Inspection on 01/11/06 for Manor Mews

This inspection was carried out on 1st November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Manor Mews 07/10/08

Manor Mews 16/01/06

Manor Mews 22/08/05

Manor Mews 24/01/05

Manor Mews 02/07/04

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 Manor Mews Manor Mews Cowick Lane Exeter Devon EX2 9JG Lead Inspector Teresa Anderson Key Unannounced Inspection 1st November 2006 11:00 Manor Mews DS0000059978.V315733.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 Manor Mews DS0000059978.V315733.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. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Mews Address Manor Mews Cowick Lane Exeter Devon EX2 9JG 01392 438048 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) sally.cross3@btinternet.com Mrs Sally Ann Cross Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To permit two named persons outside the categories of registration being over the age of 65 to remain in the home The maximum number of persons accommodated at the home, including the named service users, will remain at 10 On the termination of the placement of either of the named service users, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held earlier 16th January 2006 Date of last inspection Brief Description of the Service: Manor Mews provides accommodation and care for up to ten adults who have a learning disability. The majority of people who live at the home have lived here for over 10 years. The home is situated close to the town centre. Bus stops are close by giving easy access to the city and surrounding areas. The owner lives on site and provides transport for outings and when needed. The home is a detached Georgian style property that stands in large well maintained gardens. The building is decorated in a homely manner with contemporary furniture and fittings. The current level of fees range from £313.00 to £905.00. This does not include for example toiletries and personal items. Information about this home, including reports, is available direct from the home. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. It started at 11.00am and finished at 3.45pm. An additional visit was made to the home to view some records unavailable on the day of the site visit. During the inspection the inspector spoke with 9 of the 10 people whose home this is. The majority of whom have some degree of communication disability. She case tracked the care and services offered to 3 residents (this help us to understand the experiences of people who live here). The inspector spent time observing the care and interactions between staff and residents. She spoke with the owner/manager and with 3 of the care staff. Records in relation to care planning, residents’ monies, staff training, staff recruitment and safety were inspected. Before the site visit ‘comment cards’ were sent to all the people who live here and all were returned; to 9 staff and 6 were returned; to 7 relatives and 5 were returned; to health and social care professionals who have contact with the home and 6 were returned. Their opinions and comments are included in this report where appropriate. In addition to the above the owner provided the commission with information in a ‘pre-inspection questionnaire’. What the service does well: People who live at this home tend to stay a long time and as such there are rarely vacancies. The person who has come to live here most recently says that they were able to visit and meet with residents and staff. They said they had enough information about the home before they moved in. One person said they visited lots of homes but liked this one the best. Another said ‘I like it here’. Staff help residents to make decisions about how they live their lives, which includes some risk taking. This is recorded in care plans. Those who are able are assisted to use public transport and come and go as they please. Others are supported to achieve other meaningful goals. Less able residents are helped to receive care in a way that suits them and which keeps them safe and healthy. Residents say they see the doctor when they need to and care plans demonstrate that appropriate referrals to health and social care professionals are made. People who live here attend local clubs of their choice and partake in activities such as shopping, going to the pub and pottery classes. One resident has been helped to grow vegetables in the home garden and has just obtained their own allotment. On the day of the site visit some residents were out, another was Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 6 tending the garden and preparing to go out that afternoon, another was working and another was drawing. Residents say they enjoy the food and staff were heard offering food choices. Staff talked of how they strike the balance between ensuring that residents have a healthy diet and that residents get their preference for less healthy foods. Care plans show that there is enough detail to ensure consistent care is delivered. Timely and appropriate referrals are made to health and social care professionals including dentists, chiropodists, district nurses and psychiatrist. Residents in surveys say that staff always listen to them, that they know who to speak with if they are not happy and that staff treat them well. Residents know who their key worker is and what this person does. Staff have a good understanding of adult protection issues and receive appropriate training. The home is well decorated and maintained and is clean and homely throughout. Staff are well trained and are able to meet residents needs. There are always 2 members of staff plus the owner on duty during the day and at night there is one waking member of staff. Recruitment procedures ensure that residents are protected and are based on equal opportunities. The owner is appropriately experienced and qualified. She has an open and inclusive style of management and staff report she is always around to help. Appropriate checks and maintenance contracts ensure the home is well maintained and safe. What has improved since the last inspection? What they could do better: All monies received and given out on behalf of residents should be checked and signed by two people for audit purposes. The owner should ensure that all hand transcribed entries on medication records are checked and signed by two people to prevent errors. 3 of the 8 staff have obtained care qualifications at NVQ level 2 or above and this training should continue so that at least 50 of staff have this qualification. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 7 Quality assurance systems need reviewing to ensure that appropriate questions are used and that residents have the opportunity to speak freely. 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. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. People who come to live here can be assured that the staff will have a good understanding of them and what their needs and desires are. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people who live at Manor Mews have lived here for a long time. The most recent admission was nearly 4 years ago. Before this person was admitted to the home they visited and met with the staff and people who live here. Their needs were assessed and a plan of care was drawn up. This person told the inspector ‘I like living here’. In surveys all residents who understood the questions indicate that they were asked if they wanted to move into this home and that they had enough information about the home before moving in. One said they had looked around a number of homes but liked this one. It is anticipated that the current group of people living at the home will not change. However, staff describe how they would help a prospective resident to get to know the home and the other residents, in order to help them make a decision about where to live. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 10 Each resident has a contract and Statement of Terms and Conditions and these were seen in individual resident files inspected. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. People who live here have a plan of care that ensures staff understand each individuals needs and how these should be met. People are helped to make decisions about their lives and how they live them and this includes managing and taking risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at the home has a plan of care. This gives details of their physical, emotional and social needs. The manager explains that how these needs are met are negotiated with the resident and this is recorded so that staff give care and support in a way that has been decided by the resident. Care plans show that residents are helped to set goals that help to enhance their lives. This is as simple as going shopping for one person and about developing and building on skills for another. Care plans are reviewed regularly Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 12 and formal reviews include health and social care professionals where appropriate. Staff demonstrate a good understanding of residents, their needs and personalities and how needs should be met. They were overheard offering choices about food and what residents would like to wear. One resident showed the inspector the handbag they had chosen to carry. Some care plans include the level of detail needed to ensure that those residents with complex physical needs have their needs met safely. This includes information about the use of manual handling equipment and the prevention of skin damage. Some residents know they have a care plan. Some talked about their key workers (which is part of the care planning system in the home) and describe these as ‘the person who helps me’. People living here have differing abilities and as a consequence are able to take different levels of risk. In surveys the majority of residents say they always make decisions about what they do each day and others said usually. Some residents have been supported to enable them to travel on public transport alone and/or to manage their own monies. Staff were overheard reinforcing the route to be taken by one resident who was going out, without being patronising. Some residents are supported to help with cooking and cleaning. Other residents are not able to take this level of risk. However, care plans and discussions with staff show that the least able residents are not restricted to the extent that their lives involve no risk taking at all. Written assessments are in place and are reviewed as needed. Some residents need help with managing their monies. There is a system in place for recording this. Three accounts were checked and found to be in order and all monies are kept securely. However, it was noted that on some occasions only one person checks monies received and given. It is good practice for security purposes that two people do this. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. People who live here experience a lifestyle that enhances their quality of life. The rights of people who have disabilities are protected and promoted by the staff and the ethos of the home. People who live here benefit from a diet that is varied, nutritious and which is much enjoyed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some of the people who live at this home told the inspector of how they spend their days and the activities they are involved in. One resident visits the local pub and another has a job in a charity shop. 4 residents were out until 2pm, when they returned from the local ‘Gateway Club’. One resident explained that they go here twice a week. Some residents talked of the ‘Pheonix’ – an arts Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 14 and crafts club – that they attend. The home also offers in-house pottery sessions and this is a clear favourite of residents. Examples of residents work are displayed throughout the home. Some residents are involved in a home working programme for which they are paid. The amount of work they do is not pre-determined but is decided by each resident on a session-by-session basis. One resident who loves gardening has recently been supported to have and manage their own allotment. This resident talked of the things they have grown and bought into the home to eat. Some residents enjoy more sedentary activities such as watching the television and drawing. There are 2 rooms with TV’s (and each resident also has their own TV in their bedroom). Crayons and paper are available at all times. All the people who live here have an annual holiday. This year they went to a Caravan Park in Devon which some residents talked about and obviously enjoyed. The home has it’s own transport and this is often used to support residents to visit their families when needed. During a tour of the home the inspector saw that all bedrooms have locks although residents choose not use keys. They say that staff knock before going into their bedroom and each resident was asked for their permission before the inspector was allowed to go in. All residents said how much they enjoy the food. Those who could talked about the types of things they like and what they eat. Some residents would prefer a much less healthy diet and staff do a good job ensuring there is a balance between choice and nutrition. Staff make recordings regarding nutritional needs and intake. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The people who live here are helped to stay healthy through proactive management. Personal support is offered to the people who live here in a way that offers choice and promotes independence. Lack of attention in one area of the management of medications is potentially placing residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said that they have a doctor who they see when they need to. One resident said that staff had really helped them when they were not well. Care plans show that there is timely and appropriate involvement of health and social care professionals. This includes dentist, chiropodist, district nurse, psychiatrist and a drama therapist. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 16 One resident has healthcare needs that have challenged this service. These needs have been well met. Advice has been sought from appropriate sources and there is evidence that this has been put into practice. Another resident who is becoming increasing immobile and whose physical needs are increasing has a good range of appropriate equipment to help them and the staff, and is given supervision at the appropriate times to keep them safe. All surveys returned by healthcare professionals about the care provided. Comments included ‘the care is good and clients are well cared for’ and ‘the owner and staff are approachable and help with treatment plans’. None of the residents manage their own medication and this is, on the whole, managed well and stored safely on their behalf. The home uses a monitored dosage system and staff receive training in how to manage this. The owner/manager both orders and receives medications into the home but does not get a second person to check and sign that they have checked the medicines received into the home as is good practice. The medication administration charts show good record keeping. However, hand written entries are not being checked and signed by a second person. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. People who live here are protected from harm and can be sure any grievances will be listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys all residents said that staff always listen to them, that they know who to speak with if they are not happy and that staff treat them well. Some said they would speak with their key worker and named this person. Neither the home nor the commission have received any complaints about this home. Staff are trained in ‘safeguarding adults’. They watch a video produced by the Department of Health and many have attended training sessions organised by the local authority. They demonstrate a good understanding of issues related to abusive practice and know who to tell, both inside and outside the home, if this happened. Observation of interactions between staff and residents show mutually respectful and relaxed relationships. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The people who live here enjoy an attractive, clean and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well decorated and maintained. It is clean throughout and residents, in comment cards, say it is always clean and fresh. Staff showed how clinical waste is dealt with and this is appropriate. Current residents do not do their own personal washing. This is cared for by staff in a dedicated laundry. A bathroom has recently been converted into a wet room to ensure that the needs of all residents living here can be met. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 19 Although the lounge has steps to it and cannot therefore be accessed by those who use wheelchairs, the owner reports that she would put a ramp over the steps if this were needed. However, current residents who use wheelchairs prefer to sit in the lounge/diner. One resident confirmed this. During a tour of the building it was noted that some fire doors do not always close properly. The owner said she would deal with this immediately. When the inspector returned to the home, this had been done. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. Recruitment and training of staff ensures that the people who live here are well supported and are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection the owner/manager was on duty with 2 members of staff. The duty rota shows that this is the usual staffing level. At night there is a waking member of staff on duty. In surveys staff say they know who to contact in an emergency and what to do if a residents needs change. Staff also say they receive clear instructions about what they are expected to do and about each residents needs. In surveys relatives said there were enough staff on duty. The inspector looked at three staff files and found that staff working at this home are employed after appropriate police and other checks are undertaken. In addition the owner has recently made changes to the recruitment procedures to ensure these are based on equal opportunities. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 21 Induction records show that this initial training is based on the Learning Disability Award Framework (LDAF) as is good practice. Other training is undertaken to help staff develop the skills needed to meet the needs of the people who live here. This has included ‘Breakaway’, ‘Gentle Teaching’ and ‘Epilepsy’. 3 of the 8 staff have attained training in care to NVQ Level 2 or above and 2 other members of staff are studying to gain this qualification. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. People live in a home that is well managed, is safe and is run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner of this home is also the Registered Manager who manages the home on a day-to-day basis. She is qualified in care and management to NVQ Level 4 and holds the Registered Manager’s Award. Staff say they find her approachable and helpful and that the home has a nice atmosphere. Recently the owner/manager carried out a quality audit of the home. She asked for comments from residents, family members and visiting professionals. The style of questions used was discussed with the owner as the questions are Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 23 not always entirely appropriate. It was also noted that staff helped residents to complete the comments cards sent by the commission as part of this inspection. This might not always be entirely appropriate and it might be good practice for independent advocates to help with this. In the pre-Inspection Questionnaire the owner reports that appropriate maintenance checks and contracts are in place for systems such as heating and electrics. Appropriate fire checks take place and staff demonstrate a good understanding of this. They also demonstrate a good understanding of the residents’ lack of understanding around fire drills and they know what to do to compensate for this. Risk assessments of radiators have resulted in all radiators being covered and thermostatic valves being fitted to the hot water bath tap to prevent scalding. Window restrictors are in place where needed. Staff receive appropriate training in manual handling, fire safety, first aid, food hygiene and infection control. A recent food safety inspection carried out by Exeter City Council was satisfactory. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 X 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 2 x 3 x 2 x x 3 3 Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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. 3. 4. Refer to Standard YA7 YA20 YA32 YA39 Good Practice Recommendations You should ensure that any monies received or spent on behalf of residents is checked and signed by two people. You should ensure that all hand written entries on medicine charts are checked and signed by two people. You should continue to work towards ensuring that 50 of the care staff employed at the home are qualified to NVQ Level 2 or above. You should consider reviewing the questions used to get feedback from residents and you should consider using independent advocates. Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Devon 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 Manor Mews DS0000059978.V315733.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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