the risk of respiratory discomfort due to close proximity to the cushion fibres). It was suggested that the service user should be provided with a new armchair that they could not open up and a new activity (which would offer a similar sensory achievement) should be offered. At the time of this inspection, none of the service users required specialist equipment for physical disabilities. The inspector observed that the home used a pictorial communication board/daily diary for a non-verbal service user. Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels and staff training was planned in accordance with the needs of service users. A more rigorous approach must be applied to verifying staff references. EVIDENCE: The inspector looked at a randomly selected sample of the staff training profiles. All staff had undertaken mandatory training (such as health and safety, food hygiene and fire procedures); as previously stated, one member of staff had not attended Adult Protection training. The inspector did not look at the training profiles for all staff employed at the home; the deputy manager was therefore advised to conduct an audit to check that a sufficient number of staff possessed first aid training in order to ensure that there is always a trained first aide on duty at all times). The inspector was informed that some staff had attended training in specialist communication methods and that this training would be extended to all staff. Since the last inspection, the home now employed two deputy managers (previously one deputy manager was employed), which was viewed as a positive measure to benefit service users. The inspector noted that there had been some concern expressed about the staffing levels at one of the social services statutory reviews. The inspector looked at the staffing rotas and discussed staffing levels with one of the deputies. The current arrangements Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 20 appeared to satisfactorily meet the needs of the service users, taking into account that the service users were also engaged in activities at day centres and other community resources. The inspector checked the recruitment documents for three members of staff. It was noted that these staff had valid Criminal Record Bureau checks and two appropriate references; however, one of the references had not been verified. A requirement has been issued in this report for the service to ensure that all professional references have been stamped or issued on headed paper, and that any other references must be followed up with a telephone enquiry in order to establish the authenticity of the referee. Staff received a satisfactory level of formal, one-to-one supervision. Huddlestone Close (34-36) DS0000010298.V305437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is competently managed, and the health and safety needs of service users are met. The registered manager and MENCAP need to ensure that quality assurance (via monthly monitoring visits) is adhered to in accordance to the Care Homes Regulations. EVIDENCE: The registered manager was not able to participate in this inspection as she was accompanying a service user on their holiday. The inspector met both of the deputy managers and found that the service benefited from good leadership and a commitment to meeting the individual and collective needs of service users. The registered manager has undertaken the ‘Registered Managers Award’ and both of the deputies had applied to commence National Vocational Qualifications at either supervisory or managerial level. The inspector found out during the course of this inspection that a member of staff had been suspended and then dismissed. The inspector has not been able to Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 22 trace any evidence of the CSCI being informed of this incident via a Regulation 37 report. The inspector requested to see copies of the home’s Regulation 26 visits reports (monthly quality assurance visits by a senior person in MENCAP that does not work at the home). These reports, from April 2006 onwards, could not be produced during the course of this inspection. A requirement has been issued in this report for the home to ensure that it maintains copies of these reports on the premises, including the reports that were not available during this inspection. Three requirements relating to ‘health and safety’ were issued in the previous report; it was noted that all three requirements had been satisfactorily met. The inspector found that the home were regularly checking water temperatures, opened food items in the refrigerator were marked with the date of opening and the items in the first aid boxes had been checked for expiry dates. The inspector advised that the home might need to use an additional adhesive on the food labels, as it was noticed by staff and the inspector that applied labels could easily detach from food packages. The following health and safety records were checked and found to be satisfactory: (1) Landlord’s Gas Safety annual check (2) Annual professional maintenance of fire equipment (3) Annual portable electrical appliances testing (4) Weekly fire alarm testing (5) Legionella analysis and (6) Maintenance of electrical equipment by a competent person. The home did not possess a valid public liability insurance certificate. It was acknowledged that the home might not have received the most recent certificate from MENCAP head office; a requirement has been issued in this report for a copy of the current certificate to be sent to the CSCI. Huddlestone Close (34-36) DS0000010298.V305437.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 X 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 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 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Huddlestone Close (34-36) DS0000010298.V305437.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. 2. Standard YA22 YA24 Regulation 18 13 Requirement Timescale for action 30/11/06 3. 4. YA34 YA42 19 13 The Registered Manager must ensure that all staff possess valid Adult Protection training. The Registered Manager must 30/09/06 ensure that the shed is kept locked and those potentially hazardous gardening tools are maintained within the locked shed. The Registered Manager must 30/09/06 ensure that all references are verified to ensure authenticity. The Registered Manager must 30/09/06 ensure that the home possesses a valid Public Liability Insurance certificate, and a copy must be sent to the CSCI. Huddlestone Close (34-36) DS0000010298.V305437.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. Refer to Standard YA5 YA17 YA20 YA24 Good Practice Recommendations The contracts should be amended to clearly specify that service users are residing at 34-36 Huddleston Close. Alternative arrangements should be implemented to ensure that the service users in the three-bedded unit have access to fresh fruits and snacks. Medication bottles should be wiped free from any spillages in order to keep the prescription label intact. The gardens should be improved (for example, removal of weeds, more plants and flowers, addition of decorative garden ornaments/centre pieces) Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Huddlestone Close (34-36) DS0000010298.V305437.R01.S.doc Version 5.2 Page 27 - 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. 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