Inspection on 25/09/06 for Magnolia Cottage

This inspection was carried out on 25th September 2006.

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

Magnolia Cottage 02/10/08

Magnolia Cottage 21/02/06

Magnolia Cottage 02/09/05

Magnolia Cottage 01/03/05

Magnolia Cottage 24/01/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Magnolia Cottage 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG Lead Inspector Mrs Dorothy Binns Unannounced Inspection 25th September 2006 12:00 Magnolia Cottage DS0000027631.V314317.R02.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 Magnolia Cottage DS0000027631.V314317.R02.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. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia Cottage Address 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG 01603 897764 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) www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Position Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Magnolia Cottage is a care home providing personal care and accommodation for up to 4 younger adults with a learning disability. The service users may also have a physical disability. Care Management Group Limited whose registered office is located in London owns Magnolia Cottage and four other small homes in the environs of Norwich. The home is located in a residential area in the village of Spixworth, and close to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow. All bedrooms offer single occupation. None of the bedrooms have en-suite facilities. There is ample communal space. There are gardens to the side and rear of the building, with parking available at the front of the home. The fees for the service vary from £4602 - £6164 per month. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection lasting four hours. Discussions were held with the new manager about the progress of the home and whether requirements from the last inspection had been attended to. Records and policies were examined and a tour was made of the premises. A member of staff was also interviewed. In addition the Commission sent out surveys to the service users and relatives to see what they thought of the service. One service user and three relatives replied. Information on the Commission’s files and contact with the home between visits has also been taken into account in the writing of this report. The inspection concentrated on the key national minimum standards. At the time of the visit, the home was only accommodating three service users and two were away on holiday with staff so only one service user was seen. This is a small family type home for four service users and overall the care offered is very good and staff are committed to the service users who have a good quality of life. What the service does well: The service provides a homely and attractive environment for the service users in a family type home. They have their own rooms where they can be private and a shared cosy sitting room. The service users are looked after well and every effort is made to ensure their individual needs and preferences are catered for. Staff take the service users out on most days to ensure some outside stimulation and enjoyment and there is good liaison with the families. The health of the service users is well monitored and they have good access to doctors and other community health professionals. Their medication is properly looked after and administered. The home has good policies to guide staff in principled ways of working and in ensuring service users are protected. Staff are well supported and have access to good short course training opportunities. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Magnolia Cottage DS0000027631.V314317.R02.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 Magnolia Cottage DS0000027631.V314317.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality of this outcome area is good. Service users’ individual needs and quality of life issues are fully assessed to enable staff to support them appropriately. EVIDENCE: Two files were checked at random including that of the newest service user. Both contained detailed information about the service users including reports from outside agencies (community learning disability team and other placements). The home has its own detailed assessment document which covers all areas of need, disability, skills, routines and interests providing a lot of information to enable the home to assist the service users in the best way. The home also keeps a record showing 24 hour observation in the first few days so that the assessment can be altered to reflect more accurately the needs of the service user. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 The quality of this outcome area is good. The service users’ changing needs and choices are reflected in the care records and properly maintained. Areas of risk are assessed to balance the support to service users to assist them to lead a more independent life. Service users are assisted with their money and staff accurately record what they handle. However the money belonging to one service user still needs to be sorted out. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 10 EVIDENCE: Two care files were examined and showed that each service user had a detailed care plan generated by the assessment outlining what support they needed in all areas of their life and how staff might manage or intervene to prevent self harm or aggression. Strategies were laid down and information was given so staff knew what made the service users happy and how best to communicate with them. Each service user has a key worker to look at specialised needs. Each aspect of the care plan is reviewed monthly and staff write detailed notes every day about the progress of the service user and how they have spent their day. Three relatives responding to the Commission’s survey said they were satisfied with the overall care and one service user said he felt well cared for. Service users are not in a position to make all their own decisions because of their disabilities but staff confirmed that they were supported to make as many decisions as they were able. They each got up at a different time and were able to indicate to staff what they liked and did not like. But most of the time staff have to take the initiative and see that the service users are comfortable and stimulated. All service users need help with their money and the personal money received by the home was shown clearly in the records with an account of how it was spent and the cash held on their behalf. This was balanced correctly and receipts were appropriately kept. Two of the service users have guardians who look after their benefits and savings but one service user has all the benefits paid into the home. The home is keeping this money in a company account as it has not been possible to negotiate a bank account for the service user. A record was available showing the total amount held in the account but it was not clear what benefits were paid in. The service user was also not being given any interest for his money. It is accepted that negotiations with banks are taking place and the Commission is sympathetic to the problem and has agreed that the money may be kept in a company account. However the service user should be able to receive interest. A repeat requirement has been made. In terms of risk taking service users are supported to participate in life in the community and files showed assessments regarding how safe they were outside, in the home’s transport, taking a bath, whether they were prone to choking and other areas where safety might be an issue. The actions that staff need to take to minimise the risk were detailed Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 The quality of this outcome area is good. Service users do depend on staff making sure they have a good life as they are quite dependent. However the attitudes of the staff and the evidence of outings and leisure activities, contact with family and the time staff spend with the service users ensures that they are enabled to have a good quality of life. EVIDENCE: Service users are not able to find work or attend voluntary activities without staff support. One service user does attend the Adult Training Centre five days a week and the remaining two go with staff to the Skills centre twice a week (This is owned by the same organisation.) The staff on duty said she had been out this morning to the skills centre with the one service user at home. Staff are investigating a college course to see whether one of the service users can be supported there. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 12 Service users do go out into the community but such is their dependence that they are always accompanied and staff have to take the initiative in all activities. Staff do take them to local shops, pubs and public events. The records showed that service users are also taken out regularly for outings, visit friends in other homes and celebrate birthdays. One has shown a love of flute music so has been taken to a classical concert. Swimming and horse riding are also provided. The home has transport which it shares with another home. Staff confirmed that service users were taken out every day. Two service users not at home were on holiday with staff in Lincolnshire for a few days. The one service user responding to the survey said they had lots of things to do. Two of the service users have good family links and see them regularly. Staff confirmed that they are welcome in the home. The policy of the home is to encourage contact with families and see that those links are maintained. Three relatives responding to the survey said staff were always welcoming and helpful. Service users are given whatever privacy they can manage. They do have their own rooms though are not able to handle a key. They do have private time alone though and can play their own music in their rooms. Families confirmed they could see their relative in private. Staff do spend a lot of time with service users and see their duties as providing stimulation and outdoor activity. Service users are limited in what they can help with but one service user is learning some household tasks. The menus were family fare with snacks for lunch and a homely meal at night. All staff have to be able to cook. The staff confirmed that service users ate well and had plenty of access to snacks and drinks. Toast is often offered in the evening with hot milk. There are no special diets. Because it is a small home, staff felt they could respond to service users as they would their own family and also do the home’s shopping. There was no concern expressed about the food. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 The quality of this outcome area is good. Service users are supported appropriately and have their health needs monitored. The home’s policies and training of staff on medication protect the service user. EVIDENCE: One service user needs extra support in the bath and equipment has been provided. Otherwise service users are mobile. All three are men and there are both men and women on the staff giving service users a choice of who helps them. Personal support is provided in private and staff confirmed that routines are flexible and are dictated by the service users. The manager reported that service users were generally very healthy and did not have a lot of contact with the GP. However the files showed that when necessary service users were taken to see the doctor. One GP consulted by the Commission for his views about the home confirmed that usually service users were brought to the surgery and that carers seemed attentive. In the records there was also evidence of district nurses being involved, dentist and optician check ups and regular visits from the chiropodist. The records showed that staff monitored the weight and sleep patterns of the service users and were sensitive to health problems and their service users moods and demeanour. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 14 Service users also have a review with a social worker annually and the learning disability team can be used for consultation. The evidence was that appropriate monitoring is carried out and service users have access to community health facilities. The medication records were checked. Two service users were on holiday so there records were not available but the one remaining service user’s medication was recorded satisfactorily and tallied with the medication. There are no controlled drugs. Staff files showed that they receive training in the administration of medication. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality of this outcome area is good. Although service users may be limited in their ability to speak up, the home has good procedures and a commitment to ensuring that they are listened to by staff and protected. EVIDENCE: A complaints procedure is available in the service users guide and provided in a widget format for easier understanding by the service users. The complaints procedure is in all the rooms of the service users. The complaints procedure was also seen in the visitors book ensuring they had a voice if they needed it. The manager felt that staff were attuned to the service users and picked up any concerns from them at an early stage. Service users also have access to their families and staff at the skills centre should they not wish to speak to staff in the home. A regional manager also visits monthly and keeps an eye on how the service users are doing. The information provided by the manager showed that no formal complaints have been received and none has been received by the Commission. Full procedures on abuse and whistle blowing were seen ensuring that staff understood the standards expected of them and what to do if they suspected abuse. The procedure locks into local multi agency procedures. The protection of adults is included in the induction course for new staff. The home also has a gifts policy making clear to staff about their conduct. This shows a good commitment by the home to the protection of their service users. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The quality of this outcome area is good. The service users have a homely and comfortable environment which is kept clean and tidy and which offers private and communal space. The garden is still to be improved but work is starting in October. EVIDENCE: A tour was made of the premises and the accommodation was looking attractive and comfortable. Each service user has their own room and one has an en suite shower. Service users share a sitting room, a dining area in the kitchen and the bathroom which has been assessed by an occupational therapist for aids to help one service user who is less mobile. Radiators are covered to prevent burning and overall the home is pleasant and cosy. The garden area is accessible by a ramp but needs to be tidied up. A requirement was made at the last two inspections for improvement. The manager confirmed they now have a date for the work. The home is clean and free from offensive odours. Laundry facilities are domestic in character but are adequate for the job. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36 The quality of this outcome area is adequate. Short training courses including induction training are being provided by the home to ensure that service users benefit from appropriately trained staff but further training for a national qualification should be offered. Recruitment practices need to be tightened in order for service users to be fully protected and recruitment for permanent staff needs to be ongoing. Staff are well supported however and are accessible and approachable. EVIDENCE: Staff files showed that training of staff is ongoing and that training on different topics like medication and adult protection have been provided this year. Only one staff has achieved the NVQ2 which is only 25 of the permanent workforce and less if agency staff are counted. The standard is for 50 trained to this level. More training is required. See requirements Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 18 The rota for the home showed that normally two staff are on duty during the day and evening with one staff sleeping in at night. This is normally enough staffing for the number of service users. As two service users were on holiday with two staff, only one staff was currently rostered to be on duty at the home and this was considered to be satisfactory. The staff on duty said she was able to cater well for the service user and had taken him out in the morning to the skills centre. The manager was on call and arrived when staff called him during the inspection. The current rota showed that one or two shifts are covered by agency staff but the information from the manager showed that over the last eight weeks 19 shifts have been covered. This is quite a lot of use of agency staff and recruitment needs to continue to build up a stable staff group. There is also a bank staff who covers shifts in this and another of the homes so knows the service users well. Four fulltime permanent staff cover the home though they cannot cover all the required hours. Overall it was considered that the staff hours were satisfactory. Two staff files were examined to see what the recruitment process was. References and criminal record checks were made and identity documents were in place. Interviews had taken place and both staff had been given contracts and job descriptions. There was however not enough scrutiny of the application form and the cross referencing of referees. One file showed that no reference had been received from the last employer but from an ex colleague which might be quite different. Extra care must be taken. A requirement has been made. Induction training was in evidence on staff files and new staff are subject to a probationary period. A training profile was seen on each staff file sampled showing what courses they had done. The staff on duty also confirmed the training she had had. Both staff files examined and the staff member interviewed confirmed they had one to one sessions with a manager on a regular basis to discuss their practice. Staff also have handover meetings and their manager is available if there are difficulties. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 The overall quality of this outcome area is good. Although the manager is not yet registered, he is experienced and competent and is aware of the procedures which need to be improved in order to ensure a good service to the service users. The organisation is developing a better quality assurance programme and health and safety systems are appropriately in place making sure service users are protected. EVIDENCE: The manager of the home has been recently appointed, the previous registered manager having left in August. He also has responsibility for another small home also of four service users. An application to register is expected in the near future. The manager is experienced and is studying for his NVQ4. There is also a tier of management support from a local regional manager as well as guidance, policies and procedures from head office. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 20 The organisation has quality assurance material and there are surveys carried out to find out the views of service users, relatives and staff. A regional manager also visits monthly as part of the monitoring of the home (regulation 26 reports). The information was very detailed and a simpler set of standards may make the system easier to achieve. However the material was in place. What was missing was an overall analysis of the home with an improvement plan for the year. This still needs to be in place. A recommendation has been made. During the renovations last year much of the health and safety features of the home were reviewed. The home has full health and safety policies and procedures and the staff induction course includes these. Staff have to sign a form to show they understand them. One staff interviewed confirmed her moving and handling and first aid training. Certificates for gas and electrical testing and for the testing of water temperatures were all seen. An accident record is kept. Fire drills are held regularly and fire equipment is tested monthly. The whole of the fire system has been recently checked. Risk assessments were in place for the building and for individual service users who might need extra support to be safe. Overall there is good attention to health and safety matters and service users are protected. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 1 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 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 2 x x 3 x Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 22 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 YA28 Regulation 23(2)(o) Requirement Timescale for action 31/12/06 2. YA7 17 and Schedule 4 3. YA32 18(1)(c) 4 YA34 19 The registered person must make the external grounds suitable and safe for the service users. Previous timescale 31/03/06 A record should be kept of all 31/12/06 money received on a service users behalf including what benefits are collected. Money held in a company account should receive interest for the service user. The registered person must 31/03/07 ensure that staff receive training appropriate to their work. In this instance, more opportunity should be given to study for the NVQ2. The registered person must not 31/10/06 employ a person to work in the care home unless he has obtained the information and documents specified in paragraphs 1 –7 of Schedule 2 of the Care Homes Regulations. In this instance two references should be sought and more scrutiny made of the application. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 23 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. Refer to Standard YA39 Good Practice Recommendations It is recommended that the quality assurance system is simpler and measurable to ensure an improvement plan can be written. Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Magnolia Cottage DS0000027631.V314317.R02.S.doc Version 5.2 Page 25 - 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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