Inspection on 31/10/05 for May Lodge

This inspection was carried out on 31st October 2005.

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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

May Lodge 22/11/07

May Lodge 02/08/06

May Lodge 01/02/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 May Lodge Barrow Hill Sellindge Ashford Kent TN25 6JG Lead Inspector Lois Tozer Announced Inspection 31st October 2005 09:35 May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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 May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service May Lodge Address Barrow Hill Sellindge Ashford Kent TN25 6JG 01303 813926 01303 814974 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) CareTech Community Services (No.2) Ltd Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2004 Brief Description of the Service: May Lodge is registered to provide care to six people who have a learning disability aged between 18 & 65. The aim of the Home is to provide a service to younger adults, within the age range 18 – 25 who have a diagnosis of autistic spectrum disorder or Asperger’s syndrome. The home is a detached bungalow, surrounded by its own gardens, and comprises of 6 single bedrooms; three with full en-suite facilities, three with toilet and wash hand basin. Two communal bathrooms with WC are positioned in easy reach for all. For communal use are a lounge, with TV and video facilities and a dining room, with a music system. The home has a large kitchen and a separate laundry. A large garden, to the rear of the property has a picnic table, a variety of recreational items and some developing plant boarders. The home is in easy walking distance of the village of Sellindge that has a shop, pub, and community centre and is on a direct bus route to the towns of Ashford and Hythe. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place on 31st October 2005 between 09.35am and 5.00pm. The manager, Erica White and the area director were present during the inspection, and staff and service users were welcoming and very helpful, assisting the process happily throughout the visit – with thanks. Six people live at May Lodge. Five service users spoke to the inspector, two gave feedback, expressing happiness at living at the home. Three staff on duty gave input, all felt well supported and raised no issues of concern. All expressed knowledge of whistle blowing and adult protection. Service users were happy to work with the staff. During this inspection a range of evidence collection methods were used, these being; conversations with service users & staff; reading of care, support and goal plans and risk assessments; general observation and of activities taking place; medication & its documentation; a tour of the communal and external parts of the house and some service users personal bedrooms. Comments from service users included,- ‘I like my room, my TV’ When asked about the choice of room colour, service user points to self and grins. ‘I know I should be polite, and staff help me remember… yes, I like them, they are nice,… we go out to fun places, look at these pictures, that was a fun day’. Staff were encouraging service users to complete their chores for house day, and did so in an encouraging manner, which was readily accepted. Two service users were going out for the day, and looked excited – and were returning as the inspection was finishing, but stopped to say they had got wet in the rain, but it had been a brilliant time (one indicated by thumbs up and a big smile). What the service does well: There is a wide range of planned activities available and the range of choice for activities outside of the home is extensive and well supported both financially and by staff availability. Service users are supported to go supermarket and local shopping regularly and have input to what goes onto the menu. Some service users cook their own meals with staff support. Individual interests are well catered to and staff have good relationships with service users, enabling them to safely share problems or concerns. Staff show enthusiasm to offer a good life to the people living in the home. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 6 Staff benefit from Adult Protection (abuse) training and were clear on what to do in a situation of concern. The physical environment is safe and well maintained and gives service users a level of freedom, to visit friends in a nearby house. All service users are keen on hosting parties and every available reason to throw a party is supported. During the inspection, everyone was keenly getting ready for a Halloween party in the house. Visitors are welcome; families feel the service given to their relatives is right for them. What has improved since the last inspection? What they could do better: Previous requirements to increase communal space have not been met, however, as the service user group has changed, the need for extra communal space has decreased. However communal space for staff belongings and general administration storage (records, medication, administration and meeting space) is insufficient and was recorded as reaching a temperature above that suitable for medication storage – addressing this remains a requirement, and as this is has now been outstanding for a considerable time, the organisation is urged to take action. Communication systems for people with limited skill in verbal speech has slipped and in some cases been inadvertently phased out. Some staff have received a taster training session in Makaton communication, but this appears insufficient for the needs of the people living at the home, who were using May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 7 complex teaching and communication plans. A requirement was given, and was agreed that this would be reviewed rapidly and staff would be supported to understand the essential nature of diverse communication skills. Some individuals, on occasion, have required physical restraint. Staff have received appropriate restrictive practice training (NVCI), but the documentation to support the individuals does not focus sufficiently on positive support planning to reduce behaviours that may result in this outcome. Records of restraint are not being sufficiently monitored and analysed, which must be improved. Some environmental restraint (locked cupboards) have been accepted as necessary without consideration for the individuals development to tolerate items. Underpinning these improvements is the need to plan in a person centred manner, which includes the individual in decision and enables staff to support as the person wishes. At present, this is hindered by the corporate requirement to have certain paperwork in the individual plans, and this is not necessarily meeting the individual’s needs. The area director agreed to look and review this system. 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. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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 May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5 Assessment processes draw out individual needs and aspirations indicating if the home can meet specific needs. Prospective service users have a trial period, to see if it is right for them. Terms and conditions of residency are clear and are issued to each individual. EVIDENCE: All prospective persons wishing to live at the home benefit from a full needs assessment to ensure the home can meet specific support requirements. Assessments take into account individual aspirations, and inform the initial support plan for the trial period. The trial period is generally 3 months; a 6week review takes place to ensure that both parties are happy for this timescale, which, in negotiation, can be extended if deemed necessary. Terms and conditions of residency are presented in text format; the key points would benefit from being presented in text format, and greater accessibility is being developed. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 The service user plan would benefit from a greater person centred approach to better describe positive interventions to limit the possibility of restraint. Communication packages need improvement to increase the level of independent decision-making, and to increase staff awareness of this essential area of service user life. Participation is generally well supported, but all staff must be aware of inadvertently removing opportunities for involvement. Risk assessments are in place, and are descriptive, but would benefit from closer scrutiny when related to restraints. Environmental restrictions must be justified and plans developed to move towards fewer restrictions. Sensitive and personal information is handled and stored securely. EVIDENCE: Each individual has a written plan that outlines his or her support requirements. In the main, this is a helpful document for staff, but does not demonstrate that it has been written in consultation with the individuals themselves, and in some areas, intervention plans have been written without consultation with behaviour specialists. The plan contains a great deal of paperwork that is not necessarily relevant for each individual, but is a company standard. A more person centred approach was discussed, as was the need for a greater focus on individual communication packages to enable more May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 11 independent expression and decision-making. A suggestion that the company standard paperwork was revised, and developed to better include individuals was made. Some useful documents in the individual plan (monthly summaries, future plans) were in place, but staff were not aware how to use them properly, so had become a paper filling exercise, rather than inclusive development for the service user. Some of the staff team have received basic communication training, but the communication packages that some service users entered the home with have been inadvertently phased out, without assessment or replacement. A requirement has been made that every individual, who demonstrates communication difficulty, have a communication assessment and the outcome of such assessment is followed up with staff training and support. On occasion, some service users have required physical restraint of some kind. Staff have received training in theory and practice of minimal restraint, and documentation is in place to describe interventions. However, the plans seen lacked clarity and did not focus on the positive, proactive interventions to reduce the use of restraint. These plans need to be revisited and written in a clear and positive manner, with reference to the procedures as taught in the restraint training that apply to the individual themselves and be place specific – as risks and actions will change depending on the situation. Risk assessments are in place for known risk situations and all restraints are documented, but are not, at present, being clearly analysed and reviewed to ascertain if the plans, interventions, and staff skills and training remain relevant. All service users are actively encouraged to participate in chores around the home, but some spontaneous chores (such as pouring cold drinks and taking plates out to the kitchen), were being missed, as staff automatically conducted them. This said, staff were actively engaging people in the preparation for a party that evening, which was being eagerly anticipated by all, and participation in planned chores is a regular feature of daily life. All documentation and information is handled with clear adherence to the homes policy on confidentiality. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 14, 15, 16, 17 Service users are involved in the daily routines of the home, but some opportunities for involvement can be inadvertently overlooked. Communication packages, as described above, would benefit from improvement. All service users are supported to access community facilities for practical reasons and leisure pursuits. Family contact and friendships are well supported. Service users enjoy their meals and have some input into choosing what goes on the menu. EVIDENCE: Staff do support service users to learn practical life skills, but, as above, everyday, spontaneous opportunities can sometimes be overlooked. Actively supporting people, by working alongside them and role modelling would be beneficial, rather than staff doing the chore. Service users said, and records show, that lots of opportunities are given for people to get out and about, doing practical as well as fun things in the community. Two service users had dressed for Halloween, and were enjoying a day out at a major tourist attraction. The home continues to have as many parties and celebrations as possible, with decorations being created by the staff and service users. Each person has their own personal entertainments systems in their bedroom, and May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 13 communal areas have TV, DVD and stereo facilities. A large disco unit had been borrowed for the Halloween party, and friends and family had been invited to attend. The range of food is varied, and reflects individual likes, providing a healthy diet. Service users are involved in some food preparation, and plans are in place to develop better communication of choice in menu planning with the use of picture cards. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Personal support requirements are well described. Physical healthcare is very well supported; development of the team’s communication skills to enable service users to express their feelings with greater clarity will enhance emotional support. Medication management is robust and safe. EVIDENCE: Each person has a clear overview of what support is required for his or her personal care. Documentation shows that general health care and access to the GP when required is speedy and action taken as needed. As communication is such an important part of emotional well being, this is difficult to assess, but meeting the requirements to have better communication packages in place for each individual should enable greater future insight. No service users currently have control of their own medication, and risk assessments deem this appropriate. A discussion took place about individuals having greater involvement of medication at the point of administration. All storage and management of medication was robust and safe at the time of inspection and staff had received training, which appeared to meet the needs of the service. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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, 23 Staff support service users to understand how to complain and they seem confident to approach staff for help and support. All staff have adult protection training and understand whistle blowing. EVIDENCE: Service users are supported to have problems resolved speedily. Communication issues described earlier may limit access for some, and service user views are often picked up by staff knowledge of individual’s particular behaviour. Complaints received from parties about the home have been dealt with swiftly and professionally, with support from the central management team. Staff have received adult protection and non-violent crisis intervention training to ensure they support individuals appropriately. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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, 26, 27, 28, 29, 30 The home is comfortable and safe with a homely atmosphere. Bedrooms meet individual needs and lifestyles and promote independence, all have en-suite toilets, and three have bathing facilities. Individual bathrooms could be improved. There are sufficient communal toilets and bathrooms. Service user shared space is freely available, but is insufficient for staff to store belongings securely and the office space is crowded and not conducive for the many purposes it aims to fulfil. No resident requires specialist environmental adaptations. The home is clean and hygienic. EVIDENCE: Each individual has a large, individually decorated bedroom that is really to his or her own taste, style, and liking. Some individual bathrooms would benefit from the floor de-scaling and having a mirror fitted, so people can check their appearance before they leave their room. There is a large lounge and separate dining room, with TV and music facilities. The dining room is used for recreational activities too. The kitchen is kept locked when unoccupied by staff; service users are supported to access this facility when staff are present. Communal space for staff storage is limited to the visitor’s toilet, which is not ideal, is not secure or hygienic. The administration office is very crowded, as it has to serve multi-purposes, including medication storage. A clear record of the temperature of the office has been maintained as the medication is stored May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 17 within, and it has exceeded 25°C on a number of occasions. This room is also used for staff supervision, meetings, storage of records and day-to-day administration. The Commission were advised upon granting registration for this property, that this would be addressed, however, had not to date. This will remain a requirement in relation to storage and a recommendation to improve the communal areas for service users. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 Staff benefit from a LDAF induction and foundation programme but few have achieved an NVQ qualification. There are sufficient staff available to meet individual needs, but service user communication methods and systems need improvement. Service specific training is varied to meet basic service needs, but service users would benefit from staff with a greater depth of training specific to their individual needs. EVIDENCE: Although few (8 ) of the team hold an NVQ qualification, all benefit from a LDAF induction and foundation training programme, that gives a background of supporting people who have a learning disability. Staff work with individuals with empathy and appear to get on really well, show respect, and see each person as a unique individual. However, communication packages and systems that were in place have been phased out or discontinued. Four staff have received a 1 day taster session in Makaton communication in the last 12 months, but because structured communications systems have been lost, service users gain minimal value from this. One-day training sessions have been given to a selection of the team covering epilepsy, autism, and medication management. As a home specialising in providing a service to a group of people with autistic spectrum disorders, a training audit to ensure that a good baseline of essential training is given to all staff, and especially the senior team, who can then support with recognised good practice. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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, 38, 42 The manager at present is not registered and advises that submission of application for registration is imminent. Ethically, the home strives to promote each individuals rights and responsibilities in a supportive environment, however, must ensure that restrictions and ways of doing things are regularly reviewed so they do not become institutionally accepted. The environmental health and welfare of all persons in the home is well supported. EVIDENCE: The manager has been promoted from a deputy position, and is being supported by line management to achieve registration, and is just completing the NVQ4 award. Additional training that has been highlighted in this visit, that would aid greater success is person centred approaches to planning all aspects of individuals lives and more in-depth A.S.D. related training. The manager uses self reflection as a way of maintaining good standards, but must also be aware of challenging practices that have been implemented and not reviewed, such as locking away personal items. Whilst this may be appropriate, it must be reviewed and still have rationale, and be demonstrated that action to reduce restrictions is being implemented. Communication with May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 20 other professionals such as the community learning disability team would be beneficial. Staff have received all necessary health and safety training and all service certificates are up to date. The environment appeared safe. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 LIFESTYLES Standard No Score 11 2 12 X 13 3 14 3 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 May Lodge Score 3 2 3 X Standard No 37 38 39 40 41 42 43 Score 2 2 X X X 3 X DS0000065349.V257014.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard Regulation Requirement Timescale for action 01/03/06 YA6YA7YA11YA19 14 15 2 YA6YA8 14 15 24 3 YA6YA9 13 14 15 17 23 4 YA28 Every individual, who demonstrates communication difficulty, have a communication assessment (by a speech and language therapist, where needed) and the outcome of such assessment is followed up with staff training and support. Individual plans be 01/03/06 reviewed and have a person centred focus – drawing out what is important to the individual and how to positively support them in all situations. Reactive management 01/02/06 strategies be written in a situational context and all restraints used be reviewed by manager with aim to reduce wherever possible. (Previously unmet 01/12/05 requirement) Plan more suitable storage facilities for staff belongings. Ensure medication storage temperature is kept below DS0000065349.V257014.R01.S.doc Version 5.0 Page 23 May Lodge that stated on guidance. 5 YA9 17 Review environmental restrictions and implement plans to increase access to belongings. Staff have suitable training to be skilled and competent in their roles with this service user group, to enable service user development. Action plan to identify suitable training in place by… Manager apply for registration through CSCI 01/01/05 6 YA32YA33YA35 18 01/01/05 7 YA37 9 05/12/05 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 YA16 YA28 Good Practice Recommendations Daily chores are shared with staff and service users and incorporated in the daily shift planner. (Previously unmet requirement) Address shortfall in service user communal space. May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 May Lodge DS0000065349.V257014.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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