CARE HOME ADULTS 18-65
Jean Garwood House 25 Bramley Hill South Croydon Surrey CR2 6LZ Lead Inspector
Barry Khabbazi Key Unannounced Inspection 8th May 2006 9:30am Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Jean Garwood House Address 25 Bramley Hill South Croydon Surrey CR2 6LZ 020 8681 7338 020 8604 8904 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) Garwood Foundation Ms Jacqueline Nannette Jenner Care Home 14 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Room number 11 is to be used for 1 respite bed. Date of last inspection 17th January 2006 Brief Description of the Service: Jean Garwood House is sited in a residential street close to the centre of Croydon on Bramley Hill. The house is fully registered as a residential care home for adults with physical disabilities and learning disabilities. Some residents visit their families at weekends and so the numbers in residence can vary at certain times. The ground floor of Jean Garwood House provides 11 single residents rooms. The shared rooms in the home consist of a lounge and dining room. Corridors in the home are wide and long and easily accessed by wheelchairs. Bathrooms are located either end of the long corridor, as are the toilets. All ground floor bedrooms exit onto a patio area that surrounds the house. The first floor has been converted into a semi-independent living unit for three people and has now been registered as such. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The key Standards identified throughout this report were all assessed at this inspection. This unannounced inspection also focused on following up on previous requirements and new issues arising, for example the change in management. Timescales for previous unmet requirements were extended at the last inspection to give the new management a chance to implement them. This inspection was unannounced and all the residents were met before they went to their day activities. During this inspection the new manager and new deputy manager were interviewed. Records, policies and care plans and the building were examined. What the service does well: What has improved since the last inspection?
The service users bedrooms have been re-decoratredand in colours of the individual resident’s choice, and have all had new carpet. An accessible caravan has been acquired for shorts breaks and holidays. The payphone has been moved, following comments raised by a resident about the payphone needing to be in more private area.{Recorded in the last report as a suggestion.} The home is now more diligent in ensuring that opened refrigerated food has the date of opening recorded to protect the service users from infection. Satisfaction surveys have been sent to relatives. This will ensure that the quality assurance system also includes their input. The residents had markedly less issues to raise than at previous inspections.
Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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, 3, and 5. New residents’ assessed needs are not fully known to all staff. This could affect a staff member’s ability to meet all a resident’s needs. Although the home meets the needs of its main client group well, staff do not have the training required to meet the needs of those residents with an acquired brain injury. The residents’ rights are not fully enhanced through their contract with the home. EVIDENCE: A new service user had been admitted without the placing authority’s Care Management assessment and a copy of the placing authorities Care Plan. In addition the home’s own new service user assessment documentation did not cover all the elements of Standard 2, for example cultural needs. The following two requirements are set to address this shortfall under Standard 2: 1, Service users must not be admitted to the home until receipt of the summary of the Care Management assessment and a copy of the Care Plan. 2, The home’s own new placement assessment documentation must cover all the elements of Standard 2.3. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 9 The 2004 announced inspection report recorded the following: ‘The home has admitted a service user with a brain injury and no congenital learning disability, unlike the other service users. This service user will require different skills from staff i.e. re-learning former skills as opposed to learning new skills as with the current client group. The following requirement is therefore set: The home must provide evidence to the Commission that the staff team are adequately trained in the field of brain injury and associated rehabilitation.’ Although some evidence of researching possible providers of this training was present, training had not been secured . This requirement therefore remains in force. The last inspection report contained the following recommendation: Contracts to contain the elements of the care plan to be met outside the home through other resources. This had not occurred. This requirement also remains in force. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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, and 9. Residents’ known assessed needs and changing needs are recorded to ensure that these needs are known and can therefore be met by staff. However, residents could be better supported to make decisions about their lives if the care plans were in a more accessible format. Service users make decisions about their lives with assistance if needed. Service users are supported to take risks as a part of the independent lifestile. EVIDENCE: The 2002 announced inspection contained a requirement regarding daily notes and key-worker notes. Monthly key-worker reports are now being produced and the daily notes are more detailed. This was the case at the last unannounced inspection and has been maintained since. This requirement was previously met but should also continue to be monitored. In addition, the continuing practice of producing monthly key-worker reports means that care plans are reviewed monthly. This exceeds the six monthly reviews required under the standards.
Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 11 The last announced inspection report contained the following recommendation: Care plans should be translated into more accessible formats for the residents. This had started but needs to conclude. This recommendation will remain in force until such time. Service users are encouraged to take responsible risks, and risk assessments for both the service user and the environment and restrictions of liberty were present in files sampled. Risk assessments were updated during the last inspection to now include other options and training that has been explored before implementing any restriction of liberty for the protection of the resident. These risk assessments now contain all the elements required under Standard 9. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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, 14, 15, 16, and 17. Residents have the opportunity for self development, are part of the local community and are able to take part in appropriate activities. Residents do receive all the paid holidays they are entitled to but evening mini outings need to be re-instated. Residents are well supported in maintaining appropriate relationships, so that their social lives are maximised within chosen boundaries. Residents are offered a healthy diet and have choices in meals offered. EVIDENCE: The home mainly supports residents to find and keep jobs, continue their education and training {including literacy and numeracy}, and take part in other activities, through the sister day centre next door. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 13 As all the residents attend this day centre, its work is used to evidence the home meeting a number of standards. A copy of the day centre’s activities timetable has therefore been sent in to the Commission to evidence the above. A number of service users now attend college for computer studies, cookery and embroidery. The local community is well used by the residents and access is assisted by the home having its own transport, which now includes a second vehicle. The local shops, bowling, bingo halls, college, swimming pools, cinema and clubs are accessed and some residents access the local community independently. Staff are available to support service users while accessing the community although recently this has not occurred as frequently in the evenings as at the weekends. The management intend to acquire a new vehicle to facilitate more evening outings. The following recommendation is now set to address this new shortfall: The management should continue with its plans to re-introduce mini outings in the evenings as well as the current week end outings. The staff job descriptions have now been amended to reflect their responsibilities with regards to supporting activities. Residents spoke of good quality of outings. Activities provided within the home include individual interaction, puzzles, games, music, books, videos, art and crafts and support with individual hobbies. Although holidays have previously occurred, funding for this has recently been secured from placing authorities to the value of £700 per resident. The home has been one of the first to achieve funding agreements for holidays. In addition these are realistic holiday funding figures. It is the home’s core philosophy to promote independence and individual choice, and the daily routines and house rules generally promote this. Smoking arrangements have now been devised and are recorded in the service users’ guide. All residents have keys for their own rooms, and those that can access the lock have keys for the front door. One resident took pride in showing me her room and the fact that she had her own door bell. Mealtimes in the evening and morning have been frequently observed and are always presented in a clean and congenial setting. Meals were unrushed and residents can take as much time to eat, as they want. Meals are regular and menus appeared nutritiously balanced. The residents design the menu themselves and are able to take meals at flexible times and are also able to choose alternatives. This was also confirmed by a resident at this inspection. Residents are actively encouraged to be involved in the preparation of meals. Snacks and drinks are available at all times. Nutritional monitoring and dietician support occur where required. A pictorial menu is being developed, see recommendation under Standard 40. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 14 At the last inspection, a bag of ham was found in the fridge with no date of opening recorded. To put things in perspective, the fridge was clean, this was the only unlabelled item and the deputy immediately threw it away as its age could not be determined. The following requirement was then set: Refrigerated and frozen food items must be labelled with the date of opening. At the time of this inspection opened items in the fridge had all been properly labelled with the date of opening. This requirement is therefore currently met. At the last inspection, one resident said that the positioning of the pay phone was in a busy area and not sufficiently quiet or private. As other telephone options are available it was suggested only at this stage that options to improve privacy for residents’ phone usage should be explored. Since that time the payphone has been moved to a more private area. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical health needs are met well by this home. This ensures that the residents’ physical health is well maintained and therefore the quality of life experienced is also maximised. Residents’ medication is also well managed to ensure maximised good health. EVIDENCE: Timings for support with care are flexible. Consistency and continuity is achieved through designated key workers. The residents have access to relevant professional support to maximise independence, including physiotherapists, occupational therapists and speech therapists. Residents are supported to attend regular health checks, outpatient appointments and other medical appointments as required. The continence advisor has visited and access to chiropody, dentists and audiologists was demonstrated. Evidence was seen of regular monitoring of residents’ health including regular weighing and action in an event of significant loss or gain. Residents are encouraged to administer their own medication where possible, and they have a lockable space in their rooms to facilitate this. Medication is only provided through the G.P and prescriptions are sought for homely
Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 16 remedies to ensure secure record keeping and ensure against combining medication in a haphazard way. Medication is stored securely in a lockable cabinet fixed to the wall and individual blister packs are used. Medication profiles were present with a list of possible side effects. Training in administration of medication for staff includes identifying adverse reactions to medication. The home has now obtained and recorded the service users’ consent to medication. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23. On the whole this home manages complaints well. The home’s policies and procedures relevant to this Standard currently facilitate protecting residents from abuse. EVIDENCE: The residents had markedly less issues to raise than at previous inspections. There had been no official complaints since the last inspection. The home has a complaints procedure that meets all the elements of this Standard including a minimum response time of less than 28 days, details of the Commission and this is now also available in more accessible formats. The more accessible formats include a bold, high contrast large print version, a simplified language version, a ’Makaton’ symbol version and a pictorial and symbol version and a photograph version that requires a photo of the inspector for the home. The home does have a copy of the adult protection procedures and staff have now received training in this area. The Restraint Policy has been developed to cover all the areas required. This also includes recording mechanisms. The home has a Whistle Blowing Policy, a Gifts Policy and the Wills Policy does preclude staff from being involved in the making of, or benefiting from residents wills. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The home is hygienic and clean, homely and comfortable. This environment therefore facilitates the residents’ health and emotional well-being. EVIDENCE: The premises are decorated in an appropriate style and well maintained. The service users bedrooms have been re-decoratred in colours of the individual residents choice, and have all had new carpet. The home’s premises are accessible and in keeping with the local community. The grounds were observed to be well kept and accessible. The home has level access, doors wide enough for wheelchairs and a wheelchair accessible lift to the first floor. There is suitable lighting and ventilation. The building is always particularly clean and tidy. The home gives the impression of a clean and hygienic home. The home has specific policies covering the disposal of clinical waste, control of infection, use of cleaning materials, storage and preparation of food, and dealing with spillages. Protective clothing was observed to be present. Laundry facilities have easily cleanable non-permeable floors and easily cleanable walls. Washing machines have appropriate programmes over 65 degrees to control risk of infection. The laundry room was positioned so that laundry does not need to be carried through the kitchen.
Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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, and 35 Staff are appropriately qualified to or above NVQ level 2. This will affect how effective staff are in their work with service users. The home’s recruitment procedures protect the residents through vigorous staff vetting. Residents’ needs are not well met by appropriately and fully inducted staff. EVIDENCE: The standards require homes of this type to have 50 of staff trained to NVQ level 2. At this home 12 out of 13 staff have the NVQ 2 which represents over 90 . This home has an equal opportunities recruitment policy. Criminal Record Bureau checks were checked and were present for all staff. External volunteers are not currently used at this home. The staff files sampled also contained references, proof of identification, interview notes, statements of terms and conditions and staff photographs. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 20 The last inspection report contained the following requirement: All staff recruited since April 2002 must undertake six month foundation training to Sector Skills Council workforce training targets and both this training and the induction training must be evidenced. This has not occurred yet and this requirement remains in force. The following training requirement also remains unmet and in force under Standard 3: The home must provide evidence to the Commission that the staff team are adequately trained in the field of brain injury and associated rehabilitation. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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. Service users benefit from a generally well run home and appropriately qualified management. The home’s quality assurance system does not involve the residents and relatives, and provide feedback to them, to allow them to be involved in improvements and measure improvements in the home for themselves. The health and safety, and welfare of the residents is promoted and protected. EVIDENCE: The new registered manager has the required NVQ4 and also well exceeds the years of experience in the field required. The last report contained a requirement for the new satisfaction surveys to be sent to relatives. This has occurred and that requirement is now met. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 22 The home now has almost all of the tools needed for a quality assurance system that makes the service users central to the process. The home still needs to make the service user questionnaires more accessible But a recommendation remains regarding that under Standard 40. All that is currently needed is for the residents’ views about development to be included in an annual development plan where appropriate and for an annual meeting to be held for residents and relatives to monitor improvements in quality via the implementation of the annual development plan. The following requirement is now set to address this: The home must pull together its Quality Assurance tools into a structured Quality Assurance system that makes the service users central to the process. The home should also ensure that an annual development plan is produced that is open to the service users and information in it should include information from their quality questionnaires. The last inspection report contained the following recommendation. The home should continue to translate policies relevant to the residents into more accessible formats. This is happening with new pictorial staffing rotas, fire evacuation procedures, photo complaints procedure, but needs to continue for activities, menus and some policies that are relevant to the service users, for example, access to files policies. The recommendation therefore remains but it is recognised that this work will need to be ongoing. All of the health and safety policies and procedures relevant to this standard were seen to be present. Moving and Handling, Fire Safety, First Aid, Food Hygiene, Infection Control, and Handling and Disposal of Clinical Waste policies are all also included in staff induction. The testing of systems required in this Standard were also present and inspected. These included fire fighting equipment testing, Portable Appliance Testing, boiler and gas testing, and Bacterial analysis and testing of the water supply. Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 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 2 3 2 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 24 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 YA3 Regulation 18(1) Requirement The home must provide evidence to the Commission that the staff team are adequately trained in the field of brain injury and associated rehabilitation. {The previous timescale has not been met as of the date of this inspection} All staff recruited since April 2002 must undertake six month foundation training to Sector Skills Council workforce training targets and both this training and the induction training must be evidenced. { The previous timescale has not been met as of the date of this inspection } Service users must not be admitted to the home until receipt of the summary of the Care Management assessment and a copy of the Care Plan. The home’s own new placement assessment documentation must cover all the elements of standard 2.3. The home must pull together its Quality Assurance tools into a structured Quality Assurance system that makes the service users central to the process.
DS0000025802.V293099.R01.S.doc Timescale for action 08/05/06 2. YA35 18(1a&c) 08/05/06 3 YA2 14 01/09/06 4 YA2 14 01/06/06 5 YA39 24,1,2,3 01/09/06 Jean Garwood House Version 5.1 Page 25 The home should also ensure that an annual development plan is produced that is open to the service users and information in it should include information from their quality questionnaires. 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 YA5 Good Practice Recommendations The contract should contain the elements of the care plan to be met outside the home through other resources. {From the May 2003 inspection} Care plans should be translated into more accessible formats for the residents. The management should continue with its plans to reintroduce mini outings in the evenings as well as the current week ends. The home should continue to translate policies relevant to the residents into more accessible formats. 2. 3. YA6 YA14 4. YA40 Jean Garwood House DS0000025802.V293099.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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