Inspection on 09/05/06 for Langthorne Road

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Langthorne Road 15/04/08

Langthorne Road 21/06/07

Langthorne Road 08/12/06

Langthorne Road 21/03/06

Langthorne Road 25/05/05

Langthorne Road 25/02/05

Langthorne Road 07/09/04

Langthorne Road 12/02/04

Similar services:

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

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

CARE HOME ADULTS 18-65 Langthorne Road 136 Langthorne Road Leytonstone London E11 4HR Lead Inspector Robert Sobotka Unannounced Inspection 9th May 2006 02:00 Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Langthorne Road Address 136 Langthorne Road Leytonstone London E11 4HR 020 8989 5768 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 Yusuf Oomar Jooma Mrs Rooksanah Jooma Mrs Rooksanah Jooma Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2006 Brief Description of the Service: 136 Langthorne Road is a care home offering support, guidance and accommodation to a maximum of five service users who have learning disabilities. The home is privately owned. Service users are encouraged to participate in a range of activities and hobbies of their choice. The home is located in the Leytonstone area, within the London Borough of Waltham Forest. Bus and rail links are nearby, as are local amenities. At the time of the inspection, there were 3 service users accommodated in the home, all of whom were funded by the London Borough of Waltham Forest. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during one afternoon and was unannounced. The inspector initially tried to access the home the same morning, but was unable to do so, as the service users were out on activities. During the course of this visit, the inspector spoke to two of the service users; he conducted a tour of the premises and viewed various records. He also spoke to the proprietor and staff working in the home The aim of this unannounced inspection was to check the home’s progress towards full compliance with the legislation. What the service does well: What has improved since the last inspection? What they could do better: There were 9 requirements and 1 good practice recommendation, which remain outstanding from the previous inspection reports. 6 further requirements were made during this inspection visit. These included: Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 6 - The registered manager must ensure that records of the food offered for service users is in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. - The registered manager must ensure that all medication kept in the home is appropriately stored. - The registered manager must ensure that all parts of the home are reasonably decorated. - The registered person must ensure that staff receive supervision and appraisal sessions as outlined in the National Minimum Standards. - The registered manager must obtain NVQ Level 4 in Care. - The responsible person must ensure that the Employer’s Liability Insurance cover is sufficient to cover the registered person’s legal responsibilities to employees, service users and third party persons to a limit of commensurate with the level and extent of activities undertaken or to a minimum of £5 million. 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. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5. The home’s Statement of Purpose required minor amendments. The assessed needs of those accommodated in the home were being met. EVIDENCE: The home’s Statement of Purpose and the Service User’s guide have been reviewed and amended since the last inspection, as required. The inspector viewed the document, which appeared satisfactory, however, further minor amendments were needed. The requirement in relation to the home’s statement of purpose has therefore been repeated. At the time of this inspection, there were 3 service users living in the home and there were 2 room vacancies. There have been no new admissions to the home for a considerable length of time. Standards relating to the home’s admission systems and trial visits to the home, were therefore not assessed during this inspection and will be tested following a new admission to the home. The inspector was satisfied that the assessed needs of the current service user group were being met. Each service user had a costed contract in place, which included statement of terms and conditions. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Limited progress has been made to ensure that both individual care plans and risk assessments were kept under review. Service users are encouraged to make decisions about their lives and take responsible risks as part of their independent lifestyle. EVIDENCE: The inspector reviewed care plans of all 3 service users accommodated in the home. During the last inspection visit, it was identified that some care plans have not been reviewed. Limited progress has been made to review the care plans. Quality of care plans also varied. The requirement in relation to the care plans of those accommodated in the home has therefore been repeated and must be met without further delay. The requirement that daily log books are maintained was for the second inpection partly met. Whilst it was noted that daily notes were being maintained following the last inspection, the inspector found that staff did not always record information about service users daily living on regular basis. The requirement has therefore been repeated and must be met without delay. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 10 Service users who spoke to the inspection confirmed that they were able to make informed choices and decisions. Their views were being respected by staff on duty. Those who live in the home said that they were free to make choices around their daily living and were consulted about how the home should be run. They were also asked to choose colours schemes during recent refurbishment work and helped in choosing furniture in their bedrooms. It was noted however, that service users meeting have not taken place since May 2005, it is therefore recommended that these are restarted. The inspector checked risk assessments in respect of the service users accommodated in the home. Limited progress has been made to ensure that the previous requirement has been met. The requirement has therefore been repeated and must be met without any further delay. The recommended that each service user has an individual missing persons procedure also remains outstanding, although the registered manager was able to demonstrate that she had designed appropriate forms, which needed completing. Confidentiality was being maintained and all files were securely stored. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Those who lived in the home are encouraged and supported to become part of the local community and develop and maintain friendships and family links. Service users enjoyed food in their home. EVIDENCE: Following discussion with the service users and review of their care plans and records of activities offered to those who lived in the home, the inspector was satisfied that those who live in the home were supported and encouraged to take part in appropriate leisure activities, however as previously mentioned recording of activities offered to the service users required improvement. Each care plan viewed contained a weekly timetable. During the course of inspection service users told the inspector about activities they enjoyed. These included: drama classes, literacy classes, First Aid and Independent Living Skills classes, painting, trips to cinema, pubs etc. Those who lived in the home said that they enjoyed going on annual holidays and were in the process of planning one for this year. One of the service users told the inspector that he was preparing to take part in a drama performance with his drama group. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 12 The home adequately supported service users in attending their places of worship. Those living in the home were supported and encouraged to maintain appropriate friendships and family links. Service users spoken to confirmed that they had good relationship with their family and friends and visited them on regular basis. At the time of the inspection one of the service users went out to visit his friend. Service users said that they enjoyed food served in the home. There were sufficient food supplies in the home, which were appropriately stored. Records of food offered to those accommodated in the home required improvement, as required by law. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. The home was meeting personal and healthcare needs of the current service user group, however the registered manager must ensure that where identified, staff working in the home receive adequate training in relation to medical conditions of any service users, as identified during the previous inspection. Medication systems were generally satisfactory, however storage of medication required improvement. EVIDENCE: The home continues to met personal and healthcare needs of the service users accommodated in the home were generally met, however where it has been identified that additional training is required for staff to meet the needs of personal care needs of the service user, this must be provided. The registered manager stated that she was in the process of liaising with appropriate healthcare professional to organise the training for staff working in the home. This is a repeated requirement and must be met without any further delay. Files examined showed that each service user was registered with a General Practitioner and that those accommodated in the home were supported and encouraged to utilise community health resources. All service users had “Health Action Plan” in place, which was incorporated into their care plan. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 14 Medication systems were checked and were found to be satisfactory, however some of the medication was inappropriately stored in the home’s fridge. There was a record of medication brought into the home. Record of medication administered to service users was adequately maintained. The registered manager must ensure that all medication kept in the home is appropriately stored. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Appropriate complaints systems were in place. Service users were generally protected from abuse, however staff required refresher course about Adult Protection issues. EVIDENCE: There have been no complaints made to the home since the last inspection. Service users spoken to said that they would raise any complaints with the registered manager. Appropriate complaints policy was in place. The registered manager stated that there have been no accident/incidents since the last inspection. The home had an appropriate adult protection procedure/policy in place. The requirement in relation to Adult Protection remains unmet and has been repeated and must be met without any further delay. Failure to ensure that staff have receive adult protection training may put service users at risk. Noncompliance with the requirement will result in the Commission taking an enforcement action against the registered person. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. The premises have recently been refurbished and extended. Further work was required to ensure that adequate furnishing and fittings are in place. Improvement was required to ensure safe disposal of clinical waste. EVIDENCE: The home has recently been refurbished and extended. Two additional bedrooms have been added. Four out of five bedrooms have now en-suite facilities. In addition there is one bathroom located on the first floor. Service users spoken to stated that they were happy with the refurbished bedrooms and the new layout of the house. At the time of this inspection some parts of the building required additional work, such as additional paintwork. The registered manager must ensure that service users bedrooms include all items listed in Standard 26.2. Although the home has been opened for over two months since the refurbishment, little work has been made to ensure that the service users have been made more personalised. At the time of this inspection no service users had physical disabilities. Standard in relation to specific equipment was not applicable. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 17 The home’s rear garden has been tidied up and new patio has been laid since the last inspection. The premises were clean and hygienic. The registered manager has set up clinical waste disposal arrangements, however at the time of the inspection who bags with clinical waste were placed in the front garden and posed health and safety risk to the service users and passers-by. The requirement in relation to the clinical waste has therefore been repeated and must be met without delay. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Appropriate staffing levels were in place. Limited progress has been made to ensure that staff personnel files contain all information required by law. Improvement was needed in holding staff meetings, supervisions and appraisals. EVIDENCE: Staffing levels continue to be appropriate to meet the needs of the current service user group. The registered manager works from Monday till Friday between 9am and 6pm. There is a member of staff working in the late afternoon/early evening. The home has a sleep-in cover in place. The registered manager stated that 1 member of staff has obtained their NVQ Level 2 in Care qualification. 2 staff were in the process of obtaining their NVQ Level 3 training. The requirement in relation to staff having NVQ qualification has therefore been repeated. Staff personnel files were examined during this inspection. Although the registered person has made some progress in gathering the required information, some of the files were incomplete and did not contain all information required by law. This is the third inspection when this issue had been raised. The requirement that the registered manager must ensure that staff personnel files include all information listed in Schedule 2 of the Care Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 19 Homes Regulations has therefore been repeated and must be met within set timescales. Failure to meet the requirement at the next inspection will result in the Commission issuing an enforcement notice. The requirement for the registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs remains outstanding and has been repeated. No new staff have commenced work in the home since the last inspection visit. Minutes from the staff meetings were unavailable for inspection. The registered manager should ensure that staff meetings are held at least 6 times per year and minutes from those are available for inspection. It was also noted that some staff have not received supervision and appraisal sessions since May 2005. This required improvement. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42. The home is run by a competent manager, however she must ensure that full compliance in meeting the National Minimum Standards and Care Homes Regulations. Some of the records kept in the home required improvement. Appropriate health and safety checks were in place. EVIDENCE: The registered manager is also the proprietor. She has been managing the home since it was established. The registered manager has the NVQ Level 4 Registered Managers Awards, however she must complete the NVQ Level 4 in Care, as required by law. She demonstrated her awareness of the assessed needs of those accommodated in the home. The inspector received positive comments from both service users and staff in relation to the manager’s conduct and management style. Based on the observation and discussion with the service users and during previous inspection with the service user’s relative, the inspector was satisfied that she promotes service user’s rights and encouraged them to maintain their Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 21 rights and independence whenever possible. Service users spoken to stated that staff are always readily available to offer support and guidance. It was noted however, that improvements were required to ensure that both staff and service users meeting take place in regular basis. Appropriate quality assurance systems were in place. As the proprietor is also the registered manager, monthly visits from the responsible individual were not required. As mentioned in other parts of this report, it was identified that some of the record kept in the home required improvement. These included: - The home’s statement of purpose and the service user’s guide. - Care Plans, - Risk assessments, - Individual service user’s daily logbooks, - Staff personnel files, - Record of staff training, - Minutes from the staff meetings, - Staff supervision/appraisal minutes. Appropriate health and safety checks were in place. The home had insurance in place, however the Public Liability Cover was for £2 million and not £5 million as specified in the National Minimum Standards. The responsible person must ensure that the Employers Liability Insurance cover is sufficient to cover the registered person’s legal responsibilities to employees, service users and third party persons to a limit of commensurate with the level and extent of activities undertaken or to a minimum of £5 million. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 22 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 x 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 x 28 2 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 2 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 2 2 3 x 2 3 2 Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA32 Regulation 13(1)(c) Requirement Timescale for action 01/06/06 2. YA6 3. YA23 4. YA34 The registered manager must ensure that care staff complete appropriate NVQ training. (Previous timescale of 31/12/05 was not met). 17 The registered manager must ensure that daily logbooks kept in respect of each service user are improved and recorded daily. (Previous timescales of 01/08/05 and 15/04/06 were not met.) 18(1)(c)(i),13(6) All staff working in the home must be familiar with the Adult Protection issues. (Previous timescales of 15/08/05 and 01/05/06 were not met.) 7, 9, 19 Sch 2 The registered manager must ensure that staff personnel files include all information listed in Schedule 2 of the Care Homes Regulations. (Previous timescales of 15/08/05 and 15/04/06 were not met.) 01/06/06 01/08/06 01/06/06 Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 24 5. YA6 15 The registered manager must ensure that care plans are kept up-to-date and under review. (Previous timescale of 15/04/06 was not met.) The registered manager must ensure that risk assessments are kept up-todate and kept under review. (Previous timescale of 15/04/06 was not met.) Staff working in the home receive adequate training in relation to medical conditions of any service users. (Previous timescale of 15/04/06 was not met.) The registered manager must ensure that appropriate clinical waste arrangements are in place. (Previous timescale of 01/04/06 was not met.) The registered manager must ensure that staff files contain evidence that staff have attended mandatory training and any other training relevant to their jobs. (Previous timescale of 01/05/06 was not met.) The registered manager must ensure that records of the food offered for service users is in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. The registered manager must ensure that all medication kept in the home 01/06/06 6. YA9 17, 4(c) 01/06/06 7. YA32 18(1)(c)(i) 01/06/06 8. YA30 13(3) 01/06/06 9. YA33 7, 9, 19 Sch 2 01/06/06 10. YA17 17(2) Sch 4.13 01/06/06 11. YA20 13(2) 01/06/06 Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 25 is appropriately stored. 12. YA36 18(2) The registered person must ensure that staff receive supervision and appraisal sessions as outlined in the National Minimum Standards. The registered manager must obtain NVQ Level 4 in Care. The responsible person must ensure that the Employer’s Liability Insurance cover is sufficient to cover the registered person’s legal responsibilities to employees, service users and third party persons to a limit of commensurate with the level and extent of activities undertaken or to a minimum of £5 million. The registered manager must ensure that all parts of the home are reasonably decorated. 15/07/06 13. 14. YA37 YA43 9(2)(i) 17 01/01/07 01/07/06 15. YA24 23(2)(d) 01/08/06 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. 3. Refer to Standard YA9 YA8 YA33 Good Practice Recommendations It is recommended that each service user has an individual missing persons procedure. (Repeated recommendation.) It is recommended that the service users meetings are restarted. The registered manager should ensure that staff meetings are held at least 6 times per year and minutes from those are available for inspection. Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 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 Langthorne Road DS0000007303.V293069.R01.S.doc Version 5.1 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!