Inspection on 05/07/07 for Langley House

This inspection was carried out on 5th July 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langley House 20/06/08

Langley House 01/08/06

Langley House 02/03/06

Langley House 15/11/05

Langley House 31/03/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Langley House Langley Marsh Wiveliscombe Somerset TA4 2UF Lead Inspector Jane Poole Unannounced Inspection 5th July 2007 09:30 Langley House DS0000060091.V337873.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 Langley House DS0000060091.V337873.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. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langley House Address Langley Marsh Wiveliscombe Somerset TA4 2UF 01984 624612 01984 624797 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) Voyage Ltd Care Home 14 Category(ies) of Learning disability (14), Physical disability (1) registration, with number of places Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There is a low doorway in the bedroom on the second floor within the three bedded unit. This room is suitable only for service users who are under 5 ft 2 in in height. 2. Registered for one named person with a learning disability and physical disability to reside within the main house. (Please see letter from CSCI dated 12/10/04). Date of last key 1st August 2006 inspection Brief Description of the Service: Langley House is a large detached home set in its own grounds. It is registered with the Commission for Social Care Inspection to provide care for up to fourteen people between the ages of 18 - 65 years who have a learning disability. The home can also accommodate one client who also has a physical disability, within the main house - which has two ground floor rooms accessible for such clients. It also has eight first floor bedrooms. There is a separate annexe providing accommodation for up to three people, and a self-contained flat for one person, at the site. The registered manager is currently not working in the home but remains employed within the company. There is an acting manager in place. Fees at the home are determined on an individual basis dependant on assessed need. 1. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 7 hour period spread over two visits. Before the inspection the home completed an Annual Quality Assurance Assessment which sets outs their own assessment of the care and their plans for future. 8 Relatives/carers completed questionnaires prior to the inspection and some of their comments have been included in this report. One health and social care professional also completed a comment card. During the inspection the inspector was able to meet with staff and service users, observe care practices, tour the building and view records. What the service does well: Langley House cares for people who have complex needs and can present challenging behaviour. There is a warm, friendly atmosphere in the home and the inspector observed constant interaction between staff and service users and much laughter. Staff encourage service users to make choices about their day to day lives including the activities they wish to take part in and the food they eat. Many of the service users are non-verbal and staff were seen to be communicating using signs and non verbal cues. There are no strict routines and staff were aware of individuals preferences. Care plans give clear guidelines for staff about the abilities and needs of service users. At the present time there is no registered manager in the home but a very competent acting manager is in place. Staff spoken to described the acting manager as open and approachable and stated that there was a strong sense of teamwork with everyone communicating effectively and supporting each other. Staff demonstrated a strong commitment to the service user group. One relative wrote on their questionnaire “saying thank you to the staff does not seem enough.” Langley House DS0000060091.V337873.R01.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. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective service users are fully assessed and given opportunities to spend time in the home before they become a permanent resident. EVIDENCE: The acting manager is in the process of updating the statement of purpose and the service user guide to reflect the changes in the management of the home and the company. The inspector viewed the documentation relating to the newest service user and discussed their admission with staff. The staff had been able to visit and assess the suitability of the most recently admitted person in their previous placement. The acting manager gave evidence that when assessing prospective service users the home considers not just the needs of the individual but also how they will fit into the existing group. Service users are able to visit the home before a decision about it becoming a permanent placement is made. Staff stated that they work with existing carers to make any transition as smooth as possible. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 9 Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a care plan that reflects their abilities and needs. Risk assessments are in place to ensure that service users are able to safely take part in a variety of activities. EVIDENCE: All service users have a care plan, which outlines their needs and abilities. The inspector viewed two care plans in detail, they covered areas such as health, medication, diet, self help skills, daily living skills, social, communication and behaviour. There was evidence that these plans were reviewed on a regular basis and up dated in line with changing abilities, behaviours and needs. Staff record daily events and keyworkers write monthly summaries, which inform the care plan. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 11 Staff encourage service users to make decisions in line with their abilities to do so. The inspector observed staff offering choices of activity and food to service users. Service users are able to decide how they spend their time. Some people like to spend time in communal areas others prefer the privacy of their own bedroom. It is strongly advised that the home makes all staff aware of the implications of the Mental Capacity Act 2005, which gives guidance on assessing capacity and making decisions in respect of other people. No service user manages his or her own finances. The company acts as an appointee for 5 service users and the home holds personal finance for all service users to ensure that they are able to access their money at all times. The inspector viewed the records pertaining to personal finance and some advice was given. Risk assessments are in place covering a range of activities and behaviours. The inspector noted that one risk assessment had not been up dated in line with a change in practice. Langley House DS0000060091.V337873.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): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines in the home are flexible to meet the needs of individual service users. Service users access a variety of leisure facilities but staff expressed concerns that recent staff shortages had meant that service users were not going out as often as they needed to. EVIDENCE: There are no strict routines in the home and staff are guided by the preferences of individual service users. Service users are encouraged to take part in the daily activities of the home, the inspector saw that one service user was helping to take out rubbish and another was undertaking some cooking with a member of staff. In the three bedded unit there is a washing machine where one service user, at times, does their own laundry. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 13 During the inspection the inspector observed constant interaction between staff and service users. Many of the service users do not use verbal communication but the staff appeared competent in interacting with service users using signs and non-verbal cues. Many of the service users have TVs and radios in their rooms and are able to spend time alone if they wish to. There is unrestricted access to all communal areas. One service user continues to access fulltime education. There are many organised activities such as horse riding, trampolining, massage, walking, trips out and shopping in the local area. Staff stated that the local community had initially not been welcoming to service users but they are now much more part of the local community are welcomed in shops and pubs. Some staff stated that recent staff shortages had meant that activities outside the home had not been as frequent as they felt service users needed. On the first day of the inspection tramploining was cancelled due to insufficient staff. Many service users have holidays away from the home with family members and also with staff from the home. There is a payphone and service users are encouraged to keep in touch with family members. Staff assist service users to visit family members, some of whom live some distance away. On the first day of the inspection two members of staff went with a service user to visit their family. Relatives who completed questionnaires stated that service users are assisted to keep in touch by visits and phone calls. Many also commented positively on the way in which the staff enable service users to access community facilities in line with their individual interests. There is a five-week menu in the home which offers a variety of food in line with service users known likes and dislikes. Care staff are responsible for all cooking in the home and a member of staff in the main house prepares and cooks for all areas of the home, it is then taken to individual units. Staff stated that they offer a healthy diet with occasional treats such as meals out or take-aways. The inspector noted that the kitchen was well stocked with good quality food. Care staff are also responsible for shopping and they are usually accompanied by a service user. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 14 Langley House DS0000060091.V337873.R01.S.doc Version 5.2 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. 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. Service users have access to healthcare professionals in line with their individual needs. Care plans give details of the level of assistance required with personal care and staff demonstrate a good knowledge of preferred routines. EVIDENCE: The home employs both male and female staff, which enables service users to express a preference about the gender of the person who supports them with intimate personal care. One relative commented that they had been particularly impressed by the way that staff from the home had supported hospital staff when their relative had been admitted. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 16 The health and social care professional who completed a comment card stated that they were always able to see their patient in private and were satisfied with the overall care provided to service users. All service users have en suite bathrooms and care plans give details of the level of assistance that people require with personal care. There are no strict times for getting up or going to bed but staff appeared to have knowledge of individuals preferred routines. Care plans also give details of appointments attended and these show that service users are accessing, doctors, dentists, opticians and chiropodists. Service users are weighed on a monthly basis. Many of the service users keep their clothes in locked cupboards and staff confirmed that they helped people to choose clothes on a daily basis. There are adequate storage facilities for medication in all three units of the home. The inspector viewed the Medication Administration Records (MARs) in the main house. All were well maintained and correctly signed. There are no guidelines for the administration of medication that has been prescribed on an as required basis (PRN). There needs to be clear guidelines in place to ensure that a consistent approach is taken. Senior staff receive a one day training course in the administration of medication and other care staff undertake half a days training in this area. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Policies and procedures in place minimise the risk of abuse to service users. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Policies on making a complaint and abuse are in easy read format. Staff spoken to were aware of the whistle blowing policy and all those asked stated that they were confident that any issues raised would be taken seriously. Staff had undertaken training on the protection of vulnerable adults and this is also included in the induction programme. It is recommended that all staff now receive training in the implications of the Mental Capacity Act 2005. The inspector noted that the policies in respect of the protection of vulnerable adults had been discussed at a recent staff meeting. All staff are checked against the Protection Of Vulnerable Adults (POVA) register and undergo an enhanced Criminal Records Bureau (CRB) check before they commence work at the home. Langley House DS0000060091.V337873.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, 2, 28 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All service users have single rooms which are equipped to meet their individual needs. Many areas of the home would benefit from redecoration and deep cleaning. EVIDENCE: Langley House is situated in a semi rural location, but a short distance away from local facilities such as shops, cafes and pubs. It is fitted with a fire detection system. There are alarms on bedroom doors which are turned on at night. This means that night staff are able to respond quickly to assist anyone who leaves their room during the night. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 19 The premises are split into three units; the main house is able to accommodate up to ten people, there is a smaller house for three people and a single occupancy bungalow. All are set around a courtyard area and all have access to outside garden areas. The inspector toured the home with the acting manager. All bedrooms are for single occupancy and all have en suite facilities. One person has a key to their bedroom and other service user rooms are locked by electronic keypads, which can be de-activated in line with the individuals needs and ability. Bedrooms are furnished and decorated according to the individual needs of the service users. This ranges from extremely minimal with washable walls to very personal with personal furniture, TVs and music centres. There was a strong malodour in one en suite making the room extremely unpleasant. Each unit has its own lounge and dining area. The main meals are cooked in the main house but all units have kitchens for making drinks and snacks. Service users have unrestricted access to all communal areas. Communal areas have comfortable leather sofas but were in need of redecoration and were not homely in appearance. There is a small laundry with one washing machine and two driers. There are hand-washing facilities for staff in the laundry, but limited facilities around the home. Many areas of the home were shabby and in need of redecoration and deep cleaning. A part time maintenance person has recently been appointed and it is hoped that this will improve the standards of décor. Langley House DS0000060091.V337873.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, 33, 34, 35 & 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff demonstrate a good understanding of the needs of service users. There have been staffing shortages but the home are actively recruiting new staff. EVIDENCE: Without exception all 8 relatives/carers who completed questionnaires prior to the inspection praised the staff working at the home. Comments included “We are impressed by the staff due to the professional way the service users are cared for” “ staff are very patient and kind” and “can not fault Langley House staff in any way what so ever.” The inspector was able to meet with staff on duty and observe interactions with service users. The inspector was impressed by the level of interaction and staff spoken to demonstrated a strong commitment to the service user group. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 21 Many staff spoken to raised concerns about staffing levels in the home. The inspector viewed the duty rotas for the past 4 weeks and noted that staff levels varied greatly. For example on one morning, when there was a planned activity outside the home, there were five members of the care staff team on duty covering all three units but on the previous Sunday there had been nine staff on duty. Care staff are also responsible for all cooking, cleaning and laundry in the home. Since the acting manager took up his position he has highlighted staff training as an area that the home could improve upon. The majority of staff have now completed up to date statutory training. The acting manager is carrying out individual training needs assessments and encouraging staff to undertake training relevant to the needs of service users. Staff confirmed that they are always paid to attend training courses. According to pre inspection information supplied by the home only 3 people have a National Vocational Qualification (NVQ) at level 2 or above, this is only 10 of the care staff. A further 10 members of staff have now registered and begun the award. The inspector was able to speak with a new member of staff. They felt that they had received a good induction into the home and had been well supported by all staff. All staff stated that they receive regular supervision. The acting manager supervises senior staff and they in turn supervise less experienced staff. All staff are able to ask to have supervision with the acting manager. The inspector saw details of supervision in staff files. There are regular staff meetings and staff confirmed that this was an opportunity to raise concerns and share ideas. The inspector saw minutes of recent meetings; issues discussed included staff shortages and the home’s Protection Of Vulnerable Adults policy. The acting manager acknowledges that there have been shortages of staff and is actively recruiting at the moment. The inspector viewed the recruitment files of the three most recently appointed members of staff. All had application forms, contracts and evidence that CRB checks were in place. Written references are now kept at the company’s head office but the manager was able to confirm that he had received two written references in respect of each member of staff. After prospective staff are interviewed they spend a short period of time with staff and service users and the manager asks for feedback and the views of service users. Langley House DS0000060091.V337873.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): 38, 39 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there is no registered manager at the home, the acting manager is competent and manages the home taking into account the needs and wishes of service users and staff. EVIDENCE: Staff in the home stated that the registered manager is currently seconded to another role within the company away from the home. An acting manager is in place who was available on the morning of the first day and was able to meet with the inspector on the second day of this inspection. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 23 The acting manager demonstrates an excellent knowledge of the service users and their needs. Staff described the acting manager as approachable and knowledgeable. It was apparent that the acting manager leads by example and has a good rapport with both service users and staff. The acting manager is planning to undertake the Registered Managers Award (NVQ level 4 ) beginning in September of this year. There are clear lines of accountability in the home; there is the acting manager, acting deputy and a group of senior carers. The healthcare professional who completed a comment card prior to the inspection answered YES to the question ‘Is there always a senior member of staff to confer with?’ All records requested were made available. A fire log shows that fire detection equipment is tested regularly in house and the system is serviced by outside contractors. All accidents are recorded. Pre inspection information completed by the home states that portable electrical appliances were tested in August 2006, the heating system was serviced in September 2006 and a landlords gas safety certificate was issued in August 2006. The company has systems in place to audit the quality of care, these include monthly visits and annual service reviews which include the views of service users, families and professionals. An up to date certificate of insurance in the office. Langley House DS0000060091.V337873.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 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 x 28 2 29 x 30 2 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 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 2 X 1 3 3 x x 3 x Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 25 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 YA42 Regulation 13(6) Requirement All staff must be provided with all mandatory training, including Safe Handling, and updates as they become due. (Previous timescale of 28/02/07 not met) Risk assessments must be kept up to date to ensure they reflect current risks and control measures in place. The responsible person must ensure that the home is adequately staffed at all times. The domestic duties of care staff must be reviewed to ensure that it does not detract from the care of service users or compromise infection control procedures. Timescale for action 01/11/07 2 YA9 13 (4) [b] 30/07/07 3 4 YA33 YA33 18(1) 18 (1) 13 (3) 30/07/07 30/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 26 1. 2 3 4 YA24 YA20 YA32 YA32 More frequent maintenance services should be provided to repair damaged paintwork, flooring and to maintain carpets clean and fresh. Clear protocols for the use of ‘as required’ medication should be in place to give guidance for staff and provide consistency. All staff should receive training about the implications for practice of the Mental Capacity Act 2005. 50 of care staff should be trained to NVQ level 2 or above. Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Langley House DS0000060091.V337873.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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