Inspection on 20/12/05 for Lewisham Park, 40

This inspection was carried out on 20th December 2005.

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

Other inspections for this house

Lewisham Park, 40 15/02/08

Lewisham Park, 40 01/11/06

Lewisham Park, 40 10/03/06

Lewisham Park, 40 28/02/05

Lewisham Park, 40 12/11/04

Lewisham Park, 40 21/01/04

Lewisham Park, 40 08/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Lewisham Park, 40 Lewisham London SE13 6QZ Lead Inspector Ms Lynn Hampton Unannounced Inspection 20th December 2005 3.30 Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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 Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lewisham Park, 40 Address Lewisham London SE13 6QZ 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) 0208 3141877 Mr Percival Fitzroy Drummond Ms Maise Melanie Bell Mr Percival Fitzroy Drummond Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2005 Brief Description of the Service: 40 Lewisham Park is a large property offering residential care for up to 3 Service Users with learning disabilities. The house is located in a residential area opposite a park, and close to public transport links. The house is spacious and the care is provided by the proprietor and manager and who live in the house with their two children. The house has the appearance of a family home and the Service Users benefit from this environment. There was one vacancy at the time of the inspection. The two current Service Users are brothers and have lived at 40 Lewisham Park for a number of years. The Service Users spend their day in various planned activities such as day care and voluntary work. Their evenings and weekends are spent at home or with their mother. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in the afternoon of a weekday, 20th December 2005, and lasted over three hours. During the visit the inspector met both the owners, both of whom live and work at the home, and one of whom is the registered manager. A range of documents was examined and a tour of the building took place. The inspector met both residents. Residents had limited verbal communication, but were able to show their preferences and mood through some speech as well as gestures and body language. What the service does well: What has improved since the last inspection? The owners have both commenced appropriate training. No other staff are employed in the home, so records of recruitment, supervision, and duty rosters are not kept. The home is well managed but needs further development to fully meet Regulations and National Minimum Standards for this client group. The owners have a clear understanding of the priorities for the future development of the service, and how this will promote service users rights and welfare. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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 Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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, 5 The home has provided care to the two current residents for many years, and so has not developed information relevant to prospective service users. Work needs to be undertaken to address this, as there is a vacancy in the home. Service users must be provided with a written statement of terms and conditions. EVIDENCE: 40 Lewisham Park operated for many years as an Adult Placement Scheme, providing care to three residents in a family setting. One of the residents has now left, and the remaining two are brothers that have lived in the home for over seven years. Changes in the needs of residents, and in legislation around care services, led to the registration of the owners as providers/manager of a Registered Care Home. The owners therefore have to make changes in practice and record keeping in order to comply with Registration requirements, which is proving challenging for them given their circumstances. Although there is a vacancy, the owners reported that there are no current plans to fill it, and the long-term nature of placements has meant that they have never produced a Statement of Purpose, nor a Service User Guide, which would be essential for prospective residents. However, these are also useful documents for current residents, as it clearly defines what service they can expect from the home, which promotes their rights. Previous inspection reports have made it a Requirement that the Statement of Purpose and Service User Guide are completed in accordance with the relevant standards and available to service Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 9 users and other relevant people. The inspector discussed this at length with the owners during the inspection. The owners described how they had tried to find helpful information on the Internet, and outlined difficulties in producing a meaningful document. The inspector acknowledges these difficulties, but the Requirement remains in force with a new timescale for completion. The owners also raised concerns that the previous Requirement specified that both documents must detail the current position regarding non-provision of a screen and wash-hand basin in the room bedroom. It was clarified that the home would not be required to provide a screen and wash-hand basin while the current residents remained at the home, and continued to wish to have these specific living arrangements. However, it clearly would not be appropriate to put any new resident into a shared bedroom, and this needs to be stated in the relevant documentation. A Requirement was made in the reports of previous inspections that the Registered Persons must provide Service Users with a contract, which sets out the charges and what this covers. Previously set timescales of 31/07/03 and 30/06/04 have not been met. This was also discussed at length between the inspector and owners during the inspection. The owners reported that they had again had difficulty in identifying how they could develop such a contract, or find one suitable to use for their service. The inspector acknowledges these issues, and clarifies that the Regulation requires specifically that the home maintains ‘a record of the care home’s charges to service users, including any extra amounts payable for additional services not covered by those charges and the amounts paid by or in respect of each service user’. The National Minimum Standards recommends that this include further detail that may be set out in a Statement of Terms and Conditions. The owners may consider preparing a simplified document that would meet these requirements and promote residents’ rights, as is the purpose of the Regulation. This Requirement remains in force, and a new timescale is set. The owners were advised that continued non-compliance with this Requirement would mean that the Commission would have no recourse except to consider Enforcement Action. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 The home provides care and support on a ‘family-home’ basis, which has benefits for the service users. However, there are areas that need to be developed to comply with Regulations, regarding care planning and record keeping. Life Story books are being developed, and should be used as a basis for individual assessment and planning. Records of finances indicated that residents’ money was well administered, although a running total should be kept to enable the balance to be checked. Any expenditure of resident’s money being considered for holidays or for larger purchases should be discussed at Review meetings. EVIDENCE: The owners reported that regular Annual Reviews take place with the social worker, although not all of the minutes of these could be found on file. Care plans seen were dated to indicate that six-monthly reviews took place, although the care plans had not been altered since 2003. Documentation relating to care planning in the home could be improved. This was discussed at length with the owners during the inspection visit. Their records and care planning system has evolved since they started as an Adult Placement scheme, which required less formal systems, and much less detail. The residents are Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 11 treated as part of the family, which provides a warm and caring environment that is to the benefit of residents, but this does not comply with Regulations that are in place for the protection of service users, and which promote accepted best practice. The owners described that they are learning about care planning practice as part of their NVQ course, and are becoming aware of what needs to be in place. It was acknowledged that user-focussed assessment and planning would be of benefit, to demonstrate that the routines of the home and activities are meeting the individual and changing needs of each resident. Also, care practice would be supported by review of recordkeeping, to ensure that it provides a clear picture of assessments, plans and reviews. See also ‘Lifestyle’ section below. This is the subject of a new Requirement. The report of the last inspection visit noted that work was underway to develop Life Story books for each resident. The owners reported that these were now with the residents’ mother, who was sorting out photographs into date order. This useful piece of work could be linked into the review of care planning (Person Centred Planning). Records of residents’ finances were checked, and contained information about residents’ benefits and financial assessments. Each person had a file that contained Bankbooks and a detailed record of withdrawals and expenditure. This was helpfully cross-referenced to numbered receipts, which provided a clear audit trail of expenditure. Records and discussion with the owners indicated that every care was taken to ensure that residents’ money was spent appropriately, and in their best interests. It is recommended that a running total is also kept, that will enable a check to be made that the balance of residents’ cash held in the home is correct. The owners made enquiries about residents spending savings on holidays or smaller events such as having a meal out sometimes. Issues around promoting resident choice, and using savings appropriately to do this were discussed. Items that should be paid for out of the fees received should be clarified in the agreement with the resident (see Choice of Home, above), and areas that are unclear, or involve larger sums of money, could be discussed in Reviews or Best Interest meetings to ensure that all parties involved in the care of the resident are agreeable to one-off expenditure, should the need arise. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 17 Service users have active lifestyles that include social activities as well as education, work, and personal development. This should be fully assessed and recorded in care planning documentation. Contact with friends and family is promoted. Action should be taken to enable service users to have access to appropriate advocacy and counselling services. Service users are offered a healthy diet. EVIDENCE: Each resident has an individually tailored programme of activities that reflects his interests and abilities. Both go out every weekday to a range of activities that includes day centres, voluntary work, education and visiting their mother, who plays an important part in their lives. The owners told the inspector that the mother usually comes to the home for Christmas dinner, and that they have a lot of contact with her throughout the year, which is to be commended. The mother has clear views about aspects of the residents’ care, which may at time create dilemmas for the owners, for example if they are asked not to share information about the mother with the residents. The owners demonstrated an awareness of the issues involved in balancing confidentiality Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 13 with the residents’ rights, and reported that they had recently contacted Lewisham Partnership to discuss the situation and ask for advice. Efforts should be made to access independent advocacy, and appropriate counselling services (geared to work with people with learning and communication difficulties). A Diary is kept which contains brief details of each person’s daily life. This showed their routine of going to activities, plus some less regular events such as parties and haircuts. There were not many evening events recorded, although one resident goes to a Thursday club (organised walks around London). The resident told the inspector that he liked this, and also liked going out with a friend called Nick, who he said took him to the pub. These outings were not recorded in his diaries – the owners said that the friend was an ex-key worker who took him to the cinema, they were not sure if he went to the pub. It was also not clear from the care records seen by the inspector, whether the residents had had any recent holidays or breaks away from the home. When this was raised with the owners, they were able to produce information showing that residents had had holidays recently, and that one was planned in 2006. Care records should be reviewed to ensure that they reflect users’ choices, and goals, and provide a record of whether goals wee met and/or activities carried out. See also comments in ‘Individual Needs and Choices’ above. A Requirement was made in the reports of previous inspections that the Registered Provider must keep records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory. A previous timescales of 31/1/05 was not met, and a new timescale of 30/4/05 was set. One of the owners showed the inspector records that had been kept of meals provided in the home. This indicated that a range of interesting and varied meals was provided, with a choice between two main courses each day. This Requirement is met, and the record must be maintained hereafter. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 Service users receive personal support to meet their needs, and health issues are fully addressed. EVIDENCE: The owners were able to talk knowledgeably about residents’ needs and preferences, and explained what care and support they were offered. They reported that the residents were treated as part of the family – eating meals together and able to use all communal parts of the house, including both lounge areas. Neither resident is on regular medication, and so this standard was not assessed at this inspection visit. Care records showed that routine health checks were carried out, including opticians and dental checks. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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): These standards were not assessed at this Unannounced Inspection visit. EVIDENCE: Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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, 28, 30 Service users live in an attractively decorated and furnished home. They choose to share a bedroom, and have access to a range of communal areas shared with the owners and their family. Minor repairs in the bathroom have been outstanding for some time, and must be made good. EVIDENCE: The home is a large, semi-detached house that is furnished and decorated in a domestic and homely manner. The ground floor comprises a front lounge with TV; a back lounge with computer and access to a large garden; a kitchen with dining room to the rear, and a small toilet off the hallway. The owners reported that the residents have free access to all these areas, as they and their two children do. The upper floor comprises the owner’s private rooms and that of their family. The two current residents share a large bedroom, with a single bed each, and access to a shared bathroom/toilet area. The owners report that the residents choose to share, and have done so for many years. Also that, if they wished to have separate rooms, this would be arranged as there is one vacant room available. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 17 The home was clean and attractively decorated throughout. No hazards were detected. However, a Requirement was made in the reports of previous inspections that the Registered Provider must ensure the bath panel is replaced and the wall in the downstairs WC is made good. This had not been done. Previous timescales of 30/1/05, and 31/6/05 are not met. This Requirement remains in force, and a new timescale is set. The owners were advised that continued non-compliance with this Requirement would mean that the Commission would have no recourse except to consider Enforcement Action. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 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, 34, 35, 36 The owners have both commenced appropriate training. No other staff are employed in the home, so records of recruitment, supervision, and duty rosters are not kept. EVIDENCE: A Requirement was made in the reports of previous inspections that the Registered Providers must forward to CSCI a training plan including plans of how to achieve NVQ Level 4, and have five days training. The owners told the inspector that they had both now started on NVQ, and planned to work through Level 3, and 4 as they successfully complete each part. The owners do not employ any staff, as they provide care on-site as part of their family home. This Requirement is considered met. As the home employs no staff, there are no records of recruitment or staff supervision. There is no formal rota kept in the home. Residents are able to go out of the home independently, and one or other of the owners is at home whenever the residents are in the house, and arrange escorts as and when needed. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 19 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): 38, 41, 43 The home is well managed but needs further development to fully meet Regulations and National Minimum Standards for this client group. The owners have a clear understanding of the priorities for the future development of the service, and how this will promote service users rights and welfare. EVIDENCE: The owners had an open and positive approach to discussing the service provided by the home with the inspector. The home is well run, but they demonstrated an awareness of areas in which the service needs to develop, and were keen to seek advice regarding how these improvements may be achieved. The purpose and benefits of improving care assessments and recording were discussed at length, and the owners recognised that this was a priority for the home in the months to come. The consequences of noncompliance were also discussed, and the owners are aware that Enforcement action may be taken. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 20 Due to the way in which the service was set up, and has been managed for several years, the owners have never drawn up a budget. A Requirement was made in the report of the previous inspection that the registered providers must draw up an annual budget for the home that identifies money being paid into the service and how this is allocated, in order for the Commission to be able to assess the financial viability of the home. This Requirement is not met. It remains in force, with a new timescale for completion. In the light of the detailed conversations that the owners had with the inspector during this inspection, it is recommended that they liaise further with the Commission and Lewisham Social Services, to explore whether the home would be more appropriately registered as an Adult Placement scheme. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 2 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lewisham Park, 40 Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X 3 X X 2 X 2 DS0000025599.V276704.R01.S.doc Version 5.0 Page 22 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. Standard Regulation Requirement The Registered Providers must ensure the Statement of Purpose and Service User Guide are completed in accordance with the relevant standards and available to service users and other relevant people. 4(1,2) 5,6 Both documents must detail the current position regarding nonprovision of a screen and wash-hand basin in the room bedroom. It must also be made clear that the CSCI consider the situation acceptable only for the time being. Previous timescale of 31/3/05 not met. Timescale for action 1 YA1 01/03/06 2 YA5 Schedule 4 (8) The Registered Persons must provide Service Users with a contract, which 01/03/06 sets out the charges and what this covers. Previous timescales of 31/7/03, 30/6/04 and 31/6/05 not met. Continued non-compliance will lead to consideration of Enforcement Action. Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 23 3 YA6YA41 The Registered Persons must develop with each service user an individual care plan, based on an assessment of their needs, which complies with Regulation 15 and National Minimum Standards. The Registered Persons must ensure that care plans and records include specific assessment of service users’ leisure interests and social activities, and a record is to be kept of activities that service users participate in. The Registered Persons must take action to enable service users to access independent advocacy, and appropriate counselling services. The Registered Provider must ensure the bath panel is replaced and the wall in the downstairs WC is made good.Previous timescales of 31/1/05 and 31/6/05 not met. The registered providers must draw up an annual budget for the home that identifies money being paid into the service and how this is allocated. Previous timescale 31/7/05 not met. 01/06/06 4 YA14 16(2)n 01/06/06 5 YA15 12(1)(3) 01/03/06 6 YA24 23.2 31/03/06 6 YA43 25 (2) (c) 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard YA8 Good Practice Recommendations The Registered Persons should maintain a running total of service users finances held in the home, that will enable a check to be made that the balance is correct The Registered Persons should liaise further with the Commission and Lewisham Social Services, to explore whether the home would be more appropriately registered as an Adult Placement scheme 1 2 YA38 Lewisham Park, 40 DS0000025599.V276704.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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. 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