Inspection on 07/04/05 for Flat B 12 Hyde Close

This inspection was carried out on 7th April 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Flat B 12 Hyde Close 10/07/07

Flat B 12 Hyde Close 16/05/06

Flat B 12 Hyde Close 15/09/05

Flat B 12 Hyde Close 09/11/04

Flat B 12 Hyde Close 17/06/04

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 12 HYDE CLOSE Barnet Hertfordshire EN5 5TJ Lead Inspector Tom McKervey Announced 7th & 11th April 2005 @ 09.30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 12 HYDE CLOSE Version 1.10 Page 3 SERVICE INFORMATION Name of service 12 Hyde Close Address 12 Hyde Close, Barnet, Hertfordshire EN5 5TJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8449 0964 020 8364 8083 Hilary Crowhurst for SENSE Alan Washington Care Home 20 Category(ies) of Learning disability (20), Physical disability (20) registration, with number of places 12 HYDE CLOSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 The number of service users do not exceed 20 adults with a learning disability and/or a physical disability. Date of last inspection 9 November 2004 Brief Description of the Service: 12 Hyde Close managed by an organisation called Sense. It is a service for 20 adults who have sensory impairments and severe or complex learning disabilities. The home is purpose built and is structured in four independent flats with five service users in each flat. Each flat has its own kitchen and lounge area, two bathrooms and a toilet. All the service users have a single bedroom with a wash-hand basin. There is large sensory garden area to which all service users have access. The laundry room is shared. Each flat has a separate team of staff, which is lead by a manager. At night there is a waking member of staff in each flat and two sleeping staff are on duty for the four flats. Opposite the home on the same site, there is a specialised day service, which is separately managed. Service users have access to the facilities in the day service as well as other local community resources. Each flat has its own minibus, which accommodate wheelchairs. The home is situated in High Barnet in a pleasant residential area, and is a short walk away from shops, restaurants, pubs, and usual local amenities. The area is well serviced by public transport. The stated aims of the service are to provide support in which service users can be helped to work towards their optimum potential in areas of social, emotional, developmental and educational activities, and in this way, enjoy a good quality of life. The organisation intends to register each of the flats separately, with its own registered manager. 12 HYDE CLOSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over two days and a total of eleven hours. The purpose of the inspection was to determine what progress had been made since the last time the service was inspected, and to identify any shortfalls. The registered manager was on leave on the first day of the inspection, but was available on the second day. There were no visitors to the home for the inspector to speak to. The first day of the inspection involved spending time in three of the flats, talking to each manager and individual staff members. The inspector looked at the standard of the environment in each flat, and read documents and observed how staff treated the service users. The same process took place on the second day, visiting the fourth flat, and in addition, meeting with the registered manager. The inspector was unable to speak to service users, because of their lack of verbal skills. However, he contacted a relative by telephone, who had previously made a complaint about the home. The complaint had resulted in a strategy meeting being held under the adult protection procedures. The relative stated that she was now receiving better communication from the home about her son, which was the main recommendation of the strategy meeting. At the time of this inspection, the service users appeared to be well cared for and were supported by a dedicated team of well-trained and supervised staff. The overall findings in this report are that service users’ needs are being met and there are improved systems in place for their protection. What the service does well: Service users and their representatives are provided with very good information about the service in written and audio form. Staff have excellent guidelines to enable them to ascertain service users’ wishes and how to best meet their needs. 12 HYDE CLOSE Version 1.10 Page 6 There is a strong emphasis on maximising community facilities, so that service users spend considerable time outside the home. In the past year, two staff from the home were dismissed for physically abusing service users and they have been referred to the Protection Of Vulnerable Adults, (POVA) register. What has improved since the last inspection? What they could do better: The organisation has long intended to apply for the separate registration for each flat. This proposal is supported by the Commission for Social Care Inspection. However, this matter now needs urgent attention, because the managers in the home are feeling a sense of frustration about the delay in processing the registration. The inspector found that the registered manager is undertaking additional work for Sense, which takes him away from the home for considerable periods of time. This has occurred without prior discussion with the Commission for Social Care Inspection, and is not acceptable, and a requirement has been made to address this. Additional requirements have been made to address the following; Care plans must be broadened to cover all aspects of service users’ needs, with links between assessments, objectives and actions. The dining room furniture in Flat A must be replaced. The floor cover in Flat B must be replaced. The kitchen units in Flat C must be replaced. The problem of mould in the bathrooms in the must be addressed. 12 HYDE CLOSE Version 1.10 Page 7 An operational plan, specific to the home must be provided. The manager of Flat C must ensure that staffing levels are maintained at least to at least, the agreed minimum levels. The registered person must either urgently process the application to register the flats and the managers separately, or reinstate the registered manager full time in the home. The registered person should process disciplinary procedures within a more reasonable timescale. The organisation needs to act more speedily in resolving disciplinary procedures, and in keeping the Commission for Social Care Inspection informed about progress. One requirement is restated in this report and a further six have been added. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 12 HYDE CLOSE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection 12 HYDE CLOSE Version 1.10 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 3 There is good information provided about the service which enables relatives and care managers to make informed decisions about the suitability of the home on behalf of service users. Appropriate steps are taken to find suitable alternative placements when the home can no longer meet a service user’s needs. EVIDENCE: The Statement of Purpose has been amended to include all the information in Schedule 1 of the National Minimum Standards. Each service user has a written Service Users Guide which has also been transferred onto audio tape. Samples of two service users’ case files from each flat were examined. They contained care manager’ assessments and the home’s own more comprehensive assessments of service users’ needs. None of the service users have verbal skills and they have limited comprehension, however, there was evidence in the case files to show that relatives were involved in this process. The home was purpose built to provide a very specialised service for people with profound learning disabilities, physical and sensory impairments. Staffing levels in each of the flats reflect high levels of support, including oneto-one when appropriate. In Flat B, an assessment had taken place, which now indicates that the home is unable to meet one specific service user’s needs. The manager of the flat stated that this decision has been agreed by the service user’s relatives and care manager, and an alternative placement is being sought. 12 HYDE CLOSE Version 1.10 Page 10 Sense provides its own induction and training programme on how to meet special needs, and extensive guidelines are provided on how to communicate with individual service users. A key worker system is in place to enable staff to have a more informed relationship with individual service users. Staff were observed interacting with service users in a caring way and which indicated that they were responding to service users’ wishes. 12 HYDE CLOSE Version 1.10 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9. Although there is a wealth of good information about service users’ needs and clear guidelines are provided about how to respond to these needs, there is some confusion about how to construct and use care plans. The care objectives are rather limited in scope, and links between the assessment, objectives, actions and reviews of care plans were not evident. EVIDENCE: Two care plans were sampled from each of the four flats. Care objectives, actions to be taken and a date for reviews were recorded. However, although there are comprehensive assessments in the case files, these were not evident in the care plans, nor was an outcome of the review recorded. However, the managers responded positively to this feedback and expressed a commitment to implement changes to the care planning process. The case files contained service users’ likes and dislikes about a wide range of issues, for example; (on how to communicate), “I indicate my feelings through my facial expression. I smile when I am happy” Staff have written guidance about how to communicate with individual service users. For example, staff were observed using objects of reference like cups, keys and items of clothing. Signing was also evident when offering choices to service users to help them to express their wishes. 12 HYDE CLOSE Version 1.10 Page 12 A range of assessments of potential risks to service users when in the home and in the community were recorded. For example, a service user is supported to go out on a quad bike. 12 HYDE CLOSE Version 1.10 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12, 13,14, 15,16,17. The breadth and range of activities provided enables service users to develop and maximise their potential, and they fully participate in the local community. This enhances their social and educational opportunities. EVIDENCE: Eight case files were sampled. There was very good information available about how to provide personal care for the service users’, to ensure that their rights are respected. Service users’ preferences are documented and staff have guidelines about how the service users communicate their wishes and feelings. Each service user has a programme for the week’s activities, within the home and the community. At the time of the inspection, various activities were taking place. For example, one service user was being given hand and feet massage. Another was at the Furzefield centre using the swimming pool and Jacuzzi. A service user goes out frequently with staff on a quad bike. One service user attends college five days a week. 12 HYDE CLOSE Version 1.10 Page 14 Each flat organises a holiday for small groups of service users each year, accompanied by staff. Holidays included going to Norfolk, holidays on canal barges and other going to other resorts throughout the country. Each flat has its own vehicle, adapted to accommodate wheelchairs. Daily records were made showing that staff support service users to go out to pubs and restaurants. Many of the service users have overnight and weekend stays with their families. Some service users were engaged in cleaning and tidying their rooms with staff support. Records were seen of service users’ individual preferences for food. The menus were varied and wholesome and there was fresh fruit available. Fridges and food cupboards contained ample quantities of food. 12 HYDE CLOSE Version 1.10 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 & 21 The health needs of service users are well met from a full range of healthcare professionals. The administration of medicines has improved with a new, clear procedure in place to ensure that service users’ medication needs are met. EVIDENCE: Two case files from each flat were sampled. There were good records showing a wide range of appointments with consultants, G.P’s, dentists, chiropodists, audiologists, and specialists in sight and hearing problems. Records of accidents and incidents were appropriately recorded. The majority of service users have annual care reviews by care managers. The manager of each flat compiles a “Purchaser’s annual review” report and sends it to the respective local authority. However, it was evident that, in spite of the managers’ repeated written requests, some local authorities’ care managers, failed to visit the home to carry out a review in the past year. In Flat B, the manager provided evidence that she had requested occupational and physiotherapist assessments for two service users through the G.P. However, at the time of the inspection some three months later, the G.P had apparently not made the referrals and these assessments had not taken place. The manager has asked the G.P, to make another referral for assessments to be carried out. 12 HYDE CLOSE Version 1.10 Page 16 Prior to the inspection, the Commission for Social Care Inspection was informed that a number of PRN Lorazepam tablets, which is a controlled drug, were found to be missing. An investigation by a senior manager, failed to discover the cause of this incident. However, a new administration of medicines procedure was introduced which requires all PRN medication to be checked daily and two staff must now sign when medicines are administered. In addition, Lorazepam is now being treated as a controlled drug and a register and special cupboard have been ordered. In the meantime these tablets are being stored in the manager’s locked drawer. The tablets were counted in the inspector’s presence showing a correct balance. There are records of relatives’ wishes in the event of a service users death. 12 HYDE CLOSE Version 1.10 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 There is an appropriate complaints procedure and there is evidence that service users’ representatives’ complaints are acted on. Although there are proper policies and procedures in place to protect service users from abuse, there are inordinate delays in reaching outcomes in incidents of abuse. There has also been a history of poor reporting of serious incidents and communication about the progress of these matters, to the Commission for Social Care Inspection in some instances. EVIDENCE: Three strategy meetings have been held within the past year relating to suspected abuse occurring in Flat 12 A, and one in Flat 12 D. Following an investigation into the incidents in Flat A, two staff were dismissed and were referred to POVA. The investigation and resolution of these matters was very protracted and took almost twelve months to complete. At the time of the inspection, the staffs’ appeals against dismissal were still outstanding. This issue was addressed with Sense’s Director of Care at a separate meeting with the Commission for Social Care Inspection. The outcome of the strategy meeting regarding the injuries to the service user in Flat D, was that appropriate records of incidents had not been kept and the service user’s parents had not been properly informed about these incidents. The service user’s parent was contacted by the inspector and she stated that there was now better communication by the home. Detailed accident and incident forms, which included diagrams of any injuries, were seen. 12 HYDE CLOSE Version 1.10 Page 18 Staff records showed that several staff had recently attended training in adult protection and there is a programme to ensure that all staff will undergo this training within two months. There is an appropriate complaints procedure in place. Each flat has a complaints book, where complaints had been recorded. 12 HYDE CLOSE Version 1.10 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 29 & 30 There has been progress in the maintenance of the building and the décor of the home. However, the quality of some flooring, and kitchen and dining furniture is poor, which detracts from a safe and pleasant environment for service users. EVIDENCE: Stonham Housing Association is the landlord responsible for the maintenance of the building. A tour of the premises was carried out. There was evidence that some improvements to the environment had been made. For example, old shrubbery had been cleared from the garden and a new gate installed, resulting in a more attractive space, which is accessible to wheelchair users. Flat D had been completely redecorated and looked particularly attractive. In Flat A, the dining room furniture is old and worn. The manager stated that money had been provided to replace this. Some flats had been partially repainted and new laminate flooring provided. However, in flat B, a vinyl floor that was only a few days old, was already torn in places and could cause someone to trip and injure themselves. 12 HYDE CLOSE Version 1.10 Page 20 The kitchen units in Flat C were old and some doors did not close properly. The manager stated that it was agreed to replace the units in the operational plan for this year. There was evidence of mould in two of the bathrooms on ceilings and tiles. Specialist equipment, for example, special beds, armchairs and hoists are available and there were records to show they are regularly serviced. At the time of the inspection, the home was clean and tidy and there were no offensive odours. 12 HYDE CLOSE Version 1.10 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Staff are well trained and supervised, resulting in good morale among a group of staff who enjoy caring for the service users. EVIDENCE: 12 HYDE CLOSE Version 1.10 Page 22 The staff records that were sampled showed that all new staff are given a written induction and that mandatory training was provided. Seven staff from the various flats were spoken to. All the staff stated that they were happy in their work and the support they received from their managers. One staff stated, “I love the work I do, although it can be stressful”. Another said, “Supervision is very helpful; you are told about your performance and it is confidential”. An examination of the staff rotas was carried out. The staff rotas showed that in each flat, there were three staff on the early shift, three on the evening shift and one member of staff awake at night. Two other staff provide support for all of the flats on a sleep-in basis. There is also a manager on duty in each flat for five days a week. However, at the time of the inspection, Flat C’s rota for the following week indicated that two shifts would be short-staffed. When this was pointed out, the manager covered these shifts with bank staff. There were several staff vacancies in the home, but recruitment is currently underway and it was expected that the vacancies will be filled. Current vacancies are covered by bank staff. . 12 HYDE CLOSE Version 1.10 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 42 & 43 Although the managers in each flat provide a good quality of service, there is a lack of urgency in dealing with major issues by Sense senior managers, which is having a negative effect on the morale of the managers within the home. EVIDENCE: A draft operational plan for Sense’s objectives for 2005/6 was seen. However, there were no details of any specific plans for this home; for example, the intention to register each flat with the Commission for Social Care Inspection. A draft budget for each flat was available for inspection. However, at the last inspection, a requirement was made for an annual business plan for There was support for the registered manager from the senior staff. However, in discussion with him, it was evident that the manager has been given additional responsibilities for other parts of the organisation, resulting in him being absent from the home at least one, and sometimes two or three days of the week. Although the registered manager is available for advice by mobile 12 HYDE CLOSE Version 1.10 Page 24 phone, this means that there are more management responsibilities for the senior staff in the flats. The Commission for Social Care Inspection has not been consulted about this arrangement. A requirement has been made for the registered manager to be reinstated full time until otherwise agreed by the Commission for Social Care Inspection. The inspector found a sense of frustration from the senior staff in the home, about the delay in the separate registration of the flats. They were unaware that the application had not yet been made. A separate letter has been sent to the registered person regarding this matter. It was evident from documentation, care reviews and observation of interactions, that staff had a very good understanding of service users’ needs and wishes. Several service users’ cash tins and personal finance records were checked and were seen to be properly accounted for. The comprehensive portfolio of policy and procedures was sampled. A new medication policy was examined. The policies and procedures were dated and reviewed by Sense on an ongoing basis. Maintenance certificates were seen for the fire alarms, electrical, gas and portable appliances. Lifts and hoists were regularly serviced. The temperatures of the fridges and freezers throughout the flats were recorded daily. The manager of one of the flats is now responsible for the weekly fire alarm tests. COSHH materials were stored securely. The flooring in Flat B was torn and is a potential health and safety risk. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 12 HYDE CLOSE Version 1.10 Page 25 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 2 x x x 3 2 12 HYDE CLOSE Version 1.10 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15.1 Requirement The registered manager must ensure that care plans reflect all aspects of service users needs and assessments, objectives and actions are linked. The registered person must inform the Cimmisssion for Social Care Inspection about any serious incident affecting service users without delay. The registered person must replace the dining room furniture in Flat A, kitchen units in Flat C, and the flooring in Flat B. The regtistered person must ensure that the mould in the bathrooms is treated. The registered manager must ensure that, at least minimum staffing levels in Flat C are maintained. The registered person must reinstate the registered manager full-time in the home, or urgently process application to separately register the flats and managers. The registered person must provide an annual business and financial plan for the home.This requirement is restated from the Version 1.10 Timescale for action 30/6/05 2. 23 37 31/5/06 3. 24 23(2) 31/5/06 4. 5. 24 33 23(2) 18(1) 31/5/06 31/5/06 6. 38 38 31/5/06 7. 43 25 31/5/06 12 HYDE CLOSE Page 27 last inspection. 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 23 Good Practice Recommendations The registered person should process disciplinary procedures within a reasonable temescale. 12 HYDE CLOSE Version 1.10 Page 28 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 12 HYDE CLOSE Version 1.10 Page 29 - 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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