Inspection on 23/11/07 for Juliana Close 46

This inspection was carried out on 23rd November 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Juliana Close 46 13/06/08

Juliana Close 46 11/04/07

Juliana Close 46 04/04/06

Juliana Close 46 12/12/05

Juliana Close 46 12/07/05

Juliana Close 46 12/08/04

Juliana Close 46 30/04/04

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Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Juliana Close 46 Off Thomas More Way East Finchley London N2 0TJ Lead Inspector Tom McKervey Key Unannounced Inspection 23rd November 2007 10:00 Juliana Close 46 DS0000010456.V350853.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 Juliana Close 46 DS0000010456.V350853.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. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Juliana Close 46 Address Off Thomas More Way East Finchley London N2 0TJ 020 8343 0016 F/P 020 8343 0016 sandrapower@adepta.org.uk www.pentahact.org.uk Adepta 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) ** Post Vacant *** Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user. One specified service user who is over 65 years of age, may continue to be accommodated in the home for as long as the home continues to meet the service user`s needs. The home must advise the regulating authority at such times as the specified service user vacates the home. 11th April 2007 2. Date of last inspection Brief Description of the Service: 46 Juliana Close is a purpose-built home designed to provide personal care and support for six adults of either gender, who have a learning and a physical disability. The home, which opened in November 1993, is leased from Servite Housing Association and is managed by Adepta, which is a Barnet based organisation. Adepta also manage several other homes in the borough. The six places available, are funded by a block contract with the local authority. The home is a six-bedded bungalow in a quiet cul-de-sac in a housing estate. The communal areas comprise of a large lounge, a quiet room and a kitchen/diner. There are two assisted bathrooms, two toilets and a shower room, and there are gardens to the front, side and rear of the property. The home has its own vehicle, which can accommodate wheelchairs. The stated aims of the home are to provide twenty-four hour care and support for people with profound learning disabilities and to enable them to live as independently as possible in the community. The fees for the service are £1,429.26 per week. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out as part of the Commission’s inspection programme to check compliance with the key standards and also to assess how the requirements from the last inspection had been complied with. The inspection was completed in a period of four hours and fifteen minutes. At the time of the visit, a new acting manager was in post and she offered every assistance in the inspection process. Before this inspection, an AQAA, (Annual Quality Assurance Audit), was sent to the Commission. This document is a self-assessment of how the home meets the National Minimum Standards. Against each standard, the manager is asked to provide evidence about what the home does well, what they could do better, how they have improved in the last 12 months and what their plans are for improvement. I discussed the content of the document with the acting manager and suggested areas where the information could be improved. Six people were living at the home, all of whom have lived there for several years and there were no vacancies. The inspection process included visiting all areas of the home, observing the residents and speaking to the acting manager and staff. It was not possible to interview the residents because of their limited verbal skills. However, I noted that there was frequent communication between the staff and the residents during the inspection. The process also included looking at records and examining documents pertaining to the running of the home. What the service does well: The accommodation is purpose-built to make all areas of the home fully accessible for wheelchair users. The residents’ bedrooms are individualised and decorated to reflect their personal tastes. Residents enjoy a good quality of life and they are well supported by a dedicated staff team. There is a good range of activities that keep the residents stimulated and they enjoy full access to the facilities in the community. Care plans are person centred in a way that involves them and their relatives in deciding how their needs are best met. The staff ensure that residents’ health is maintained by regular check-ups and specialist appointments. The organisation provides a very good training and development programme for its staff and recruitment procedures are thorough in ensuring that new staff are properly screened before working in the home. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: I found that two of the previous requirements were not met which could have an impact on the welfare and safety of the people who live in the home. As identified at previous inspections, there is a persistent problem with staff not always signing when they administer medication. This could cause mistakes to be made which could compromise the safety of residents. The settee in the residents’ lounge is broken and needs to be replaced for their comfort and the cleanliness of the oven should be monitored so that food hygiene is improved. There have been several managers appointed to run this home in a relatively short period of time. The Commission is concerned about the lack of consistency of approach in the day-to day management of the home. This poses a risk that residents are not having continuity in their care and staff morale could suffer. The organisation must ensure that the acting manager applies for registration within the timescale stated. Attention is needed to improve the fire safety of internal doors, which have gaps around the edges, so that residents and staff are better protected from risks from fires. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 7 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. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): No new residents have been admitted to the home for several years; therefore, these standards were not assessed. EVIDENCE: Juliana Close 46 DS0000010456.V350853.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, 8 & 9. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including looking at residents’ records. Each person living in the home has an individual care plan that sets out their personal, social and health needs and provides clear guidance for staff about how best to support them. Risk assessments ensure that the residents are able to partake in a wide range of activities at home and in the community and they are supported by staff to live as independently as possible. EVIDENCE: The home has adopted a person-centred approach to care planning and at the time of the inspection, the new plans had been implemented for three people. The acting manager told me that she is in the process of preparing new care plans for the other three residents. I looked at the three new care plans, which provide a comprehensive view of the resident and which involves them and their relatives in the process. Each Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 11 person has an identified key-worker, who is responsible for keeping the care plan up to date. The care plans were very detailed and included life histories. They provided good information and guidance about how to meet the person’s needs. This is important because none of the residents are fully articulate and this guidance ensures that staff interact with residents in a consistent manner. The residents’ care plans also contained guidelines for staff about how to support them to make choices. For example; “X can get frustrated when they don’t understand. You need to explain via objects of reference or pointing to show what they are meant to do”. For a person who is partially sighted; “Staff need to stand directly in front of X in their line of vision when communicating with them. “X” chooses clothes and shoes by picking out what they wants to wear”. Residents choose meals at weekly meetings where pictures of meals are shown to them. Detailed risk assessments are carried out for each resident that addresses activities in the home and out in the community. There are three male and three female residents. In the AQAA document, the acting manager identified the residents as being British, two of whom are Christian and one is Jewish. One person attends religious services regularly. In accordance with the family’s wishes, the Jewish resident does not require specific meals. Juliana Close 46 DS0000010456.V350853.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including examining case files and observing staff. The people who live in the home have a lifestyle that reflects their individual needs and aspirations and staff support them to access the local community resources. There is a good programme of stimulating activities that enhance residents’ development and they are treated with courtesy and respect. The residents are supported to choose their meals, which are well balanced and nutritious. EVIDENCE: Five of the residents attend day centres or colleges during the week. The sixth resident is elderly and is supported on frequent outings in the local community and has a programme that includes reflexology. This person also attends church and visits a friend who lives in another residential home. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 13 A record is made after each shift about what activities the residents take part in. These include, assistance with food shopping, going out for meals in local pubs and restaurants and using leisure centres for swimming etc.. A computer has been installed for use by the residents to play games and there is sensory equipment for stimulation and relaxation. There are records of residents being visited by relatives or going home for weekends, and there are procedures in place for them to express their sexuality appropriately. The home has an equal opportunities policy. None of the residents have keys to their bedrooms because of their profound disabilities, but I observed that staff knocked on bedroom doors before entering. I noted that staff spoke to the residents constantly and in a courteous and caring manner, addressing them by their preferred names. The residents appeared well cared for and were appropriately dressed in clean clothes. One resident is a practising Christian and attends religious services regularly. The service provides support for a non-practising Jewish resident who does not currently require any specific diet. There is a letter to this effect from this person’s relatives. The menus showed a good variety of nutritious meals and the people who live in the home are supported in planning the menu at weekly meetings. One resident has diabetes and another is overweight. Both residents are on appropriate diets as advised by the dietician. . Juliana Close 46 DS0000010456.V350853.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 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence from residents’ health records and assessing medication standards. The personal care of residents is provided discreetly and with dignity and their physical and emotional needs are generally being met. However, there is a persistent problem in this home of poor recording of administration of medicines, which potentially puts residents’ health and safety at risk. EVIDENCE: I observed that bathroom and toilet doors were kept closed when staff were supporting residents with their personal care. The residents’ care plans provide guidance about how each resident prefers their personal care to be supported. The staff rota confirmed that there was always male and female carers on duty to ensure that care was provided in an appropriate dignified manner with respect to the gender of the resident. All the residents are registered with a G.P, and up to date records are kept of healthcare appointments. One resident has diabetes, and all staff had been Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 15 trained by the District Nurse to monitor their blood glucose and to administer insulin. The residents’ case files contain information about appointments with psychiatrists and psychologists as appropriate, and individual physical and emotional needs of the people who live in the home were well documented in their care plans. None of the residents are able to self-medicate. There is an appropriate medication procedure, and the medication was stored safely, but there were some gaps in the administration records where staff had failed to sign after giving medication. This is a frequent finding at previous inspections, which compromises the safety of the residents and I am restating a requirement that this problem must be addressed. Juliana Close 46 DS0000010456.V350853.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 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including observation, speaking to staff and examining records. Although there is an appropriate system to ensure that complaints are dealt with, the proper procedure for recording complaints has not been followed. The residents can be confident that they are protected from potential abuse because of staffs’ training and awareness about abuse issues. EVIDENCE: I noted that a comment had been made by a resident’s relative in the minutes of a relatives’ meeting. This was about medication that was not in a blister pack when sent with the resident when he went home for the weekend. A complaint form was sent to the relative, but this was not logged as a complaint in the complaints records and a requirement is made to ensure that all complaints are logged and responses are recorded. The residents appeared well cared for and they indicated that they were happy in the home. There was a relaxed and friendly atmosphere and the interactions between the staff and residents were warm and friendly. The staff records showed that they had attended training in adult protection procedures, and those who were spoken to, were knowledgeable about the “whistle-blowing” procedure and their roles in relation to protection of the residents from abuse. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 17 Juliana Close 46 DS0000010456.V350853.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, 26 & 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including visiting all areas of the home. The comfort and wellbeing of the residents has been improved by redecorating communal areas, and addressing some maintenance issues, but residents would benefit from having some new lounge furniture and more attention being paid to keeping the kitchen area clean. EVIDENCE: I visited all internal and external areas of the home, including bedrooms. In the kitchen, the oven was not very clean which was also identified at the last inspection. This was immediately addressed in my presence. The lounge and dining areas were clean and tidy. I was informed that the home did have a cleaner for a while, but she had left, so care staff are doing the cleaning until a new one is recruited. At the time of the inspection, the general standard of cleanliness was good and there were no offensive odours. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 19 The residents’ bedrooms were clean and tidy and were decorated in accordance with residents’ personal tastes. Each bedroom had personal mementoes and family photographs. The requirements at the last inspection regarding the removal of old furniture outside the home had been complied with and this area was now tidy, and the garden had been maintained. The lounge carpet had been cleaned and the walls in the communal areas had been repainted. I noted that a lounge settee was broken and was propped up on a brick. The acting manager told me she was in the process of ordering a replacement , but I am making a requirement to ensure this is done soon. There had been a long-standing serious problem with the drainage system in a shower room that caused a foul odour. This problem had been resolved and the shower was back in use. Juliana Close 46 DS0000010456.V350853.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): 31, 32, 34 & 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including examining staffs’ records. The residents’ needs are being met by the number and skills of the staff and they are protected by thorough staff recruitment policies and procedures. EVIDENCE: Since the last inspection, a new member of staff was employed and the acting manager said there were two part/time vacancies that were covered by bank staff who worked regularly at the home and knew the residents well. The new staff’s records showed that they had a written induction programme, which covered all areas of care and the policies and procedures in the home. The group of staff to whom I spoke, were knowledgeable about the people living in the home and their roles in providing care and support. The staff rota accurately identified the staff on duty and showed that there was a sufficient number of staff available to support the residents. I saw a print-out of the staffs’ training programme, which was comprehensive. For example; they had attended courses on the mandatory health and safety subjects, epilepsy and medication. Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 21 The staff records also showed that they had been properly screened before starting work in the home. This included obtaining references from previous employers. There was a reference number for each staff, showing that they had been checked by the Criminal Records Bureau. Juliana Close 46 DS0000010456.V350853.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, 41 & 42 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Frequent changes of managers is causing concern about the lack of consistency of approach in the day-to day management of the home. This poses a risk to residents by not having continuity in their care and a risk that staff morale is adversely affected. There has been an improvement in how residents’ money is accounted for which safeguard their interests. Checks are being carried out on health and safety systems in the home, but urgent attention is needed to improve the fire safety of internal doors to protect residents and staff from harm. EVIDENCE: Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 23 This home has had several managers over the past four years. The most recent manager was only in the home for a short period before being transferred to another home. This post is currently being filled by an acting manager who was transferred from another Adepta home, where she worked for some time with a similar client group. She has recently applied for the manager’s post. The staff that I spoke to, expressed concern about the frequent turnover of managers and the inconsistent support they have had in recent years. However, they had confidence in the present acting manager’s ability and hoped she will be successful in her application for the post. I saw minutes of meetings between the staff and the people who live in the home and also relatives’ meetings, which showed that they had an input into the running of the home. I checked the money held on behalf of the residents and found that it balanced against the recorded amount. Receipts were seen for goods purchased on residents’ behalf. I was satisfied that money was not being borrowed from residents and lent to others, which was a practice I found at the last inspection. The manager told me that there is still a problem with the bank regarding authorising signatories for those who can withdraw residents’ money, but steps are being taken to resolve this. A recent health and safety survey of the building identified that there were significant gaps around internal doors that compromise fire regulations. This had not been addressed at the time of the inspection and I am making a requirement for this matter to be attended to urgently. COSHH materials are now safely stored and the food stored in the fridge was properly sealed and labelled. Staff have been trained in health and safety issues and the fire log showed that fire alarms were checked weekly. Juliana Close 46 DS0000010456.V350853.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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 X 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 2 X 2 X 3 X 3 2 X Juliana Close 46 DS0000010456.V350853.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 YA20 Regulation 13(2) Requirement Staff must sign for all administered medication. This requirement is restated from the last inspection. The previous timescale was 31/05/07. All complaints must be properly logged, along with the response made and the outcome. A new settee must be provided for the comfort of the residents. The kitchen oven must be regularly cleaned to ensure good food hygiene. This requirement is restated from the last inspection. The previous timescale was 31/05/07. A manager must be appointed who is qualified and experienced to manage the home. Until this time, acting manager must apply for registration with the Commission for Social Care Inspection to ensure continuity for the people who live in the home. The recommendations of the DS0000010456.V350853.R01.S.doc Timescale for action 31/12/07 2. 3. 4. YA22 YA24 YA30 22(2) 16(1)(c) 23(2)(d) 31/12/07 31/12/07 31/12/07 5. YA37 8.1(a) 31/01/08 6. YA42 13(4)(a)(c) 31/12/07 Page 26 Juliana Close 46 Version 5.2 health and safety audit regarding internal fire doors must be implemented. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Juliana Close 46 DS0000010456.V350853.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Juliana Close 46 DS0000010456.V350853.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. 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