Inspection on 15/05/08 for Keswick House

This inspection was carried out on 15th May 2008.

CSCI found this care home to be providing an Good service.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Keswick House 16/05/06

Keswick House 22/02/06

Keswick House 29/09/05

Keswick House 05/03/05

Keswick House 22/06/04

Keswick House 10/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

CARE HOME ADULTS 18-65 Keswick House 212 Lightwood Road Longton Stoke-on-Trent Staffordshire ST3 4JZ Lead Inspector Dawn Dillion Key Unannounced Inspection 15th May 2008 10:00 Keswick House DS0000008241.V364891.R03.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 Keswick House DS0000008241.V364891.R03.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. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keswick House Address 212 Lightwood Road Longton Stoke-on-Trent Staffordshire ST3 4JZ 01782 336656 01782 336656 Keswick.house@btconnect.com 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) Mr Alan John Bradshaw Mrs Joy Bradshaw Mrs Joy Bradshaw Care Home 12 Category(ies) of Learning disability (12), Physical disability (2) registration, with number of places Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: Keswick House is located in Stoke On Trent, Staffordshire; the three-storey property provides a service for twelve younger adults. The homes registration category enables them to provide a service for two people who have a physical disability. The property consists of ten single and one shared bedroom, three of which are equipped with en suite and the remaining are fitted with a washbasin. A bathroom is located on first floor, a shower room on the second floor and a toilet on the ground floor. The home also provides a lounge, a separate dining room, kitchen and laundry area. People living in the home have access to a well-maintained garden. Staffing is provided on a twenty-four hour basis, to ensure the total supervision and support of people living in the home. Information relating to the fees charged for the service provided at the home was not made available to us, the reader is advised to contact the home directly for this information. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means the people who use this service experience good quality outcomes. The unannounced key inspection of Keswick House was undertaken within seven hours. The inspection methodologies that were used to establish the quality of care provided and the effectiveness of the management of the home, to promote equality, diversity and best practices, entailed the examination of the records, relating to the homes policies and procedures. During the process of the inspection, four people that accessed the service and three staff members were interviewed, as part of the inspection process to gather an overview of the quality of the service provided by the home. Information contained within the homes Annual Quality Assurance Assessment, is incorporated within the contents of this report. We sent out twelve of our ‘have your say’ surveys to people and received a 100 return. Observations of the premises were undertaken, to ensure that the environment and systems in operation were safe and conducive in meeting the needs of the people who use the service. The Registered Manager was not present on the day of the inspection. What the service does well: People living in the home were able to maintain a lifestyle to reflect their interests; daily routines encouraged participation and social inclusion. The Annual Quality Assurance Assessment identified that, “Clients who are able to are able to take responsible risks, we have risk assessments in place.” One person informed us that, “I’m happy here.” Another person told us, “It’s a nice place to live, I would recommend living here.” One person told us that, “The staff are nice.” Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Keswick House DS0000008241.V364891.R03.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 Keswick House DS0000008241.V364891.R03.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 and 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who may wish to access the service are provided with the necessary information to enable them to have a choice of where they live, to guarantee that their assessed needs will be met to promote their health and welfare. EVIDENCE: People wishing to access the service were provided with relevant information relating to the service and provisions available at the home. The Service User Guide gave information about systems in operation, staff support, access to medical service and the terms and condition of residency. The registered manager should ensure that the Service User Guide is reviewed to identify the fees charged for the service provided at Keswick House. Discussions with the Senior Care Assistant confirmed that no one had been admitted to the home since our last inspection visit. The admissions procedure included a pre admission assessment to enable them to establish whether they Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 9 would be suitably equipped to meet the persons assessed needs. People wishing to access the service were also able to visit the home before moving in, to enable them to have a choice to where they live. Keswick House DS0000008241.V364891.R03.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 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Practices and procedures enable people to be actively involved in decisions affecting they lifestyle to promote individual choice and wellbeing. EVIDENCE: We looked at three care plans, all of which provided detailed information relating to the level of support and assistance the individual required, to meet their assessed needs and to promote their independence. For example, there was a ‘Service User Assessment’ in place to provide staff with information about the level of support the individual required to promote normal daily living and independence. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 11 People using the service are actively involved in the development of their care plan. A 24 hour care plan is in place which was hand written by the person using the service. The plan provided information relating to their daily routine, preferred times to retire to bed and awake, domestic tasks and personal care. The Annual Quality Assurance Assessment stated that, “Care plans are reviewed with clients.” A survey received from a staff member stated, “Care plans are updated with information daily and are always accessible.” Appropriate monitoring systems were in place to promote people’s health and welfare. For example, records were maintained of a persons epileptic seizures to ensure that they were able to share relevant information with the medical consultant. Behaviour displayed by a person living in the home raised concerns about the safety of other people who use the service and whether this person was being provided with sufficient supervision to ensure their welfare. Discussions with people that use the service confirmed that regular meetings were undertaken giving them the opportunity to participate in the running of the home, and to be kept up to date with any imminent changes to the service. We looked at one minute of a meeting, which identified discussions about, menus and social activities. General observations during the process of the inspection evidenced that staffs approach promoted peoples participation in all activities within the home. People were able to take an informed risk to promote their rights and independence and risk assessments were also in place. For example there was a risk assessment in place about road safety. A person who lived in the home told us that, “I like going to Longton and Handley shopping, I like buying writing paper.” The Annual Quality Assurance Assessment identified that, “Clients who are able to are able to take responsible risks, we have risk assessments in place.” Keswick House DS0000008241.V364891.R03.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who access the service are able to make choices about their lifestyle, and are supported to undertake activities that promote their interests and social inclusion to ensure the individuals wellbeing. EVIDENCE: There was a positive emphasis focused on equality and diversity with people having different lifestyles and pursuing various interests. Two people living in the home worked on a voluntary basis at a day centre for the elderly, assisting with meals and social activities. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 13 People also had the opportunity to learn new skills; a number of individuals attended the local college, learning daily living skills, horticulture, jewellery making and sewing. We looked at three care plans that incorporated an activity programme, which included visits to the social club and access to the local library. One person living in the home was from the ethnic minority group and was of the ‘Bahai’ faith, staff informed us that this person did not wish to practice their faith whilst in the home but attended their relative’s home to pursue their faith. People were provided with the relevant support and assistance to enable them to maintain contact with their family and friends. One person informed us that, “I went out for a meal with my mum and dad today.” She also told us that her friends and family visited her at the home. The Annual Quality Assurance Assessment stated, “Family and friends are welcome at anytime.” “Clients go home for weekends to their family, some go on holiday with their family.” Discussions with staff and the examination of care plans also confirmed that people were able to develop and maintain intimate relationships. General observations during the process of the inspection confirmed that the conduct of the staff promoted the rights and privacy of people living in the home, for example staff were observed knocking on bedroom doors prior to entering. Staff asked people their preference with activities, such as cooking and social activities. The Annual Quality Assurance Assessment stated that, “Clients are able to join in with general cleaning of the home, cooking and laundry.” Information contained within the care plan identified discussions about people having the option to whether or not they wanted a privacy lock on their bedroom door. One person informed us that, “I am not bothered about having a lock on my door.” One person informed us that, “I’m happy here.” Another person told us, “It’s a nice place to live, I would recommend living here.” With reference to mealtimes, we spoke to three people who use the service who were preparing and cooking the evening meal. One person informed us that, “The meals are lovely, I help the staff cook.” Another person said, “The food is nice, curry is my favourite.” Keswick House DS0000008241.V364891.R03.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs to promote their wellbeing. The principles of respect, dignity and privacy are put into practice to ensure equality and diversity. EVIDENCE: The majority of people living in the home were fairly independent requiring limited support with personal care. Care plans were detailed to provide staff with relevant information relating to the level of support the individual required to maintain their independence. The Annual Quality Assurance Assessment identified that, “Flexible personal support is provided to ensure clients dignity and control over their lives.” Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 15 Care plans evidenced that people had access to relevant healthcare services to promote their general health and welfare. Records also evidenced that people were offered the option of an annual health check and had routine health screening, for example opticians, dentist and chiropodist. With reference to the homes medication system and practices, records that were examined evidenced that people were receiving their medicines as directed by the prescribing General Practitioner to promote the individuals general health. A written protocol was in place for the use of homely remedies. Discussions with staff and the examination of training records confirmed that staff had received medication training. Information contained in one care plan identified that this person selfadministered their medicines. The care plan stated that on a weekly basis staff would monitor medicines, to ensure that this individual was taking the medication appropriately. A risk assessment was also in place to ensure the safety of this person. Keswick House DS0000008241.V364891.R03.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 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a complaint procedure to ensure their welfare. The homes recruitment procedures ensure that people are protected from abuse. EVIDENCE: The home had a complaints procedure that was accessible to people living in the home. The examination of records relating to complaints received by the home identified that they were recorded and also identified what action was taken to resolve the concern or complaint. The complaint procedure identified that people living in the home did have access to a self-advocate, providing them with independent support if and when necessary. This was also identified within the care plans we looked at. One person said, “If I had a complaint I would tell the staff.” Another person told us that, “If I had a complaint I would speak to the staff, they are good at sorting things out.” Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 17 The Annual Quality Assurance Assessment identified people who do not have capacity, “We would observe for anything untoward and if necessary ask an advocate to be involved.” We have not received any complaints or safeguarding issues relating to the home. The home had received two complaints within the past twelve months; one was related to a relatives concern about maintaining the safety of his daughter and the other complaint was about a radiator not working. The examination of records and discussions with the Senior Care Assistant evidenced that these complaints had been addressed appropriately. Two out of three staff that were interviewed were not sure of meaning of safeguarding also known as adult protection. However, all three confirmed that they had received adult abuse training. All confirmed that they were in receipt of the whistle Blowing policy. We observed that staff had access to the homes safeguarding policy and the ‘No Secret’ book. The registered manager should ensure that the safeguarding policy is reviewed to ensure that contact details are up to date. Discussions with staff confirmed that all people living in the home required some element of support with managing their financial affairs. We looked at three balance sheets and funds held in safekeeping, all appeared satisfactory. Keswick House DS0000008241.V364891.R03.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 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The design and layout of the home promotes peoples privacy and general comfort. The lack of emphasis focused on health and safety may compromise the safety of people living in the home. EVIDENCE: Keswick House is located in Stoke On Trent, Staffordshire; the home is accessible via public transport and is close to all local amenities. The three-storey semi detached house consisted of two properties, the internal design allowed access to both properties and the exterior was maintained as Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 19 two properties in keeping with the local area. The home provided ten single and one shared bedroom, located on the ground, first and second floor. Information contained within one of the care plans evidenced that people were given the opportunity to choice how they wanted their bedroom decorated. Three bedrooms were equipped with an en suite and the remaining were fitted with a washbasin. The service provides a lounge, dining area, a domestic style kitchen and laundry. People living in the service have access to a well-maintained garden. We noted that the shed in the garden was in a state of disrepair and that the glass was not secured, compromising the health and safety of people accessing the garden area. The home has recently been adapted to provide additional bedrooms and communal areas and have applied for registration for these bedrooms. The hygiene and cleanliness of the home was of a good standard. Keswick House DS0000008241.V364891.R03.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, 33, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a skilled and experienced team of staff, who ensure that peoples’ assessed needs are catered for to promote their health and welfare. EVIDENCE: The Senior Care Assistant told us that there were thirteen staff members employed within the home and that twelve had obtained the National Vocational Qualification and one person was currently undertaking the training. The home was registered to accommodate twelve people, on the day of the inspection the staff informed us that two people had gone on holiday with the registered provider/manager. We looked at the staff working rotas that evidenced that two Care staff were provided in the morning and afternoon, having one wakeful night staff and one person sleeping in. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 21 Discussions with one person who accessed the service informed us that, “The staff are nice.” One staff member told us that, “There is a good relationship between clients and staff.” Discussions with a staff member confirmed that one person required close supervision when in the community, however the behaviour this person displayed in the home on the day of the inspection, raised concerns to the level of supervision provided to this individual, to safeguard other people who use the service. It has been identified as a requirement that an appropriate assessment of this individual should be undertaken to ensure that the home is suitably equipped and staffed, to cater for this persons needs to ensure their safety and welfare. Information derived from a staff survey stated, “There is always enough staff to meet individual needs but if a client was to deteriorate obviously more staff would be needed.” With reference to the homes recruitment procedure, we looked at three staff files, which evidenced that appropriate safety checks were undertaken prior to people commencing employment, to ensure the safety of people who use the service. Information obtained from staff surveys confirmed that they received an induction when they commenced employment within the home. The examination of the ‘Training Record Log,’ identified that staff had received the following training within the last 12 months: Fire safety, food and hygiene, coping with aggression and health care plans. This information was also identified within the staff surveys. Keswick House DS0000008241.V364891.R03.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 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management of the service promotes equality and diversity to ensure that people are able to live a lifestyle of their choice to guarantee the individuals health and general welfare. EVIDENCE: The registered manager was not present on the day of the inspection, however the staff left in charge of the home were skilled and experienced and were able to assist us with the facilitation of this inspection. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 23 The previous inspection report stated that, “The manager was enthusiastic to consider and discuss alternatives available for service users, and to enable individuals to become more independent.” The Annual Quality Assurance Assessment identified that the registered manager had obtained the Registered Managers Award and had 20 years experience in social care. Quality Assurance questionnaires were distributed to people living in the home, staff and other outside agencies, to ascertain people views on the quality of the service delivery. The Annual Quality Assurance Assessment identified that information collated from the questionnaires were discussed with people that use the service. We received a hundred 100 return of service user survey with a positive response relating to the service provided at Keswick House. The Annual Quality Assurance Assessment provided by the home was not fully completed and the information contained insufficient detail of how the home would improve the service in the future, to maintain the quality of the service delivery. One staff member told us that, “The management support is good and I feel comfortable, I have all the training I need.” Information obtained from a staff survey stated, “My manager is excellent she gives me all the support I need and meets with me regularly to discuss how I am working.” With reference to systems and practices that promote the health, safety and welfare of people who lived at the home, records evidenced that routine safety checks were undertaken. The Registered person should ensure the glass on the shed is secured. Keswick House DS0000008241.V364891.R03.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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 3 Keswick House DS0000008241.V364891.R03.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 YA33 Regulation 18(1)(a) Requirement An assessment of the identified person should be undertaken to ensure adequate staffing levels are provided to ensure the protection of other people living in the home this is to promote safety of all people who use the service. Timescale for action 20/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA39 Good Practice Recommendations To review the Service User Guide to ensure the fees charged for the service and provisions are identified. The Annual Quality Assurance Assessment should be fully completed to provide an accurate reflection of the service provided and how the home will maintain the quality of the service delivery. Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Keswick House DS0000008241.V364891.R03.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!