Inspection on 25/08/05 for Lifestyles Care Home

This inspection was carried out on 25th August 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 but made no statutory requirements on the home.

Other inspections for this house

Lifestyles Care Home 10/07/08

Lifestyles Care Home 20/07/07

Lifestyles Care Home 23/01/07

Lifestyles Care Home 06/06/06

Lifestyles Care Home 14/12/05

Lifestyles Care Home 15/02/05

Lifestyles Care Home 09/08/04

Lifestyles Care Home 30/09/03

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

CARE HOME ADULTS 18-65 Lifestyles Weeland Road Eggborough Goole DN14 0RX Lead Inspector David White Unannounced 25 August 2005 09:30 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 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 Stationary 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. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lifestyles Care Centre for the Young Disabled Address Weeland Road Eggborough Goole North Humberside DN14 0RX 01977 661492 n/a n/a Regent Life Styles Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Post vacant ,km 20 Category(ies) of PD Physical Disability (20) registration, with number of places J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15th/17th February 2005 Brief Description of the Service: Lifestyles Care Centre was originally a hotel, which has been converted into a care home with a nursing provision. It offers permanent and respite nursing care for young people with a physical disability. The home is situated in Eggborough, a village 7 miles from Selby. Within quarter of a mile are a pub and some small local shops. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6.5 hours and was carried out by two inspectors, Mr David White and Mrs Jo Bell. One additional inspection visit has been made since the last inspection. Letters sent to the registered person following this visit can be obtained from the CSCI office on request. Inspectors looked around the premises and a number of records were inspected. Four residents, five members of staff and the manager were spoken to and the care records of the four residents were inspected. The inspectors also attended a carer staff meeting. What the service does well: What has improved since the last inspection? A new pre-admission assessment form has been developed which provides more detailed and informative information so that the home is able to decide whether they are able to meet someone’s needs. New employees are not started in work until all the necessary pre-employment checks have been carried out so protecting residents from potential harm. Residents can enjoy more activities through the introduction of a structured activity programme. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 6 The wired glass in the door of bedroom 19 has been replaced so making the bedroom safer and more pleasant for the resident to live in. A new lounge chair has been acquired for one of the residents to help to keep them comfortable. Residents and their relatives have been given the chance to voice their views about the home by filling in a questionnaire survey. The manager has produced a monthly newsletter which will inform residents and relatives of what is happening in the home and of planned future events. Staff feel that the culture of the home is changing and said the manager was “forward thinking” and the “wishes of the residents were being put first.” What they could do better: Many of the requirements from the previous inspection have not been dealt with. There are a number of problems with the environment. Two matters are of immediate concern and could put residents at risk and these are: 1. The lounge and dining room carpets are dirty, worn and threadbare in some areas. The frayed area in the centre of the carpet is a tripping hazard andboth carpets need replacing. 2. The radiator in the smoking lounge needs a guard to protect residents from scalding. Other matters which could be better are: Oxygen must be stored securely and safely so that the safety of the residents is not put at risk. Controlled drugs must be administered in accordance with the homes medication policies and procedures so that residents are not at risk of harm. All bedrails must be checked to make sure they are securely fitted and safe so that residents safety is protected. The suction machine equipment must be removed from the sink in the sluice room so that staff can access handwashing facilities. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 7 Staff who work above 48 hours per week should make a declaration in writing to indicate they have agreed to do so as per the european working time directive. The manager should give notice in writing to the Commission of any death, illness and other events in the home. The home must submit a copy of the gas safety records to the Commission to confirm that gas safety checks have been made to protect the safety of residents at the home. 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. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Some progress has been made in improving the admission procedure to make sure there is a proper assessment before people move into the home. EVIDENCE: The manager has developed a new pre-admission assessment format which provides more detailed information than the previous format. Pre-admission assessments are carried out by the manager and a qualified nurse and the manager is aware that pre-admission assessment information needs to be detailed and specific so that the home is able to make a decision as to whether they are able to meet someone’s needs. Information is also collected from other sources such as a care manager to help with making decisions about the suitability of people wishing to move into the home. The care records of a resident having respite care contained pre-admission assessment information. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9 Care planning documentation is detailed and provides staff with the information to be able to care for the residents. Risk assessment strategies are in place to promote the independence and safety of residents. EVIDENCE: The care plans of four residents were looked at. The care planning documentation contained detailed information that specified the needs of each resident and how these are to be met. Risk assessments are in place regarding the prevention of pressure sores, to reduce risks from falling, nutrition and mental health problems. Care plans specified what actions were to be taken if certain behaviours occurred and special measures were clearly recorded to prevent accidents. Daily records were up to date and reflected the care being provided. Care plans are reviewed regularly and encourage the involvement of the family and other health professionals. Staff said that handover periods take place between shifts so that information can be passed on. All the staff spoken to had a good knowledge and understanding of the needs of the residents. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15, 16 and 17 The activities programme provides stimulation and enjoyment for the residents. Flexible visiting times mean that residents can maintain links with family and friends. Meals are nutritious and offer a varied diet for residents. EVIDENCE: The home is hoping to appoint an activities co-ordinator. There is an activities programme which was on display in the home. On each shift one of the care team is allocated to be responsible for organising the activities set out in the activity programme. Some residents choose not to take part in the activities and are not put under pressure to change their minds. The home has a minibus and residents have been on a number of outings away from the home. Some residents said they just liked to watch the television. Resident interests are documented within individual care records and a social assessment reflecting the social care needs of each resident has been introduced. One resident visits the local pub and attends church services at a nearby chapel. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 12 Visitors can visit the home whenever they wish. Staff were seen to be interacting well with the residents and one resident said that the staff are “excellent, kind and caring”. There is a choice of food at mealtimes and alternative meals are offered if a resident does not like the food on offer. Special dietary needs are catered for. Four of the residents receive nutrition through a PEG feed and the care plans provided information about what needed to be done to make sure that these residents nutritional needs were met. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 The healthcare needs of residents are well met. The medication practices have the potential to put residents at risk. EVIDENCE: Individual care plans state clearly how needs have been assessed and the actions that needed to be taken. Staff could be seen spending time with residents and enjoying humour with them. The residents at the home need a high level of personal and nursing care and staff were seen providing this care in a sensitive manner. Daily routines are flexible and are based on the resident’s wishes. Equipment and aids such as electric wheelchairs and ceiling and tracking hoists are in place to promote the independence of the residents. A GP visits the home routinely and can be accessed at any time if medical attention is needed. Residents have access to dental and optical services and a chiropodist regularly visits. A continence advisor assesses residents with continence needs. Some of the residents have communication difficulties and the care plans contained specific information as to what staff should do to communicate effectively with these residents. The Medication Administration Records were inspected and found to be accurate and up to date. The Controlled Drugs register had entries missing to confirm that controlled drugs when being administered had been witnessed by J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 14 a second person. This practice does not conform to the home’s medication policies and procedures. Oxygen is stored at the home and the storage area is clearly marked. This storage area was located within the residents lounge and was not locked and the oxygen was not fixed securely to the wall. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Resident views and concerns are listened to and acted upon. There are vulnerable adults policies and procedures in place to safeguard residents from abuse. EVIDENCE: The home has a complaints procedure that has recently been updated and is on display in the home. Since the previous inspection the home has received one complaint. The records show that the complaint was investigated and the person making the complaint was sent a written response explaining the outcome of the investigation. Residents said they would discuss any problems with their key worker or the manager. The home has vulnerable adults policy and procedure which provides guidance as to the actions which need to be taken in the event of or suspicion of abuse taking place. Half of the staff have recently attended a vulnerable adult protection awareness course organised by Windsor recruitment agency. The rest of the staff team are attending the course within the next month. The induction programme for new staff includes what to do if abuse was suspected. Care staff spoken to had a good knowledge of what to do if they thought abuse could be happening in the home. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 standard(s) 24, 26, 27, 29 and 30. Limited progress has been made in improving the environment. There are a number of matters present and outstanding which put people at risk of harm and do not provide safe and comfortable surroundings in which to live. EVIDENCE: The standard of the environment is very poor. Although some of the issues raised at the previous inspection have been addressed, many remain outstanding and a look around the environment highlighted a further number of concerns that need to be addressed. A number of issues remain outstanding from the previous inspection and immediate requirements were made to address the following matters: 1. The lounge and dining room carpets are both very dirty and the lounge carpet is worn and threadbare in places. Both carpets look unpleasant and the lounge carpet is a tripping hazard. Both carpets are in need of replacement. 2. The radiator in the smoking lounge must be fitted with a radiator guard. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 17 A number of other areas require attention and these are: 1. The exposed pipe work and electrical sockets in the access to the dining room, some bathrooms, some bedrooms and behind the laundry door must be boxed in. 2. The water pressures in the residents bathrooms must be sufficient so that residents are able to have a bath. 3. Plasterwork needs to be completed around the electrical sockets in the access to the dining room and by the staff locker area. 4. Malodours in bedroom 29 need to be removed. 5. There is a crack in the window of bedroom 5 and the window needs replacing. 6. The suction equipment laying in the sink of the sluice must be removed so that staff have access to hand washing facilities. 7. Bedroom 4 needs decorating where the plasterwork has been carried out. 8. Skirting boards need to be fitted on the corridor near bedroom 24. Staff carry out recorded checks of the hot water temperature checks and any problems with the water temperatures are referred to the registered provider. A hoist in one of the bathrooms was corroded and is in need of painting. The service records show that the hoist was recently serviced and is safe to use. A number of the residents have bedrails and risk assessments were in place to promote the independence and safety of the residents. However in one bedroom the bedrails were not secure and difficult to use. In a number of areas of the home particularly in doorways the paintwork was chipped and the manager said that this was mainly caused by the use of wheelchairs coming in to contact with the walls. Call bells are accessible for residents in bedrooms, bathrooms, toilets and other communal areas. There were no records available of any routine maintenance work that had been carried out in the home. Two laundry assistants are employed to look after residents clothing. Sluicing facilities help to reduce the risks from the spread of infection and there were sufficient supplies of aprons, hand paper towels, soap dispensers and alcohol gel throughout the home. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35 The home employs enough trained staff and carers to meet the needs of the residents. Improved recruitment procedures safeguards residents from abuse. EVIDENCE: There was the manager, 1 qualified nurse and four carers on duty at the time of inspection to care for eleven residents. Staff carried out their duties in an unhurried manner and spent time sat down talking with residents. In an afternoon there is one nurse and three carers on duty and at night there is 1 nurse and two carers. Some permanent staff have recently left the home and the home has appointed another nurse and four more carers subject to satisfactory pre-employment checks. Sine the previous inspection all the necessary pre-employment checks have been carried out before a new member of staff starts in post. Application forms completed by prospective employees contain a full employment history and written references are requested from the person’s most recent employer. CRB checks including checks against the POVA list are included in the recruitment process. All the staff spoken to had received health and safety training. Training is also provided which is specifically linked to the needs of the residents. A member of J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 19 the Huntingdon’s Society is due to visit the home to give a teaching session for relatives and the staff. Staff spoken to had a good understanding of the needs of the residents and showed a commitment to providing the residents with a good quality of care. All staff said how much they enjoyed working with the resident group. Staff said that they sometimes work more that 48 hours per week. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The manager has through effective leadership made changes that have lead to improvements in the quality of life for residents. There are shortfalls in the overall management of the home that do not promote and safeguard the interests of residents. EVIDENCE: The manager has been in post for nine weeks and has made an application for registration with the Commission. She is a qualified nurse with limited experience in management. Staff spoken to said that since the manager had started working at the home they felt that there have been “improvements” in the running of the home with more emphasis given to the wishes and choices of the residents. They said the manager was “approachable, helpful, discreet and forward thinking” and encouraged them to give their views and opinions about the home. The manager has developed an activities programme, is keen to provide staff with training specific to the needs of the resident group and has developed a more informative pre-admission assessment document. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 21 The manager is developing systems to seek the views of residents, relatives and others about the services provided by the home. A monthly newsletter has been developed and is sent out to relatives. Survey questionnaires have been sent out to relatives and residents asking their views of different aspects of the home. The response from the surveys was positive and the findings included in the newsletter. Regular staff and resident meetings are being held and are recorded and the carers working at the home also have a separate meeting which the inspectors were invited to attend at the time of inspection. The home does not have an annual development plan. The manager is carrying out a fire risk assessment of the home following guidance from the fire authority and fire drills are carried out on a regular basis. Individual and general risk assessments are in place to promote health and safety and the staff risk assessments are being updated. Documentation was in place to show that lifts and equipment have been serviced recently. All staff receive health and safety training from the point of induction to the home. The gas safety records were not available at the time of inspection and the provider is asked to submit copies of these to the Commission. As detailed under the section of this report dealing with the home’s environment, there are a number of environmental issues that need addressing to ensure residents and staffs safety: All accidents and incidences are recorded within the home’s accident book. Recently there has been two incidences which have been reported verbally to the Commission but not in writing as is required under regulation 37 of the Care Homes Regulations 2001. The manager is now aware of the procedure to be able to do this. J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 1 1 x 2 1 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 1 x J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13 Requirement In accordance with the Royal Pharmaceutical Guidelines of Great Britain, the manager must make sure that oxygen is stored securely and safely. Controlled drugs must be administered in accordance with the homes medication policies and procedures. All exposed pipe work and electric cables must be boxed in and made safe. The lounge and dining room carpets are dirty, worn and frayed in some areas. The frayed area in the centre of the carpet is a tripping hazard and both carpets need repacing (previous timescale of 31/05/05 not met). The radiator in the smoking lounge needs a guard (previous timescale of 28/02/05 not met). Timescale for action As from 25/08/05 and after. 2. 24 13 & 23 01/09/05 Immediate requiremen t issued at the time of inspection. Immediate requiremen t issued at the time of inspection. 30/09/05. Page 24 Plasterwork needs to be completed around the electrical sockets located in the access J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 area to the dining room and by the staff locker area. The malodours in bedroom in bedroom 29 need to be removed. The window in bedroom 5 is cracked and is in need of repair or replacement. Bedroom 4 needs to be decorated to cover the area where plasterwork has been carried out. Skirting boards need to be fitted to the corridor outside bedroom 24. 3. 4. 26 27 16 23 All bedrails must be checked to make sure they are securely fitted and safe. The water pressure in resident bathrooms must be sufficient to ensure that residents can have a bath (previous timescale of 31/05/05 not met). The suction machine equipment must be removed from the sink in the sluice room so that staff can access handwashing facilities. The manager shall give notice to the Commission of any death, illness and other events in the home as listed under regulation 37 of the Care Homes Regulations 2001 and this notification must be confirmed in writing. Gas safety records must be obtained and a copy of these sent to the Commission. As from 25/08/05 and after. 01/09/05 01/09/05 30/09/05 As from 25/08/05 and after. 30/09/05 5. 30 13 As from 25/08/05 and after. As from 25/08/05 6. 42 37 7. 8. 42 13 30/09/05 J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 25 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. 4. Refer to Standard 24 24 29 33 Good Practice Recommendations Records of routine maintenance and renewal of the fabric and decoration of the home are kept and are available in the home. Protector guards should used to prevent damage to the paintwork caused by wheelchair use. The Oxford hoist is corroded and should be painted. The registered provider should make sure that staff who work above 48 hours per week have made a declaration in writing to indicate they have agreed to do so as per the european working time directive. The manager should receive management training to NVQ level 4 or equivalent. The home develops an annual development plan. 5. 6. 37 39 J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 J53 J04 S27965 Lifestyles V242244 250805 Stage 4.doc Version 1.40 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. 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