Inspection on 25/04/07 for Magnolia Lodge

This inspection was carried out on 25th April 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

Magnolia Lodge 09/12/09

Magnolia Lodge 25/02/09

Magnolia Lodge 28/04/08

Magnolia Lodge 05/10/06

Magnolia Lodge 30/11/05

Magnolia Lodge 15/12/04

Magnolia Lodge 16/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Magnolia Lodge Herbert Road Chelston Torquay Devon TQ2 6RP Lead Inspector Stella Lindsay Key Inspection (Unannounced) 25th April 2007 1:30 Magnolia Lodge DS0000018392.V331373.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 Magnolia Lodge DS0000018392.V331373.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. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia Lodge Address Herbert Road Chelston Torquay Devon TQ2 6RP 01803 605348 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) Rotel Ltd Vacancy Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2006 Brief Description of the Service: Magnolia Lodge is a care home for up to eleven adults with Learning Disabilities. The large detached house is situated in a residential area of Torquay, close to the railway station, bus routes and the Riviera Centre. There is a car park to the front and gardens are laid out mainly to lawn at the back. Entrance to the Home is by level access into a sun lounge that is used by the smokers in the Home. The ground floor has a lounge and dining room, office, kitchen and a laundry, and six bedrooms each with an en suite toilet and shower or bath. One of these is used by staff on sleep-in duty. Stairs lead to the lower ground floor, which is a self contained flat for one resident. It has a bedroom, bathroom, and lounge. Stairs lead to the first floor; a staff sleep-in room is situated on a mezzanine floor halfway up the stairs. The first floor has a further six single en-suite bedrooms, and a bathroom. Current fees range from £420 to £1,000 per week. Information is available in the lounge, including the Service users’ Guide, but not an inspection report. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in April 2007. The inspector met all eight residents, the two managers, and three other staff on duty. Surveys and comment cards had been received from staff, residents, relatives and care managers. All types of written records were seen, and the manager provided information too. The inspector looked at all the shared rooms and some of the bedrooms. All the standards that the Commission thinks are most important were looked at during this inspection. What the service does well: What has improved since the last inspection? The Managers at Magnolia Lodge are bringing in lots of improvements. One care manager giving feed back said that the home is calmer and better ordered. A person’s needs had been fully thought about before they were invited to move into Magnolia Lodge, to make sure that their needs could be met there. All residents had care plans, which contained a lot of information for staff about help that residents need with personal and health care. Training had been provided for staff that may need to help residents in an emergency, and they had been given certificates. Medicines were being dealt with in a safe way. All staff had received training in the Protection of Vulnerable Adults, in order that they might be able to identify and report abuse and protect the residents. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 6 Decorating the rooms and mending anything that was broken was being done more quickly. Fire doors had been adjusted so that they shut properly, to protect people if there were a fire. Waking night staff had been provided, to meet emotional needs of residents and to ensure their safety. A third member of staff for the evenings, starting at 4pm had just been introduced. This is good practice, as now residents can be supported with activities outside of the house during evenings. 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. The summary of this inspection report can be made available in other formats on request. Magnolia Lodge DS0000018392.V331373.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 Magnolia Lodge DS0000018392.V331373.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 Quality in this outcome area is good. There is enough information to choose whether to live at Magnolia, though some residents will need help to understand it. Careful assessment has been carried out before offering accommodation to a new person. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A Statement of Purpose had been produced and is sent to Care Managers who are considering commissioning this service. A copy would be sent to relatives or advocates on request. It is not available in a form suitable for prospective residents. An easy-read Service Users’ Guide has been produced with pictures and drawings to aid understanding. This is an improvement, but further work is needed to help those with little language to understand. A copy is always available on the table in the lounge. There had been one admission since the previous inspection. Full information had been provided by the Specialist Support Team, who had assessed the person’s needs. Visits were made, potential difficulties considered, and alterations in staffing organised in order to meet identified needs. Some residents had met this person previously at social occasions and a discussion Forum. The new resident had also recorded their own reflections. Magnolia Lodge DS0000018392.V331373.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. Care plans, though up to date, were not produced with the residents or in a form that they all could understand. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans had been written on behalf of all residents, detailing their personal and health care needs, medication, dress and appearance as well as contact with family and regular social activities. These are checked monthly by the key worker, and every two months staff are expected to sign to say that they have read an up-dated their knowledge. Plans for working towards independence were not seen, and the care plans were not produced in a form that all residents could understand. Some staff had attended training on Person Centred Planning, and the Managers were intending to undertake this training in the near future. A Speech and Language Therapist, using photographs, had produced a programme for managing cigarettes for a resident. Staff were aware of how Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 10 improvements can be made in involving residents in the development of their own care plans. One resident has a regular visit from a local advocacy service. Relatives returning surveys said that they had confidence in the staff’s understanding of their relative, but felt that there was an on-going need to assess social interests and provide appropriate choices outside day care hours. Staff had not so far provided enough information for residents about choices they could make, in a way that would motivate and empower them. They were in the habit of staying in during the evenings. Discos and day centre attended were specifically for people with disabilities. One care manager who returned a survey considered that the home could improve its liaison with other agencies. Magnolia Lodge DS0000018392.V331373.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is adequate. Residents enjoy their activities, but should have more choice and motivation to engage in a variety of activities, particularly in the evenings, and more choice and involvement with meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are able to attend a day service which is owned and managed by Rotel. One resident goes five days per week to another day care facility. Residents have been encouraged to go to SPOT meetings (Speaking Out In Torbay), and one had attended a Mens’ health group. A new resident has arrived with a full and varied programme of outside commitments, including voluntary practical work for Age Concern, and two days at a training farm. One resident was provided with a support worker to enable him to safely go to work on gardening, and he was also trying out the farm placement. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 12 There is a music centre in the dining room, which had been used for parties and buffets. Some residents had enjoyed discos provided in the community for people with learning disabilities. One resident went to lunch at a local pub with one of the Managers during this inspection, and said they had enjoyed it. The choice of activities was still limited, but managers and staff were preparing to offer greater variety. Staff levels in the evenings had just been increased, to make possible more activities outside the home for those who need support, although the benefits were not yet happening. A cookery club was planned, and there were plans to engage a trainer to run a keep fit club within the home. Some residents enjoyed a game of bingo in the lounge sometimes, but mostly there was just the television. Holidays had been arranged to suit residents. Two had holidays with relatives planned. Four were looking forward to a trip to Butlins, very soon. Another was pleased with their planned trip to Greece. The relatives who returned surveys said that the home was good at keeping them informed and sharing any concerns. Food in the fridges included yoghurts, milk and salad. The Staff on duty had recently taken responsibility for ordering food, and did this on-line, with delivery to the home. This was found to be efficient, though not involving service users. Residents did not know what was for supper. One said they would like to help in the kitchen. Magnolia Lodge DS0000018392.V331373.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Staff had given personal care according to individual need, with residents being supported to keep their appearance as they wished, and to have their health care needs met satisfactorily. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Health and personal care needs were recorded in detail on the residents’ care plans. They are supported with personal care when necessary, and supported to access medical care. All residents are registered with local GP’s and receive regular health checks including dentist, hearing and sight examinations. One resident had been accompanied to a hospital appointment on the day of this inspection. A resident was being assisted in their decision to give up smoking, successfully. One parent returning a survey said they were pleased their relative was enabled to access an Alexander teacher to help with their mobility. No residents had been assessed as being competent to self-medicate, and there was not a format for this assessment that could be used for any new resident. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 14 Medication was seen to be stored and recorded correctly, including Controlled Drugs. Several residents required medical help that involved ‘invasive procedures’. One resident carried information on them about what should happen if the situation arose. Training had been provided for staff to enable them to provide this safely, and only staff that had received this training accompanied any such resident to go out. Magnolia Lodge DS0000018392.V331373.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. There are systems in place to listen to residents concerns, and issues that had been raised were dealt with effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Complaints policy had been reviewed and up-dated. The Assistant Manager had discussed it with staff during supervision sessions. One resident had been supported to make a formal complaint. It had been concerning the disturbing behaviour of another resident, and as a result changes were made to the benefit of all concerned. All residents told the inspector that they had someone they could speak to (one of the staff) if they were worried about anything. All staff had undertaken training in the Protection of vulnerable adults. Most residents were assessed as needing help to care for their own money. This was done with great care, checking cash and receipts against the daily records, and checking bank statements to ensure that benefit payments are received. One of the Managers carries out a full audit monthly of all residents’ money. Magnolia Lodge DS0000018392.V331373.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,30 Quality in this outcome area is adequate. Some improvements to the environment had been made, and redecoration and cleaning had taken place, but some health and safety issues were still outstanding. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Magnolia Lodge is a detached villa with a pleasant garden. Residents all have their own bedroom with en suite toilet and shower. There are a lounge and dining room for communal use, and a sun lounge by the entrance, where smoking is permitted. The system for reporting maintenance requirements was working better than at the time of the previous inspection. There is a maintenance book, with a page for each room. The two Managers were ensuring that quotes were obtained when necessary, and that instructions were given to the regular maintenance worker reliably. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 17 The bathroom and some bedrooms had been redecorated. The Managers stated that they were planning to redecorate some bedrooms while the occupants are on holiday. The bathroom door did not have a suitable lock. Locks for bedroom doors should be a type that cannot be ‘deadlocked’ from inside, and that service users cannot lock themselves out by mistake. Checks for Legionella had been carried out, to prevent sickness occurring. Environmental risk assessment still needed to include risks associated with hot water and hot surfaces. There was no liquid soap or paper towels in the communal bathroom. The laundry floor was worn and in need of recovering. The tables in the dining room still had a rough surface. On one day of the inspection they were covered with tablecloths, but on the other day they were bare. Not all the requirements made by the Environmental Health Officer following their visit on 24th August 2006 had been met. Documentation for food safety management was needed to meet new regulations. The ceiling above the oven was still in need of repair, and there was no light in the dry store cupboard. Other work had been done, including cleaning, maintaining the fridge and freezer at safe temperatures, tiling the wall behind the oven and sinks, and provision of new chopping boards. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. Staffing levels had improved, and good induction training was provided. Training that would meet the changing needs of residents was being provided, and individual supervision and appraisal had started. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A rota was available, showing that there are now three staff on duty at most times. One or other of the two Managers is on duty from 8 – 4pm Monday to Friday. Other Support Staff work 50 hour shifts, including two nights sleeping in. This is considered by staff and management to be good for residents because of the continuity, and staff like to have the long periods of time off that follow. Management need to be alert to lapses in energy due to staff tiredness. Waking night staff had been provided, to meet emotional needs of residents and to ensure their safety. A third member of staff for the evenings, starting at 4pm, had just been introduced. This is good practice, as now residents can be supported with activities outside of the house during the evenings. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 19 It was seen that residents felt comfortable with staff, and some said that they were able to talk to them. Five of the seven Support Workers had achieved NVQ2 or equivalent, and one was working towards the Registered Managers’ Award. Rotel has a system for the recruitment of reliable and safe staff, but the files of the two most recently recruited staff were at head office and not available at this inspection. Two other staff files were examined, and it was seen that Rotel has produced its own application form, to ensure consistency and fairness in recruitment, and to ensure that an employment history is recorded. Two written references had been obtained, CRB clearances and proof of identity obtained, to protect residents from potential harm. Each staff member had a recruitment and training file. A Skills for Care induction programme is used, and staff returning surveys confirmed that they had received this and that they received sufficient information before starting work with residents. The Manager records staff training on a spreadsheet, which shows outstanding requirements as well as achievements. This shows that some staff but not all have received training in Basic Communication, Epilepsy, Challenging Behaviour, and Person Centred Planning. All staff had received training in the Protection of Vulnerable Adults. There had not been training in equal opportunities, and residents had not been involved in determining staff training plans. The Manager had introduced a system for supervision, staff had been given a Learning and Development Supervision agreement, and dates agreed. Supervision sessions had started, and were booked in the diary for twomonthly meetings for each member of staff. Annual Performance appraisals had been held. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. The new management structure is effective in making improvements, and has started the quality assurance process, but some safety issues are outstanding. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotel is a family-run business. Iona Fosca and Iain Dodge, both directors, are applying to the CSCI to register as Managers of Magnolia Lodge, as a job share. They have both achieved NVQ4 in care and are working towards the Registered Managers’ Award. Alison Whitehead is the Responsible Individual for Rotel, and appointed as another Director. She provides support and quality audit to the home. Progress made with meeting the requirements made at the previous inspection, as well as comments made by relatives returning surveys; show that this arrangement is working to improve the service offered to residents at Magnolia Lodge. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 21 A staff handbook is available with Rotel’s policies including the disciplinary process. A professional firm is engaged for business advice. Staff meetings had been held, with minutes kept – showing that staff training, menus, and cleaning had been discussed. Investors in People recognition was renewed in January 2006. The Managers have introduced a new Quality Assurance system, starting with gathering feedback in a structured fashion form residents and outside agencies. Residents’ meetings had also been held. The Manager stated that these will all feed into the home’s improvement plan. Some safety issues remained;On both days of this inspection, razors had been left in the bathroom. Water in the upstairs bath was found to be above the agreed safe temperature. The enamel in the bath was chipped, causing a potential hazard. Two bedroom doors were seen propped open. As the residents like to have their doors open regularly, an approved hold-open device must be fitted, with advice from the fire safety officer. The Fire risk assessments had been renewed, with each room assessed separately. The fire precaution system had been serviced professionally on 16/03/07. Staff had all attended fire safety training, either at Magnolia Lodge or another Rotel establishment. All staff had received basic First Aid training. Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 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 Standard No Score 1 2 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 3 25 X 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 3 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 Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA27 Regulation 12(4)a Requirement A suitable lock must be provided for the bathroom, so that residents can maintain their privacy without risk of being locked in. The Registered Managers must ensure safe and hygienic conditions throughout the home, including; - the tables in the dining room should have a smooth, washable surface. - the ceiling above the oven should be repaired - there should be documentation for food safety management, to protect residents from risk of infection. The fire precaution system must be complete in order to protect residents from the dangers of fire - fire doors must not be held open. Previous timescale 25/11/06 Safety in the bathroom must be assured, by ensuring that razors are always removed after use, that the enamel of the bath is repaired, and that water temperature is controlled. DS0000018392.V331373.R01.S.doc Timescale for action 31/08/07 2. YA30 13(3) 31/08/07 3. YA42 23 (4) 31/08/07 4. YA42 13.4 31/08/07 Magnolia Lodge Version 5.2 Page 24 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 YA1 YA6 Good Practice Recommendations The Service User Guide should be in a format understood by all residents. Goals for moving into their own homes should be in the care plans of those residents that indicated this desire to the Expert By Experience in October 2006. Staff should make much more use of alternative forms of communication: photos, symbols, and makaton, due to the communication needs of residents. Staff should make arrangements to enable residents to engage in local social and community activities, including training, fitness and recreation. The menu should be understood by residents to enable choices to be made at each meal. There should be a self-medication risk assessment process for all residents, to promote self-medication where this is found to be safe. 3. YA7 4. 5. 6. YA13 YA17 YA20 Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Magnolia Lodge DS0000018392.V331373.R01.S.doc Version 5.2 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!