Inspection on 31/05/07 for Jane`s House

This inspection was carried out on 31st May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jane`s House 01/06/06

Jane`s House 30/12/05

Jane`s House 15/06/05

Jane`s House 07/10/04

Jane`s House 23/04/04

Jane`s House 20/01/04

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

CARE HOME ADULTS 18-65 Jane`s House 89 Barrow Road Streatham London SW16 5BP Lead Inspector Lynne Field Unannounced Inspection 31st May 2007 10:00 DS0000022736.V338869.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 DS0000022736.V338869.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. DS0000022736.V338869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jane`s House Address 89 Barrow Road Streatham London SW16 5BP 0208-677-6196 0208 677 4273 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) Jane’s House Limited Ms Chan Bisessar Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) DS0000022736.V338869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2006 Brief Description of the Service: Jane’s House provides long term care for people who have enduring mental health problems. There are currently three male residents, although the home has accommodated a mixed gender group since opening in 1990. The home is situated in a residential street off the main road leading to Streatham High Street, and is close to public transport routes, shopping and leisure facilities. It is a semi-detached house on four floors, and blends in well with other houses on the same street. The registered manager owns the property and also owns two other small homes nearby. The philosophy of care states: The home is flexible with care and support provided as required by anyone who has suffered with mental ill health. The home charges a weekly rate of £337.29 to £679.67. There are additional costs for toiletries, newspapers and hairdressing. Some residents are charged for the cost of staff escorts to accompany residents on visits to hospital. DS0000022736.V338869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out on the 31st May 2007. During the visit the inspector met the registered manager and one of the care staff who took part in the inspection process. The inspection included a tour of the home and the garden. The inspector was able to examine a number of records which included residents files that contained initial assessments, care plans, risk assessments, reviews and daily records. Medication records, the complaints book and health and safety records were also inspected. The inspector received a pre-inspection questionnaire that provided background information. This has been incorporated into the report. The inspector met two residents and was able to observe friendly and respectful interaction between staff and residents. Residents have differing levels of communication skills but they were able to indicate they liked living at the home. What the service does well: What has improved since the last inspection? The home has worked hard to comply with the requirements made at the last inspection. DS0000022736.V338869.R01.S.doc Version 5.2 Page 6 The statement of purpose has been reviewed and includes information specified in schedule 1. Risk assessments have been reviewed and developed. The resident and the manager sign these. The bathing facilities have been improved by adding a new shower room and this will benefit the residents. The medication is being recorded when it is received and there is a running total kept of the medication that is recorded on the medication chart. Staff have had refresher training in Adult Protection issues and this is recorded in staff files. 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. The summary of this inspection report can be made available in other formats on request. DS0000022736.V338869.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 DS0000022736.V338869.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information for residents and others is now complete and provides useful information about the home and the service provided. Assessment arrangements are comprehensive and allow for clarity about needs before placements are offered. Prospective residents and their relatives can come and look around the home and meet staff before they decide to move there. EVIDENCE: The home has a service users’ guide and a Statement of Purpose. These have been reviewed and updated since the previous inspection in June 2006. They now contain information prospective residents would need to help them make a decision about the home and whether it can meet their needs. There have been no new admissions since the last inspection. However, the policy is to carry out a full assessment of residents needs before admission. They receive assessments from the multi-disciplinary team involved with the person and complete a form of their own. The registered manager told the inspector prospective residents are able to visit the home prior to any DS0000022736.V338869.R01.S.doc Version 5.2 Page 9 admission and she would assess them to ensure the home could meet their needs. The inspector viewed all three residents files and saw copies of the assessments in each residents’ file. DS0000022736.V338869.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and show that residents’ needs are considered in depth and regularly reviewed. There are opportunities for residents to be involved in the process to give their views. Risk assessments are equally detailed and also regularly reviewed making it easier for residents to lead active lives. EVIDENCE: Resident’s case files are kept securely in a locked cupboard. The inspector viewed each resident’s case file. These included daily records, monthly evaluations, care plans and minutes of review meetings. The inspector was told that the care plan format had been reviewed and developed since the last inspection. There was evidence that care plans are reviewed and evaluated every six months and were signed by the resident, the registered manager and the care manager where appropriate. DS0000022736.V338869.R01.S.doc Version 5.2 Page 11 Files contained risk assessments and these were comprehensive, with information about trigger and warning signs around deterioration in residents’ mental health, and information on actions to be taken. The registered manager said that they review these once a year or more often if the need arises. The home has discussions with the residents’ care manager and psychiatrist about the category of risk and each resident has a relapses and risk management plan. The risk could be self-harm, such as a history of taking overdoses of medication. There are action plans for each risk identified and steps to be taken to minimise the risk. The registered manager is aware of residents’ needs regarding confidentially and is able to reassure residents that they will be informed of any actions taken with regard to the contact of other agencies and that their permission will be sought with regard to passing on information where this is appropriate. DS0000022736.V338869.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported with regard to personal development and are able to access a variety of activities, maintain links with their family and the local community and to live as independent a life as possible. A healthy and enjoyable diet is provided with residents eating together and sharing food. EVIDENCE: The inspector met and spoke to two of the residents during the course of the inspection. The third resident was out for the day. He is very independent and the home has given him the opportunity to become more independent and take more responsibility for himself. Risk assessments are on file and action plans are in place. This was discussed in the residents review meeting and is DS0000022736.V338869.R01.S.doc Version 5.2 Page 13 documented. One resident goes to a day centre three times a week and goes home to visit his mother some weekends. All residents enjoy each other’s company. One resident who is Indian said he likes listening to his Indian music and he goes to the Temple. The staff encourages residents to choose what they want to eat and help cook meals. The registered manager says, “she want people to live like herself,” and she wishes to encourage residents to develop. A four weekly cycle menu is used. Meals are in residents meetings but it can be changed if a resident does not want what is on the menu. The home is quite diverse with residents having a variety of racial backgrounds. Residents enjoy trying each other’s different food. The inspector spoke to one resident at lunchtime who said he killed food. Staff are attending a course on Nutrition and Health at Croydon College, which they said has raised their awareness of healthy eating. One resident enjoys going for a walk but gets lost if he goes out on his own. To help promote his independence, he walks down the road to one of the other homes the registered manager owns. Staff phone the home to say he is on his way and watch him for a short distance. When he arrives the staff phone to say he has arrived. DS0000022736.V338869.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in ways they prefer and their health and emotional needs are met. Residents are protected by the homes policies and procedures for dealing with medicines. Recording the spot checks made will add another level of safety to the arrangements. Residents are consulted about their final wishes and the home is sensitive about how it does this. EVIDENCE: The residents’ files and care plans give information about residents’ health needs. All the residents have lived at the home for a number of years and the staff support the residents to maintain their physical and emotional health. Staff support residents with personal hygiene by encouragement rather than providing direct physical care. The member of staff the inspector spoke to said DS0000022736.V338869.R01.S.doc Version 5.2 Page 15 that they, “try to help residents be as independent as possible”. On the day of the inspection one resident was not feeling very well and the home had called the GP. The files seen by the inspector confirmed residents are in contact with various health professionals including care coordinators, psychologists and social workers. The registered manager said she felt able to contact the other professionals involved with the residents to discuss problems or issues with them if the need arose. None of the residents are self medicating and staff support residents to take their medication. The inspector checked all residents’ medication with the registered manager and it was found to be correct. The registered manager said she does a spot check of the medication once a week has introduced a running total for the amount of medication they have left for each resident to ensure that they have the correct amount and this corresponds to the medication signed for from the pharmacy. It would be good practice if the spot checks on the medication could be recorded on the medication charts. All medication coming into the home and medication that is not required is recorded in the medication book. Medication not needed is returned to the pharmacy for disposal and this is recorded in the book. The registered manager has encouraged residents to record their wishes in the event of their deaths and has developed a form they can use to record these wishes. One resident has filled it in himself, saying what type of music he wants as well as giving other details and signed it. DS0000022736.V338869.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an appropriate complaints procedure which allows residents to raise concerns and complaints. Improvements have been made to the safeguarding adults arrangements with training provided for staff and staff now having access to a copy of the local authority adult protection guidelines. EVIDENCE: The home has a complaints procedure. There have been no recent complaints. The complaints book is on display in the hall for residents or visitors to look at or write in. One resident told the inspector that they were, “happy here”. The registered manager told the inspector if there was a complaint they would speak to the person who had made the complaint and if necessary investigate it. She said most complaints would be made verbally and dealt with immediately but there have not been any complaints made since the previous inspection in June 2006. There is information available on the protection of vulnerable adults. The home has a copy of the multi-agency procedure that it has obtained since the last inspection. The member of staff who spoke to the inspector said they were aware of issues around the protection of vulnerable adults. The registered manager said all staff have received training in adult protection since the last inspection in May 2006. DS0000022736.V338869.R01.S.doc Version 5.2 Page 17 The home has a policy regarding the protection of the resident’s finances. One resident has a Post Office account. He goes to the Post Office to collect his money and budgets for himself. There is a risk assessment in place and an action plan to minimise the risk. One residents’ mother is his appointee and the registered manger is an appointee for the other resident. The home holds personal money for two residents. As part of the inspection the records and the money were checked by the inspector and found to be correct. The inspector saw copies of the minutes of the resident’s meetings that are held in the home. These covered a range of issues including meals, answering the phone and taking messages, planning activities, trips out, and the garden. DS0000022736.V338869.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is bright and comfortable. The accommodation for both individual and shared use is furnished appropriately and maintained as well as possible given the nature of the high level of challenging behaviour in the home. Residents’ rooms are comfortable and are decorated to reflect their personalities. The standard of hygiene was very good with no unpleasant odours. EVIDENCE: The home is situated in a Victorian house in a residential street. The inspector was given a tour of the home. There is a communal sitting room with French doors leading to a conservatory that is used as a smoking room. The day room has recently been redecorated and there are new curtains. This then leads to a pleasant and well-maintained garden. The home has had a new garden wall DS0000022736.V338869.R01.S.doc Version 5.2 Page 19 built at the back of the garden. There is a kitchen that leads into a spacious dinning room to the rear of the ground floor, that overlooks the garden. One resident’s bedroom is on the ground floor and there is a separate toilet. Two residents have bedrooms on the first floor. One of the bedrooms has been partitioned off to make a new shower room. Although part of the bedroom was made into a shower room, the bedroom is still large enough to meet the regulations and this was done when there was not a resident using the room. The third bedroom on the first floor was vacant at the time of the inspection. On the half landing there a bathroom and WC and a separate WC. Residents’ bedrooms have been personalised. All were clean and well decorated. The residents have personalised them according to their individual preferences, choices and cultural interests. The house has a cellar where there are laundry facilities. Tinned and dry food is stored in this area but away from the laundry area and this was generally well set out with items stored on shelving. DS0000022736.V338869.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff cover is sufficient, recruitment is sound and staff are provided with a range of training and supervision opportunities. Reliable arrangements have been made about staffing matters which results in staff able to provide a good service for residents. Further attention to staff induction and foundation arrangements and to the renewal of CRBs will enhance the already good arrangements. EVIDENCE: The staff rota was inspected and confirmed the number of staff on duty was correct. The home has one member of staff on duty during the day and one sleeping member of staff at night. There is a sleep in room on the top floor of the home and residents know and are able to call staff throughout the night if they need to. The inspector was told that should a resident need to be escorted to an activity or an appointment for some other reason, they will arrange for another member of staff or the activities organiser to act as an escort. This was reflected on the rota seen by the inspector. The registered manager was on the rotas inspected, but is supernumerary. This enables her to visit one of DS0000022736.V338869.R01.S.doc Version 5.2 Page 21 the other homes she owns to provide staff cover or support residents in any outside activity or appointment if needed. There was one member of staff who was on duty at the time of the inspection. They said all staff in the home are in the process of taking a course in Nutrition and Health run by Croydon College and they had been on a number of other courses such as POVA and Medication and Mental Health. They said they had regular supervision and the files inspected contained evidence of regular supervision and supervision notes that had been signed by the member of staff and the registered manager. The inspector was told there had been a staff meeting the previous week and most of the staff from the three homes the registered manager owns had attended. Staff meetings are held every two months and the inspector was shown copies of the minutes of the meetings. Two staff files were examined and included one new member of staff to the home. These included copies of the application forms, two written references, a signed copy of their contract stating terms and conditions and identification. All files checked had CRB checks. The registered manager said they would not start a member of staff to work in the home unless they had been CRB checked. All staff had copies of CRBs on file. The inspector noticed several staff who have been employed by the home, had CRBS that were three or more years old. It is good practice to renew these every three years to keep them up to date. The home has over 50 of their care worker qualified to level 2 NVQ or above. There were copies on the staff files of the certificates issued for the courses staff had attended. Although there were copies of the induction training that was given, this was only about the home and health and safety issues and did not fully comply with “Skills for Care” level of induction. This needs to be addressed. There were records confirming staff has recently undertaken a number of courses relating to the residents of the home, such Attitude to Mental Health, Depression and Schizophrenia, Aggression, Verbal Skills of Tackling Aggression, Medication and Treatment of Mental Health. DS0000022736.V338869.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know the home is well managed and planned. The home needs to obtain the views of residents or other people that come to the home with regard to quality assurance. EVIDENCE: The registered manager demonstrated a clear understanding of the needs of the residents and her responsibilities in ensuring that the home met registration standards. The inspector spoke to one resident, who confirmed that he liked living there by his body language and facial expressions. One resident was out and the other resident did not want to speak to the inspector DS0000022736.V338869.R01.S.doc Version 5.2 Page 23 because he was feeling ill. The inspector observed throughout the inspection the interaction between staff and residents was warm and appropriate. The home has not completed any monitoring of residents, relatives and other stakeholder views by carrying out surveys of relatives or other professional that visit the home. They have completed a number of self-monitoring reports and sent a copy to the CSCI office. The inspector saw copies of residents meetings and these were very informal but noted residents were able to speak about and make their views known about the menus, holidays and outings. The home had a policy on health and safety and the inspector viewed health and safety records. The registered manager confirmed that there were regular checks at the required intervals, by external contractors, for servicing the fire safety system, the boiler, central heating system and the emergency call system. Certification was in place regarding the Landlord’s Record of Gas Safety, Portable Electrical Appliance testing, and Certificate of Electrical Installation. Records showed that regular checks of the fire alarm call points were made and that fire drills were conducted. A fire risk assessment and floor plan was completed and is in place. The registered manager said LFEPA had visited on the 21/02/07. They had had a good inspection report with no requirements or recommendations made. The inspector was shown a copy of the letter sent by the LFEPA that confirmed this. DS0000022736.V338869.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 3 x DS0000022736.V338869.R01.S.doc Version 5.2 Page 25 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 YA35 Regulation 18 (1) (c) (i) Requirement The registered manager must ensure that all staff receives a full induction and foundation programme during the first six weeks and then six months of their employment. The registered manager must ensure that they produce written information detailing the action taken to monitor residents, relatives and other stakeholder views with regard to the quality of the service they provide. This is a repeat requirement the timescale of 01/06/07 was not met. Timescale for action 31/08/07 2 YA39 24 (2) (3) 31/08/07 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 YA20 Good Practice Recommendations The registered manager should record and sign on the medication charts when spot checks of the residents’ medication records are carried out. DS0000022736.V338869.R01.S.doc Version 5.2 Page 26 2 YA34 The registered person should renew the CRBs of staff who have worked at the home for longer than three years. DS0000022736.V338869.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000022736.V338869.R01.S.doc Version 5.2 Page 28 - 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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