Inspection on 09/05/07 for Lynton Terrace, 1-3

This inspection was carried out on 9th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynton Terrace, 1-3 04/12/06

Lynton Terrace, 1-3 23/05/06

Lynton Terrace, 1-3 13/10/05

Lynton Terrace, 1-3 29/04/05

Lynton Terrace, 1-3 20/09/04

Lynton Terrace, 1-3 01/06/04

Lynton Terrace, 1-3 23/06/03

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

CARE HOME ADULTS 18-65 Lynton Terrace, 1-3 Lynton Road Acton London W3 9DU Lead Inspector Ms Susan Woolnough-Singh Key Unannounced Inspection 9th May 2007 10:00a Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynton Terrace, 1-3 Address Lynton Road Acton London W3 9DU 0208 992 3343 0208 992 3353 peter.ashworht@hestia.org 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) Hestia Housing & Support Manager Designate in post (Peter Ashworth) Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th December 2006 Brief Description of the Service: 1/3 Lynton Terrace is a detached property, situated in a residential area of Acton and close to Acton Main Line Station and bus routes. Acton town centre is about a mile away and there are local shops nearby. The home is a mental health facility for ten service users, providing medium to long-term accommodation. Hestia Housing and Support manage the home. The communal areas on the ground floor comprise of two lounges, one of which can be used by service users who smoke, a dining room and kitchen, and a games room. A small kitchenette is located on the first floor. There are ten single bedrooms, four of which are on the ground floor. Three bathrooms, one with a separate shower, are available for the ten service users. All of the bathrooms have toilets and there is one separate toilet close to the communal facilities. The staff sleeping-in room, which has its own bathing facilities, is on the first floor. This is also used as the manager’s office. There is a small garden to the rear, with a separate building which houses the laundry room. There is off road and street parking. The staff team consists of a Project Manager, two Deputy Managers, and a team of four Project Workers. They support the service users with personal care, practical tasks and leisure activities. There are no waking night staff and one member of staff sleeps in at night. A new post of housekeeper has been introduced to oversee all of the domestic duties and support service users with practical tasks. The current charges are £742 a week. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 9th and 10th of May 2007. The inspection process took a total of nine hours. All of the key standards were assessed on this occasion. Nine people were being accommodated at Lynton Terrace; one person who resides at the home had been in hospital for a number of months. The Manager Designate was present during the inspection. He confirmed that he is in the process of applying for Registration with CSCI. He commenced employment at the home in January 2007. The home has service users and staff from various ethnic backgrounds and the staff team reflects this diversity. There is also an appropriate gender mix of service users and staff. Nine requirements and one recommendation were made at the last inspection which took place on 4th December 2006. The Manager Designate was able to demonstrate that these requirements had been met or plans had been made to comply. What the service does well: What has improved since the last inspection? What they could do better: The number of staff on duty needs to be kept under review to ensure the best interests of people using the service are met. Two staff are on duty during waking hours to support nine people (one person being in hospital). Through discussion with staff and observation it was clear that staff have to support and Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 6 motivate people in their daily routines and some people’s mental health needs are such that they require significant input from staff. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The ‘Guides’ provided to people who use the service provides good information on Lynton Terrace and local services. People have their needs assessed prior to moving in to Lynton Terrace. EVIDENCE: It was a requirement that the Statement of Purpose and Service Users’ Guide were reviewed, updated and made available to the people who use the service and the Commission for Social Care Inspection. The Statement of Purpose and Service Users Guide had been reviewed and updated in February 2007. The records of fours service users were examined. These contained a Community Psychiatric Nurse assessment of need. A Licence Agreement was Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 9 available for each person living at the home. There is a written induction for people new to the service to introduce them to the procedures of the home. The aims and objectives of the home and needs of people were discussed with the Manager Designate. All require support with daily living although some people are able to experience higher levels of independence than others. Overall, staff need to offer encouragement and support for the people who use the service to carry out the routine tasks of daily living. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are available for people who use the service; the plans set out their needs and are reviewed every three months. Staff assist people who use the service to make decisions. People who use the service are able to give their views and suggestions at residents meetings. Risks associated with daily living are assessed as part of the care planning process. Risk assessments will be reviewed if people’s needs change. EVIDENCE: The records of four service users were examined. The file of each service user contained a service user care plan, risk assessments and daily records. Care plan headings include personal development, education and occupation, community links, leisure, daily routines and mealtimes. These headings are linked to the Lifestyle Standards (NMS) Care plans contained information on Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 11 health care and are reviewed every three months. People who use the service have a key worker. People who use the service are encouraged by staff to make some decisions with regard to their daily lives. This decision-making will be within the person’s present mental capacity to make informed decisions and choices. Residents meetings are now held every Thursday; agenda headings for discussion include household tasks, maintenance issues, holidays and leisure and quality reviews. On this occasion the Inspector was only able to talk with one person who lives in the home, about the quality of care. This person was able to answer affirmatively but did not give a general view on the home. The Inspector spoke with two members of staff. The care of people who use the service is monitored and staff discusses any changes and events in daily handovers and staff meetings. Risk assessments are completed for people who use the service. Financial vulnerability and general ability and vulnerability are assessed. At the time of the inspection the risk factors for one person had changed and the relevant referral had been made to a mental healthcare professional. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is aware of the need to assist people in their personal development and engage them in activities and life outside of the home. However, some people who use the service choose not to do this. The provision of meals in the home is good. EVIDENCE: The care plans state how people are to be enabled in their personal development. Agenda items for resident meetings indicate that in house activities, household tasks and food consultation are to be discussed. Community Psychiatric Nurses monitor and review the progress of people who use the service. People who use the service are encouraged to participate in Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 13 the community and activities outside of the home. However, it appeared from talking to the staff that few people make the choice to do this. A requirement was made at the last inspection that staff continue to encourage people to participate in the day to day running of the home. Documentation and discussion with staff suggested that the home was endeavouring to meet this requirement. Encouragement is given to participate in household activities; most people are given support to look after their bedrooms and in addition to this some people help with general household tasks. One person attends a mental health resource during the day. People who use the service make the decision how to spend their day and have particular routines. It was clear form talking with staff and observation that people need quite a high level of support particularly in the area of motivation to carry out basic daily routines. Service users have differing levels of contact with family and friends as this depends on their circumstances. Staff cooks one meal a day, this is the evening meal. The Inspector saw the menu for the evening meal this incorporates one ethnic dish a week. One person is assisted by staff to cook the food of his/her choice. People prepare their own breakfast and lunch with the assistance of staff. A daily record of meals is kept. A housekeeper is employed; she has overall responsibility for the food shopping and will assist people if required. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of the support people need in the area of personal care and offer this as required. The complex mental health needs of people who use the service are monitored by the relevant professionals and by the staff. It is recommended that the recording for all health appointments be improved to enable staff to monitor this. There are arrangements in place for the safe administration of medication to service users; the training of staff in safe handling needs to be reviewed. EVIDENCE: People require different levels of support for personal care. Some people are able to maintain a reasonable level of personal care and other requires support and encouragement to do this. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 15 The aim of the Lynton Terrace is to provide permanent accommodation for people who require a mental health service. If needs change people may move on to accommodation with less support or conversely to psychiatric hospital. At the time of the inspection on service user was in hospital. There has been a history of non –compliance of medication for some people, this was the case at the time of the inspection. The mental health professional linked to one person was aware of this and regular contact was in place. The files examined indicated that care plan approach reviews had taken place recently. The home has access to two-community resource centres were professional advice on peoples mental health can be sought Action to be followed with regard view of physical health care is covered in the care plan. The Inspector discussed with the Manager Designate the benefits of having a record of contact to all primary health care professionals such as GP, dentist, optician etc. A record is available but not readily accessible. This is a good practice recommendation. People, who use the service, at the time of the inspection, were not responsible for administering their own medication. A blister packed 28-day medication system is used; staff administer and sign for medication given. The Medication administration record was examined and found to be in order. Medication was stored correctly. A review had taken place recently for one service user. Two staff are designated to order medication and monitor the system in place. The Training Matrix completed provided to the Inspector indicated that some staff had received training in medication and the monitored dosage system. It was not clear that all staff had received up to date training on basic knowledge of medicines and polices, procedures and safe handling. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place for people to raise their concerns; the evidence seen suggested that these were taken seriously. Training in protection of vulnerable adult awareness has taken place for some staff, not all staff have received this training. This has been identified in the training plan for the home. EVIDENCE: Hestia has a complaints procedure, which is available for people who use the service at Lynton Terrace. There is also a comprehensive list of contacts for support, counselling and social services in the resident’s handbook. The Inspector looked at the complaints log, there was one complaint made, which was covered three areas of dissatisfaction. The complaint had been taken seriously and investigated. A satisfactory outcome had been reached. A further issue had arisen in relation to the property of one person who uses the service; this had been referred to the CMHT. New staff undertakes induction training, this includes an element of training with regard to safeguarding vulnerable adults. The staff-training matrix indicated that four staff had received Protection of Vulnerable Adults Training. Three staff have not received this but the training matrix has listed this training as a future priority. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 17 Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The accommodation provided for people is comfortable and clean. Improvements have been made is some areas since the last inspection. Work still needs to be undertaken on the windows and improvements to bedrooms. EVIDENCE: A tour of the building took place with the Manager Designate. The communal areas of the home are pleasant and comfortable. On the whole the home is reasonably well furnished and decorated. Since the last inspection a new bathroom has been installed on the ground floor, this has been done to a good standard. There are two lounges on the ground floor, one of which is for smoking. It is recommended that the smoking room be redecorated to provide a fresher look. A requirement was made at the last inspection for an action plan to be sent with regard to the replacement of windows. This was discussed with the Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 19 Manger Designate after the inspection. Funding has been applied for from an external organisation but has yet to be approved. However, Hestia is in the process of getting quotes and will initially finance the replacement. A small sample of bedrooms was seen. One of these had recently had new flooring. The bedrooms were adequate. People who use the service have their own keys and choose how to keep their bedroom. Staff intervention and help with cleaning is often needed. It is to be recommended that the home look at ways to enhance the appearance of people’s bedrooms. A Housekeeper is employed on a full time basis. All areas of the home are being kept to a good standard on cleanliness. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A minimum number of staff are on duty during waking hours. This needs to be reviewed to ensure that people who use the service are offered opportunities to maintain and develop social and independent living skills. A satisfactory recruitment process is in place for the protection of people who use the service. The home must have information from CRB checks available for inspection. The training for National Vocational Qualifications and basic training is satisfactory. The Manager designate has undertaken planning for future staff training to improve their knowledge and skills. EVIDENCE: The current staffing levels of two project workers on each of the early and late shifts, and one member of staff sleeping in at night continues. The staff team Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 21 consists of two deputy project workers, four project workers and a housekeeper. There is an on call system for out of hours emergencies. The staffing levels in the home must be kept under review. The Inspector observed and ascertained during the two days of the inspection that people who use the service need quite a high level of support. As mentioned under previous standards some people require the support of staff to undertake daily routines and functions. Other people who use the service were observed to need staff attention and emotional support. Staff gave this. People also need help and encouragement to maintain and develop social and independent living skills. The personnel files of two staff were examined. The required documentation was in place in relation to application forms and references. CRB checks are sought for new staff but are not available for inspection as they are stored at Hestia head office. Some form of evidence in relation to CRB checks must be kept at the home. Staff records indicated new staff induction had taken place and regular supervision was being offered to staff. A recommendation of the last inspection report was that a training matrix or spreadsheet be considered to record staff training. The Inspector was provided with an up to date training profile and training development plan 06/07 for all staff. A requirement of the last inspection was that staff must have the training for the duties they perform including advanced mental health training. The majority of staff have received training in mental health and conflict management/working with challenging behaviour. It us to be recommended that all staff have received training in conflict management. The manager designate was able to give confirmation that Advanced Mental Health training had been booked for 2nd and 3rd July 2007. This was a requirement of the last inspection. Three staff have an NVQ qualification and four staff are currently undertaking NVQ training. The training profile demonstrates that staff have attended a number of training courses relevant to their work. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager Designate was able to demonstrate that plans had been made to develop Lynton Terrace for the benefit of people who use the service. A review of the service had taken place for the benefit of people who use the service. Health and Safety procedure are in place. Food Hygiene training needs to be undertaken by all staff to ensure good practice is in place. EVIDENCE: A new Project Manager has been recruited to the home since the last inspection. The Manger Designate has a Degree in Psychology and Health Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 23 Studies. He has undertaken training in supervision and appraisal, recruitment and selection and health and safety. Registration with CSCI was briefly discussed; preparation for this had been done. A requirement was made at the last inspection that the Registered Provider must work to improve relationships within the staff team and to develop and improve the service. The Manager Designate was able to demonstrate through discussion and documentary evidence that service development was taking place. A requirement was made at the last inspection for a review of the quality of care to be carried out. A Lynton Terrace Scheme Review took place on 22nd February 2007. This included issues raised by the families of people who us the service, and the results of the resident’s satisfaction survey. The analysis highlighted a number of issues for consideration and action. An internal inspection of Terrace was carried out by Managers external to the service. A Fire assessment was completed in October 2006. This also covers the fire safety arrangements for the home. The fire record books were seen. The last fire drill evacuation took place in April 2007. Some staff had received training in first aid, food hygiene, and health and safety and fire awareness. The planned training schedule indicated that further training is planned for food hygiene; this must be made a priority as all staff prepares meals. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 X X 2 x Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 25 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 YA20 Regulation 13 (2) Requirement Timescale for action 01/08/07 2. YA32 18 (1) (a) 3. YA33 19 ((4) (b) 4. YA38 12 The Registered Manager must ensure that all staff who administers medication have received training on basic knowledge of medicines and principles of medication handling and recording. The Manager Designate and 01/08/07 Registered Provider must review the minimum staffing levels to ensure staff are able to meet the aims and objectives of the home. The Manager Designate and 01/08/07 Registered Provider must ensure that information on Criminal Records Bureau Checks must be available for inspection. The Manager Designate and 01/08/07 Registered Provider must ensure that all staff have undertaken food hygiene training. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 26 No. 1. 2. 3. 4. Refer to Standard YA19 YA35 YA24 YA25 Good Practice Recommendations A format for recording all health care appointments for people who use the service should be developed. All staff should have training in conflict management/working with challenging behaviour. The smoking lounge should be redecorated. Consideration should be given to improving the ambiance of service users bedrooms. Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lynton Terrace, 1-3 DS0000027756.V339671.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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