Inspection on 09/02/06 for Maison Moti

This inspection was carried out on 9th February 2006.

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

The inspector found 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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Maison Moti 28/09/07

Maison Moti 04/01/07

Maison Moti 30/08/05

Maison Moti 28/02/05

Maison Moti 31/08/04

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

CARE HOME ADULTS 18-65 Maison Moti 200 Chase Side Southgate London N14 4PH Lead Inspector Jane Ray Unannounced Inspection 9th February 2006 09:00 Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Maison Moti Address 200 Chase Side Southgate London N14 4PH 020 8440 7535 020 8441 7378 info@maisonmoti.co.uk 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) Maison Moti Limited Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specific service user who is over 65 years of age and has mental health needs may be accommodated in the home. This condition will need to be removed at such times as the service user vacates the home. 30th August 2005 Date of last inspection Brief Description of the Service: Maison Moti is registered to provide accommodation and care for fifteen people under the age of sixty-five who have a mental disorder (mental health problems). A condition of registration has been approved for a service user who is over the age of sixty-five to remain at Maison Moti, as long as the home can meet her needs. The home is situated in Southgate in a residential street and blends in well with other local houses. All the amenities of Southgate are a short walk away and the home is well situated for bus and underground transport. Maison Moti Ltd operate this care home and four supported living projects for people with mental health problems. At the time of this inspection, there were 13 people living at Maison Moti. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 9 February 2006 and was an unannounced inspection. The inspector stayed at the home for four and a half hours. The inspector met the Operations Manager, newly appointed home manager, deputy manager, three support workers and eight of the thirteen residents. One resident has had their placement terminated since the last inspection as the home can no longer meet their needs. The inspector spoke to most of the residents individually or as part of small groups. The communal rooms and bedrooms were inspected along with records, policies and procedures. A new manager has just been appointed and the inspection took place on her second day in post. The Operations Manager was also available for most of the inspection as he was visiting the home to undertake her induction. What the service does well: What has improved since the last inspection? Since the last inspection the home has been redecorated and has new carpet and looks really well maintained. The home has implemented the new care plans and these need further work but represent good progress. The home has provided a tea urn and jug of cold drink in the small lounge that the residents can access at any time of the day or night and the residents said they are very satisfied with this arrangement. A cook and cleaner were both in post at the time of the inspection and so the home has adequate ancillary support. The fire exit doors were all working properly and fridge and freezer temperatures were all being recorded. The activity worker can now work up to fifteen hours a week to complete activities, which is an increase in her input. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 6 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. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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): 2,3 and 5 The residents living in the home all had very comprehensive assessments prepared by the care professionals and the home itself. EVIDENCE: The records for four current residents at the home were inspected. These all included comprehensive assessments from care professionals and where appropriate the previous placement. In addition the home had also completed it’s own assessment of the person’s needs. In the four resident records there was only one contract between the home and the resident available and this did not include details of the fee payable. The deputy manager explained that only one resident has a copy of a contract in their file. The other contracts were complete but not available in the residents files. The inspector from meeting the residents and discussing their needs with the staff and from speaking to a visiting community nurse was of the opinion that the service is able to meet the needs and aspirations of the current residents. There is also a process underway to assess potential residents for the vacant place in the home. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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): 6,7,8 and 9 The residents all have care plans and risk assessments but these need to be kept up to date and signed by the residents. The residents are supported to make decisions for themselves and to give their opinions about the running of the home. EVIDENCE: Four of the residents care plans were inspected. These all contained current care plans that had been prepared in the previous six months. One of the care plans had not been signed by the resident and there was no evidence that this had been discussed with her. It is required that all the care plans are signed by the resident if they wish to do so. The residents spoken to were all able to name their key worker and said they were happy with this person and were able to describe how they were supported with personal shopping and healthcare appointments. It was also noted that key workers have sessions with the resident to discuss progress with their care plan and this is recorded in their case notes. The four care plans all contained records of care plan review meetings although the operations manager said that at times it can be hard to ensure the care manager is present. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 10 The risk assessments for the four residents were also inspected. One highlighted a healthcare risk that was not reflected in the persons care plan. The deputy manager explained that this health care issue had been resolved and was no longer a risk and the risk assessment needed to be updated. It is required that the risk assessments are kept up to date. The residents all spoke about how they make decisions about going out, when they go to bed or get up when they wish to see family and friends. A few have restrictions placed on them for example the staff hold their cigarettes and help them ration their smoking. When asked about this the residents are able to say why this happens and why they agree with the action. One resident said “I know I smoke too much”. The risk assessments reflect these restrictions and the reasons are clearly documented. The residents were able to tell the inspector about how they have a monthly residents meeting to talk about what is happening in the home and participate in decisions. One resident said that at the last meeting they had discussed “lunches, activities and cleaning duties”. He said he felt able to give his ideas and that these were accepted by the other residents and staff. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 While links with the community and the activities available enrich the residents social opportunities, attention is needed to ensure those residents who are provided with one to one staff hours to facilitate these activities have this input in place. The dietary needs of the residents are well catered for with lots of fresh fruit and vegetables and a high standard of cooked food. EVIDENCE: The home employs a part-time activities organiser and her hours have been increased to between 10-15 hours a week since the last inspection. She organises activities in and outside the home. The residents spoke about these activities and clearly the most popular are trips to the cinema, into London and shopping. Some residents discussed how they did not wish to participate in the organised activities but preferred to go out independently or with a member of the care staff. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 12 For the last two inspections the issue has been raised of the seven residents who have funding for one to one staff hours. It is still not possible to tell from speaking to staff and looking at records exactly what is being provided with these one to one hours. A requirement is made that this is now addressed to ensure the residents get the full support they require be it with their independent living skills in the home or their community participation. The residents were able to tell the inspector how they participate in domestic activities in the home. One resident said “I don’t really like cleaning my room but every week a member of staff helps me to have a good clean”. Another resident said “I know my days for doing my laundry and when I am helping with the drying up”. These activities were also reflected in the residents care plans. Some residents are supported to attend college or day services. One resident was able to tell the inspector about how he goes to college and is learning DJ skills. One resident who is Hindu and speaks Urdu was able to describe how his cultural needs were met, with food within the home and a member of staff who speaks his language. He said he chose not to practice his religion. Residents were able to tell the inspector how relatives and friends were welcome to visit the home or they were supported to visit them at their homes. All the residents had a key for their bedroom and it was observed that the staff always knocked before entering the rooms. The residents were observed to be comfortable entering all the communal areas of the home. The menu was inspected and is healthy and provides a good range of food. Individual preferences including a vegetarian option is available. On the day of the inspection a nice lunch of noodles and stir fry vegetables was prepared and the residents said they enjoyed this food. Residents can give their preference for a lunch and this is made during the week. One person said she always asks for cheese and onion toasted sandwiches. The home now has a cook who works six days a week to prepare the main evening meal and Sunday lunch. The home provides cold drinks and a tea urn in the small lounge so residents can access drinks at any time during the day or night. Residents have their weight monitored on s monthly basis and are supported to have a healthy diet. One resident currently has high cholesterol and is being supported to eat an appropriate diet to address this. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 residents are satisfied with how they are supported by staff according to their individual needs. Most residents have now been supported to access primary healthcare input but this needs to be extended to all the residents. The medication system is organised appropriately but there needs to be further work on the use of PRN medication. EVIDENCE: The inspector spoke to the residents who were able to speak positively about the support they received from the staff. One said “they give me the help I need and I am able to ask them for help and they always speak nicely to me”. The residents were able to describe the support and this included help with going out shopping, going to the hairdressers, doing the laundry and ironing”. The residents were observed choosing the times they got up and what they wanted to wear. They were all wearing appropriate clothing that was in a good condition. They spoke about going regularly to the hairdressers and barbers. The care plans for four residents were inspected. They all showed that they were receiving regular input from the mental health services. Three of the four had now been to the dentist and optician but one still had no record of being supported to access this health care input. A requirement has been made at Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 14 the two previous inspections for all the residents to be supported to access healthcare appointments and if they refuse then this should be recorded. Clearly this has nearly been completed but needs to be restated one more time to ensure that this has been extended to all the residents. The medication was inspected. One resident is self-medicating and there is no risk assessment in place for this. The home uses a local pharmacist who delivers the medication weekly in dossett boxes. Three residents have their medication directly from the hospital and the home staff place this medication in the dossett box. The medication was appropriately stored and the medication administration records were in place and correctly completed. Staff training records showed that staff who administer medication have received the medication training. A resident had medication that had been administered for a health problem that then recurred and the medication that was left was being used as a PRN medication. A requirement is made that this medication is also reviewed with the GP and formally recorded as PRN if required. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 homes complaints procedure is designed to ensure peoples views are listened to. The home uses the local adult protection procedure and has a clear whistle blowing procedure. Where residents need support to mange their money there is a system in place for this but there needs to be better storage of receipts. EVIDENCE: The complaints procedure and complaints records were inspected. The procedure is very clear and is available in the main hall for the residents to access along with the whistle blowing procedure. There have been no complaints in the last six months but previous complaints have been appropriately recorded and there is evidence that the concerns have been addressed. The residents when spoken to also said that if they had any problems they felt comfortable speaking to the staff and these would be dealt with. The home has adopted the Enfield adult protection procedure. The personal finances for two residents who needed support with managing their money was inspected. There was a clear system in place to provide a clear audit trail for their money. The only issue was that recent receipts had been put together for all the residents and it was hard to find the receipts relating to specific residents expenditure. It is required that receipts are always kept separately for each resident. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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): 24,25,27,28 and 30 The home is comfortable, well maintained, clean and attractive. The residents are satisfied with the facilities available in the home. EVIDENCE: The inspector looked around the whole building. There is one shared room and the rest are being used as single rooms. The two people who share a room both stated that they enjoy a shared room. Six of the bedrooms have en-suite facilities and in addition there are three toilets, two bathrooms and a shower room. The communal areas include a large lounge, a smaller sitting room which is the smoking room, a dining area and kitchen. The garden has an attractive patio area. Since the last inspection new carpet has been fitted and the home has been redecorated and the home was very well maintained. The home was spotlessly clean and has a utility room that is accessed by the residents to do all their personal laundry. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 service at Maison Moti is now appropriately staffed. Thorough recruitment checks are in place. There is an ongoing programme of training. Staff need to receive regular supervision and an annual appraisal. EVIDENCE: Since the last inspection the staffing has increased to include a cleaner working five days a week for six hours each day and a cook working three hours a day five days a week to cook the main evening meal. In addition the activity organiser can now work up to 15 hours a week. This means that during the week there is a manager working 9am-5pm and two care staff on an early and late shift. At the weekend there are also two care staff on duty. At night there is one sleeping and one waking member of staff. This means that during the week the care staff can concentrate on supporting the residents but there needs to be further work on how that time can best be used to focus on achieving the best outcomes for the individual residents. The inspector spoke to the staff on duty and sat in for a staff handover. From this the inspector was able to see that the staff had a good understanding of the residents individual needs and their broad roles. The inspector looked at four staff files and they all contained the necessary recruitment checks including two references and a CRB disclosure. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 18 The inspector looked at the staff training records for the four staff and they had all completed an induction and there was evidence of an ongoing training programme. Four of the ten staff had completed their NVQ level 2 in care although one was waiting for a certificate. One further member of staff was near to completing the training, which means the home has nearly reached the 50 of staff completing the NVQ. In addition other staff are also undertaking the relevant qualifications including social work training. The inspector looked at the staff supervision records and the staff have not been receiving regular supervision and some are due an annual appraisal although the appropriate systems are in place. A requirement is made that all staff receive regular supervision and an annual appraisal. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 In order to ensure the health and safety of the residents the home needs to take a number of actions to safeguard health and safety in the home including ensuring all fire doors can close in the event of a fire, arranging weekly fire alarm checks and ensuring all staff training is up to date. The annual quality assurance exercise needs to be implemented to seek the views of everyone who is involved in the service. EVIDENCE: The inspector met the manager who has just been appointed. The manager was undertaking her induction at the time of the inspection. The manager will now need to complete the registration process. The home has completed a quality assurance exercise in the past but this now needs to be repeated and to seek the views of relatives and care professionals. Once responses to questionnaires have been received then the responses need to be collated into an action plan. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 20 During the tour of the premises it was observed that the fire doors upstairs and downstairs were both wedged open. The wedges were immediately removed. Both doors were fitted with a dorguard but on the downstairs door the dorguard was preventing the door from closing properly and made the fire door ineffective. The record of fire alarm checks showed they had not happened for the two weeks prior to the inspection. The fire drills were taking place monthly. The fire risk assessment was available and complete. The evacuation procedure was in place and the residents said that the fire drills allowed them to understand how to evacuate the building. The fire alarm and emergency lighting had been serviced. The maintenance certificates were checked and were satisfactory for the electrical installations, electrical appliances, gas, boiler and water system. The home has a comprehensive health and safety policy and risk assessments. All accidents and incidents are appropriately recorded and there have been two accidents recorded in the last six months. The staff have been trained in the necessary areas of health and safety. It was however noted that for a member of staff who had been in post for over two years that some of the training took place in 2004 and is due to be renewed. Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 1 1 x 3 X 2 X X 1 x Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 YA5 Regulation 5(1)(b) Requirement The registered person must ensure that each resident has a contract between the home and themselves detailing what the home will provide for the service user as part of the fees available in their case notes. The registered person must ensure that all the residents have been supported to understand and sign their care plans once they are satisfied with the contents. The registered person must ensure the individual risk assessments remain up to date to reflect changes in the resident’s needs. The registered person must ensure that each resident is supported in line with their care plan and 1:1 funding to have the input they need to ensure they are supported to achieve their full potential. The registered person must DS0000010639.V286344.R01.S.doc Timescale for action 31/03/06 2. YA6 15(1) 31/03/06 3. YA9 13(4) 31/03/06 4. YA11 12(1) 15/04/06 5. YA19 12(1) 31/03/06 Version 5.1 Page 23 Maison Moti ensure all the residents have been supported to access dental and optical input. This requirement is restated as most residents have received this input but one has not and so the previous timescale of 31/10/06 was not met. 6. YA20 13(2) The registered person must ensure where PRN medication is needed that the resident is supported to have the necessary input from the GP. The registered person must ensure that where a resident self medicates that the necessary risk assessment is complete. The registered person must ensure that where the home supports the resident to manage their finances that the receipts for goods purchased are kept separately for each resident so they can be identified for the audit trail of the residents finances. The registered person must ensure all the staff have regular supervisions and an annual appraisal. The registered person must ensure that an annual quality assurance exercise is completed that seeks the views of relatives and care professionals as well as the residents and that the responses are collated into an action plan. The registered person must ensure the internal fire doors are all able to close properly. 31/03/06 7. YA20 13(2) 31/03/06 8. YA23 13(6) 31/03/06 9. YA36 18(2) 31/03/06 10. YA39 24(1) 30/04/06 11. YA42 23(4) 28/02/06 Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 24 12. YA42 23(4) The registered person must ensure the fire alarms are checked weekly The registered person must ensure that staff health and safety training is repeated and kept up to date as required. 28/02/06 13. YA42 18(1)(c) 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Maison Moti DS0000010639.V286344.R01.S.doc Version 5.1 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!