Inspection on 14/02/06 for Loring Hall

This inspection was carried out on 14th February 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Loring Hall 06/12/06

Loring Hall 16/05/05

Loring Hall 08/02/05

Loring Hall 03/06/04

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 Loring Hall 8 Water Lane Bexley Kent DA14 5ES Lead Inspector Keith Izzard Unannounced Inspection 14th February 2006 09:30 Loring Hall DS0000051557.V265792.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 Loring Hall DS0000051557.V265792.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. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Loring Hall Address 8 Water Lane Bexley Kent DA14 5ES 020 8302 9302 020 8302 8686 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) Oakfields Care Ltd Mr John Parker Care Home 16 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (1) of places Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 place registered for category LD(E) relates to named service user only. 16th May 2005 Date of last inspection Brief Description of the Service: Loring Hall is a large two storey, listed building set in spacious grounds. The home was registered on 27th February 2004 to provide long term care for sixteen service users who have a learning disability. At the time of inspection the home was half full, having accommodated eight service users on a staggered basis since the summer of 2004. The property is very well furnished and the accommodation of a high standard. All service user rooms are single and have en suite facilities. The home is split into two self- contained units with a potential for eight service users to occupy each of the units on the ground and first floor. There are other communal areas within the building that allow for a range of occupational and recreational facilities in addition to the individual units. The existing management team has a good level of experience in learning disability and the indications are that a good level of training will be provided for care staff, all those in post are undergoing NVQ level 2 training. The proposed range of activities for service users is extensive and the grounds offer considerable potential for occupational therapy and to develop work skills. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second scheduled unannounced inspection of this home within the current inspection year 2005 – 2006 that took place over a whole day on 14th February 2006. This report should therefore be read in conjunction with the previous report dated 16/05/05. This inspection provided for two interviews with residents, two interviews with care staff, and one with a senior carer and the manager. Care files were examined as were documents relating to health and safety and staffing. The building was also inspected throughout. In general terms the home was operating to a satisfactory standard and had complied with previous requirements and recommendations, including two requirements made at an additional visit on 19/09/05 to investigate an anonymous allegation. The allegation was not substantiated and the two requirements were unrelated and to do with staffing procedures and pre admission information and assessment. Residents and staff members, both observed and interviewed, appeared to have a good rapport. Two residents interviewed stated that they were happy with the home as appeared others who were observed interacting with staff members who appeared to be both caring and professional. Team meetings for all staff must be held on a more regular basis, this is particularly important given the anonymous complaints and adult protection investigations that have occurred. Whilst complaints have been found to be unsubstantiated and three members of staff have been reinstated following the first adult protection investigation, the home is still involved in adult protection procedures respect of another matter to do with an income support payment discrepancy for one service user. The outcome of this will be closely monitored and appropriate action taken by the home and the CSCI if necessary. Despite the positive outcomes, the Inspector is aware the morale of both the manager and staff members in the home, has been affected by these matters and the protracted time taken to reach a resolution. How, these matters issues are now being dealt with, and hopefully resolved, will be a primary focus of the next inspection of the home. What the service does well: Good communication has been maintained with the CSCI in relation to any significant incidents within the home. The staff members have responded positively to investigations of both complaints and a protracted adult protection investigation. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The manager agreed to update both the Statement of Purpose and the Service User Guide. The former had a number of omissions and the latter needs to be developed in a user- friendly way for those with communication difficulties. Service user care plans including relatives / advocates and involved professionals must be held six monthly. Written invitations must be sent out and reviews must be held regardless of whether relatives and outside professionals attend or not. The home has recently changed its Pharmacist to Boots and discussion is taking place regarding training being provided for staff members. The Inspector recommended that this be implemented for all staff dealing with medication as soon as possible. One service user must have an appointee/ advocate as he is currently without any independent support, outside of the home. The service user finance files must be retained by the registered manager and available for inspection at any time. The manager must clarify to the CSCI in writing when the home will achieve the required 50 of qualified staff members to NVQ level 2. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 7 The home must conduct an annual survey of the views of service users, relatives /advocates and involved outside professionals. The service user survey must facilitate those service users who have communication difficulties and be in an appropriate format. Staff must be made aware of any changes to adult protection procedures arising from the recent investigation and the recommendations made by the investigating team have been made the subject of a requirement in this report and must, therefore, be implemented. The home must ensure that all night–time care staff are involved in at least two fire drills per year. Team meetings for all staff must be held on a more regular basis, this is particularly important given the anonymous complaints and adult protection investigations that have occurred. 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. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 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 the following standard(s): 1 The home must update the Statement of Purpose and Service User Guide. EVIDENCE: All of the standards in this section were assessed as met at the previous inspection on 16/05/05. Please see the previous report for standards 2-4. On this occasion, however, Standard 1 was reassessed and the manager agreed to update both the Statement of Purpose and the Service User Guide. The former had a number of omissions and the latter needs to be developed in a userfriendly way for those with communication difficulties. The information to be included in these documents is listed in Schedule 1 of the National Minimum Standards Care Homes for adults. See Requirement 1. Loring Hall DS0000051557.V265792.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 EVIDENCE: All of the Standards in this section were assessed as met at the previous inspection on 16/05/05. Please see the previous report. However, Standard 6 was reassessed on this occasion as almost met as some reviews had been deferred owing to a poor response to review invitations. The manager was advised that formal reviews of service user care plans including relatives / advocates and involved professionals must be held six monthly and invitations, having been sent out in advance in writing, should go ahead should go ahead regardless of the attendance response. See Requirement 2. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 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): 11 Service users have opportunities for personal development. EVIDENCE: Standards 12 – 17 were assessed as met at the previous inspection on 16/05/05. Please see the previous report. Standard 11 was previously assessed as almost met and a recommendation was made to ensure that an assessment of occupational needs be conducted for residents in order to differentiate these from social activity needs and a plan produced and submitted to the CSCI to show how any identified occupational needs will be met. The Inspector was informed of the results of this assessment and the resultant increase in the range of activities both within the home and through external college courses. Standard 11 is now met Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 12 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): 20 &21 The ageing, illness and death of a service user would be handled as the individual would wish. The system for dealing with medication was sound and well organised. EVIDENCE: Standards 18 and 19 were assessed as met at the previous inspection. Please see the previous report dated 16/05/05. Standard 21 was previously assessed as almost met and a requirement was made that the wishes of service users in be assessed and recorded in relation to their wishes in the event of serious illness or death. This was complied with and this Standard is now met. In relation to Standard 20, the system for medication was examined and was well managed. None of the service users are able to deal with their own medication and all staff members who deal with it are trained to do so and the training is recorded. MAR sheets were examined and recorded appropriately and tallied with the blister packs that were retained in a lockable cabinet. External medication was stored separately. Suitable arrangements had been made for recording incoming medication and for returns of any unused medication. The home has recently changed its Pharmacist to Boots and discussion is taking place regarding training being provided for staff members. The Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 13 inspector recommended that this be implemented for all staff dealing with medication as soon as possible. See Recommendation 1. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 14 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 Overall, adequate procedures were in place to ensure complaints to the home were appropriately managed and to protect residents from abuse. EVIDENCE: In response to an anonymous complaint, received on 13/07/05, an unannounced additional visit inspection was conducted by both an Inspector and a Regulation Manager to investigate the allegations on 21/07/05. The allegations were that medication was not dealt with satisfactorily, residents were sworn at and a page was torn out of the communication book and residents were fed a diet of frozen pies and chips. Both the Inspector and Regulation Manager could not find any evidence to substantiate any of the allegations other than that a page was missing from the communication book. This incident had been recorded and a subsequent instruction had been given to staff to ensure that book was kept in a safe place, as the incident had involved a service user getting hold of the book and tearing the page out. Service users able to verbally communicate stated that they had never experienced being sworn at by staff members. The supplies of food and the daily menus were examined that showed that a varied diet was being provided. One mistake regarding medication had been reported, as required, by the manager to the CSCI under Regulation 37. In all other respects the medication system was assessed as meeting the Standard. Overall, the allegations were not substantiated and it seems possible that these were malicious allegations from a member or ex member of staff. During the course of the above investigation several issues were identified in relation to staffing documentation. Please see Standard 34. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 15 Since the last scheduled inspection and subsequent report dated 16/05/05, an allegation was made by a service user of assault by three staff members, following an incident of challenging behaviour. The three members of staff were immediately suspended and the matter appropriately investigated by the police and social services under Adult Protection Procedures. After a lengthy investigation it was concluded that there was no evidence to support the allegation and the three members of staff were reinstated. Just prior to this current inspection, the registered provider noticed a discrepancy in relation to an income support payment to one service user. This matter was appropriately reported under regulation 37 to CSCI and adult protection procedures implemented with the local authority. The matter is now under investigation and the outcome will be reported on in the next inspection of the home. Should the investigation identify any wrong doing by any member of the staff of the home, then, the appropriate action will be taken by the home and the CSCI. Please see below and Requirements 3 & 4. The Inspector examined the complaints log that showed only the incidents already mentioned and was satisfied that both complaints and adult protection issues had been dealt with appropriately and that service users are protected from abuse and that complaints are investigated appropriately. The manager advised that in view of the protracted adult protection investigation the local authority were in the process of providing a training session for registered managers. The manager agreed that this information should be share with other staff members and the opportunity taken to revise the homes adult protection procedures, if necessary and to provide additional training for all staff in this area. See Recommendation. 2. The system for dealing with the finances of residents was examined. It was noted that the provider deals with the overall income and settlement of care fees but individual pocket money is dealt with by the manager. All the service users have independent appointees except the service user who is subject to the current adult protection investigation, the manager stated that a staff member in the Social Services Department in the London Borough of Wandsworth has confirmed that there is a note on their file that the provision of an appointee by that local authority was declined by a staff member at the previous placement of the service user. This will, no doubt, be subject to further investigation by the Police. In any event, the service user must now have someone appointed as an independent appointee. See Requirement 3. The individual recording of pocket money was seen to be well organised and accountable. The Inspector was surprised, however, to learn that the provider had retained a number of service user financial files over a period of months. Had this not been the case, then, the discrepancy noted by the provider might have come to light earlier. The manager was advised that he should have control of these files at all times as they must be readily available for inspection at any time. The Inspector does not imply any improper behaviour Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 16 on the part of the owner of the home, indeed, it was that the owner who reported the income support discrepancy. It was also noted that the owner had not requested a number of reimbursements from service users’ own money that he was entitled to do so, effectively making charitable contributions to individuals’ funds by writing off the debts. The Inspector agreed with the manager that the above situation be rectified as soon as possible and ensure service user financial files are retained by the registered manager forthwith. See Requirement 4. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 17 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): N/A Please see the previous report dated 16/05/05. EVIDENCE: All of the Standards in this section were assessed as met at the previous inspection on 16/05/05. Please see the previous report. The home was noted to be clean and hygienic at this second inspection. Loring Hall DS0000051557.V265792.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 & 36 Overall a good standard of training was provided for staff members. Clarification is required in writing as to the anticipated date when 50 of care staff will be NVQ level 2 qualified. Team meetings must be held more regularly. EVIDENCE: Standard 35 was assessed as met at the previous inspection. Please see the previous report dated 16/05/05. Training records for individual staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for all new staff and foundation training following this. The Inspector recommended that records of induction and foundation training should be signed by, both the care worker, and the manager. See Recommendation 3. The Inspector noted that although further recruitment of permanent staff is underway and awaiting CRB clearance, there appears to be a shortfall in relation to the percentage of 50 staff members who have achieved NVQ Level 2 by 2005. This situation must be reviewed and a written response provided to CSCI as to what action is being taken to achieve the required percentage within the near future. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 19 See Requirement 5. At an additional inspection unannounced inspection on 15/09/05 the manager was required to overhaul the recruitment documentation and procedure. This requirement was confirmed in a letter to the home and the Inspector is satisfied that the areas identified have been addressed and that the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards were met. Whilst individual supervision sessions and annual appraisals are provided in accordance with Standard 36 it was noted that the required frequency of team meetings had not been achieved and it was recommended therefore that this should be improved. In other respects the Standard was met. See Recommendation 4. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 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 & 39 - 42 A survey of the views of service users their relatives and involved professionals needs to be implemented. Recording of information identified by the adult protection investigation must be implemented. Health and safety of service users had been attended to but night- time care staff must be involved in a minimum of two fire drills per year. EVIDENCE: The manager meets the requirements of Standard 37, although is awaiting completion of his registered managers award, due to be completed this autumn. Some progress has been made to implement Standard 39 but the home must introduce a formal survey of the views of residents, relatives / advocates and also involved outside professionals involved with the care for residents. The survey of residents must be in an appropriate format for residents with communication difficulties. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 21 See Requirement 6. Policies and procedures were in accordance with Standards however it was noted the a number of records seen by the adult protection investigators had been subject to some recommendations, the manager has already taken steps to respond to these but they must be implemented as soon as possible. See Requirement 7. A number of records to do with safety and maintenance were seen by the Inspector and were found to be up to date and well recorded. The manager confirmed that all staff had annually updated fire training, however it was noted that not all night time care staff had taken part in at least two fire drills over the past year and this was therefore made the subject of a requirement. See Requirement 8. In all other respects fire drills, alarm tests and checking of fire prevention equipment was recorded and up to date. The inspector recommended that in view of some changes in the building the fire risk assessment for the building should be reviewed. See Recommendation 5. Evidence, was available that routine servicing and testing had taken place on the electric, gas and water systems. Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 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 2 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Loring Hall Score X X 3 3 Standard No 37 38 39 40 41 42 43 Score 2 X 2 3 2 2 X DS0000051557.V265792.R01.S.doc Version 5.0 Page 23 No 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 YA1 Regulation 4& Schedule 1 Requirement The Registered Person must ensure that an updated Statement of purpose and Service user Guide are produced in accordance with the Standards and Regulations. Formal reviews of care for service users must be held at least every six months. An appointee / advocate must be provided for one service user. The files pertaining to service users’ finance must be retained by the registered manager and be available on demand for inspection. The Registered Person must review the progress made in respect of whether the home will soon achieve the required 50 of staff qualified to NVQ level 2 and confirm this in writing to the CSCI. The registered Person must ensure that surveys of the views of residents,relatives, advocates and involved professionals regarding the service provided are conducted annually. The recommendations arising DS0000051557.V265792.R01.S.doc Timescale for action 01/06/06 2 3 4 YA6 YA23 YA23 5 13 17 & Schedule 4. 18 01/06/06 01/06/06 01/05/06 5 YA32 01/06/06 6 YA39 39 01/06/06 7 YA41 17 01/05/06 Page 24 Loring Hall Version 5.0 8 YA42 23 from the adult protection investigation must be implemented as soon as possible. All night- time care staff must be involved in a minimum of two fire drills per annum. 01/05/06 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 Refer to Standard YA20 YA23 Good Practice Recommendations All staff who deal with medication should receive training from Boots Pharmacist at the earliest opportunity. The refresher training to be provided to the manager in local adult protection procedures should be passed on to care staff members. If necessary the homes procedures should be updated accordingly. Records of all training provided should be signed by care workers and also by the manager. Team meetings should be held on a regular basis in accordance with this Standard. The fire risk assessment for the home should be reviewed and updated. 3 4 5 YA35 YA36 YA42 Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Loring Hall DS0000051557.V265792.R01.S.doc Version 5.0 Page 26 - 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!