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Inspection on 06/10/05 for Mckechnie House

Also see our care home review for Mckechnie House for more information

This inspection was carried out on 6th October 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

When asked what the service does well Mrs Revelle said that she felt Broad Horizons Limited, in their three care homes, were able to offer a homely environment. The two service users at McKechnie House are involved in the daily domestic duties of the home. No domestic staff are employed. From the limited communication that was possible with the service users, the inspector understood that both service users were happy living at McKechnie House. Staff working with the service users were seen to be sensitive to service users` wishes, having a good understanding of their individual needs despite some communication difficulties arising from their assessed learning disabilities and particular autistic tendencies. Within the service Broad Horizons Limited has a small, established staff group. Relationships between service users and care staff were seen to be sensitive and caring and established friendships have developed within the service user group.

What has improved since the last inspection?

Mrs Revelle said that Broad Horizons Limited had undertaken a review of their policies and procedures and that some revision and amendment had been necessary. Within Broad Horizons Limited, nine staff have completed three modules of the Learning and Disability Framework (LDAF) training entitled Safe Practitioner, Communication and Adult Abuse Awareness. National Vocational Qualifications (NVQ) level 2 training has been progressed and the majority of staff have completed or are working towards completing this training. Two care staff are awaiting a final module/assessment visit to complete NVQ level 3 training in care.

What the care home could do better:

Mrs Revelle said that Broad Horizons Limited recognises the need to continually review and update training for care staff. It was acknowledged that this was a way help ensure that `staff are equipped for the job.` The need to continually decorate and maintain the care home, inside and out, was highlighted by Mrs Revelle. Ongoing work in all three properties is planned, with kitchen renovations and garden hard landscaping planned in each home. Whilst it is acknowledged that great strides have been made in the presentation of the Statement of Purpose and the Service Users` Guide, the need to develop a Service Users` Guide in a format easily readable by the service users is highlighted once again in this report. Quality assurance and quality monitoring systems need to be developed and established and continued review and updating of policies and procedures still require attention.

CARE HOME ADULTS 18-65 Mckechnie House 104 Mill Road Mile End Colchester Essex CO4 5LJ Lead Inspector Pauline Dean Final Announced Inspection 09:30 5 – 6th October th Mckechnie House DS0000017880.V255929.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 Mckechnie House DS0000017880.V255929.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. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mckechnie House Address 104 Mill Road Mile End Colchester Essex CO4 5LJ 01206 751463 01206 843367 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) Broad Horizons Limited Mrs Jean Brown Fleming Revelle Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 2 persons) 9th March 2005 Date of last inspection Brief Description of the Service: McKechnie House is an established small care home, first registered in October 2001 for two younger adults with learning disabilities. The registered provider is Broad Horizons Ltd, with Mrs Jean Revelle as the responsible individual/ registered manager. McKechnie House is one of three small care homes, with the same proprietor, located in Mill Road and as they are in close proximity there is interaction between service users and staff. The home is found in a residential area of Colchester, located close to Colchester General Hospital. Close by there are local shops and facilities, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the two service users is on the first floor, both having single rooms with a wash hand basin fitted. There is a bathroom with bathing and shower facilities and toilet. An office/staff bedroom is also found on the first floor. On the ground floor there is a front lounge and a kitchen/dining area. The property is semi-detached and has gardens to the front and rear. There is some off-road parking in the front garden. The rear garden is enclosed with a paved patio area, decking and a lawn. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days in October 2005. This was the first inspection of the inspection year 2005 to 2006. Throughout the two day inspection there was discussion with the responsible individual/registered manager, Mrs Jean Revelle, with a senior care staff member assisting the inspector during the inspection. The three small care homes of Broad Horizons Limited were inspected over the two day period of the 5th & 6th October 2005, with the inspector moving from one home to the other during the inspection. A total of 15½ hours was spent on the inspection in the three care homes. Four members of the care staff were interviewed and all service users were met and spoken with during this inspection. No visitors or relatives were interviewed during this inspection. Tours of the premises were conducted and both care and staff records were sampled. In addition, some of the policies and procedures were sampled and inspected. Twenty-four of the forty-three standards were inspected; of these nineteen were met, with five standards nearly met. There is a marked improvement in meeting requirements since the last inspection and the shortfalls noted relate to the production of a Service Users’ Guide in a format that would be readily understood by Service Users; care planning and risk assessment reviews; health and hygiene training; quality assurance and quality monitoring processes; and the need to review and revise policies and procedures. What the service does well: When asked what the service does well Mrs Revelle said that she felt Broad Horizons Limited, in their three care homes, were able to offer a homely environment. The two service users at McKechnie House are involved in the daily domestic duties of the home. No domestic staff are employed. From the limited communication that was possible with the service users, the inspector understood that both service users were happy living at McKechnie House. Staff working with the service users were seen to be sensitive to service users’ wishes, having a good understanding of their individual needs despite some communication difficulties arising from their assessed learning disabilities and particular autistic tendencies. Within the service Broad Horizons Limited has a small, established staff group. Relationships between service users and care staff were seen to be sensitive and caring and established friendships have developed within the service user group. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 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 Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 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): 1 & 2. Clear detailed information, by the way of the Statement of Purpose and the Service Users’ Guide, is provided to placing authorities, prospective service users and their families to enable them to make a choice of whether they wish to be admitted to the home. Prospective service users’ individual needs and aspirations are assessed prior to admission to help ensure that the home is able to meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide have been reviewed and revised, in terms of content, to meet requirements. There is, however, still a need for Broad Horizons Limited to further develop the Service Users’ Guide into a briefer and more accessible format for the current service user group. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 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 & 9. Service users’ assessed and changing needs and personal goals are detailed in their individual care plans to help ensure that their personal needs are met. Care planning records detail service users’ right to make decisions about what they wish to do. Overall, staff enable service users to take responsible risks, with both risk assessments and risk management strategies in place. EVIDENCE: Individual plans of care are in place for all service users. All aspects of health, personal and social care needs are identified and planned for within nine aims and a personal needs section. Within this documentation there was evidence of service user involvement in the management of their care needs. Records detailed choices made and acted upon. Examples seen were relating to the choice of food and activities. Care plans sampled were seen to be reviewed every three months, but recently this had slipped and reviews are now due as they are outside the six month requirement. Risk assessments and risk management strategies have been developed and are detailed within the care planning documentation. There is, however, a need to revisit risk assessment reviews, for whilst reviews have taken place, Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 10 there is a need to ensure that these are revisited within care planning needs to promote independence through effective risk management strategies. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 & 17. Service users are supported and enabled to have opportunities for personal development through the provision and promotion of appropriate leisure and training activities in the community. Family contact and visiting arrangements are open and relaxed, with family links promoted and encouraged. The home offered a healthy, varied, planned menu, with consideration given to preferences and dietary requirements. EVIDENCE: Service users are enabled and supported to participate in local community activities. Neither of the current service users access further education/training centres or have employment. They were said to enjoy having meals out at a local pub and shopping in Colchester town. This was confirmed by one of the service users who said that they enjoyed going for walks. Individual activities such as computer games and playing ball in the garden are encouraged and both service users were said to be encouraged to use their basic reading and writing skills. Evidence of this was seen within their care plan documentation. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 12 Both service users take holidays. Each individual funds these, as both service users were resident at McKechnie House before the introduction of the National Minimum Standards. The home has the use of a holiday caravan at St Oysth and during the summer both service users have had day trips and overnight stays at the caravan. One service user said that they enjoyed these trips and care staff spoke of friendships developing between residents in McKechnie House with the other residents of the Broad Horizons homes. Links with families and friends are supported and encouraged. Both service users at McKechnie House have links with relatives, with regular telephone calls and visits to their families. Menus are planned and chosen by service users daily. Detailed records are kept of how this selection is made. Service users are encouraged in assisting with the preparation of food and drinks, as they are able, and with the washing up and clearing away after a meal. Service users enjoy meals out and this was planned following the inspection. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 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 & 20. Service users’ personal and healthcare needs are met within the home and records evidenced that service users are supported to access healthcare professionals as needed. The administration of medication for service users was found to be detailed and recorded to help ensure that service users’ health needs are met. EVIDENCE: A senior care staff member spoke of ways in which they would support and provide personal care to the two male service users. They detailed action they would take to ensure that these tasks are managed in a sensitive manner respecting privacy and dignity. The registered manager confirmed that the majority of care staff are male at McKechnie House for this reason. Both service users use the service of a local GP surgery located across the road. Service users are escorted to visits to GP visits and are supported in decisions made about healthcare/medical treatment. Other healthcare services are used as required. Records on care planning files evidenced this. Medication storage, administration and medicines entering and leaving the home were sampled and inspected. Only one service user is on medication. The records were found to be in good order, with adequate secure storage. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 14 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. Appropriate practices were in place to help ensure that service users’ views are listened to and acted upon and their protection is promoted. Staff training, the awareness of management and staff, policies and procedures and staff recruitment practices help to safeguard this. EVIDENCE: The home’s complaints procedure was seen to be in place and is to be found with the Service Users’ Guide and in care planning documentation. A simple pictorial complaints procedure has been drafted for service users. A member of care staff interviewed was aware of this procedure and said that should they have any concerns they would take them to the registered manager. Equally they had a good understanding of the Adult Protection Procedure and again they would raise any concerns with the registered manager. Recent Adult Abuse Awareness training under LDAF training had further enforced this procedure. One service user spoken with said that if they had any concerns they would raise them with ‘Jean’. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 15 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 & 30. McKechnie House provides a safe, homely and pleasant environment, which was clean and comfortable. EVIDENCE: McKechnie House offers accommodation in a domestic type dwelling. It was light, bright and airy and is in keeping with the local community in a residential area. Decoration and maintenance is ongoing, with decoration ongoing in the hall, staircase and landing. The inspector was informed that both service users have been involved in the preparation for decoration. Both bedrooms and the lounge/dining room have been decorated to the liking of the service user group and new work surfaces, cupboards, kickboards and a sink unit are planned for the kitchen. Mrs Revelle said that these changes are to be completed by Christmas 2005. Some landscaping and changes to the rear garden are planned for Spring 2006. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 16 A domestic washing machine is located in the kitchen, with McKechnie House currently using the tumble dryer next door at Mill House. There is access to their garden and shed through a connecting gate in the rear garden. Senior care staff on duty said that these arrangements are sufficient, although it is planned for a tumble dryer to be fitted in the McKechnie House garden shed. The current arrangements were said to meet requirements. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 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. Staffing levels and skills are appropriate to the needs of service users. There are appropriate recruitment procedures in place. Overall, an induction and a basic staff training programme helps to ensure that training and skills requirements are identified and met. EVIDENCE: Broad Horizons Limited has introduced Learning and Disabilities Framework (LADF) Training for all care staff. A total of nine staff members have completed three courses – Safe Practitioner, Communication and Abuse Awareness training. In addition National Vocational Qualification (NVQ) training is encouraged. The senior care staff member interviewed at McKechnie House said that they have completed a NVQ level 2 in care (October 2004) and they are interested in commencing a NVQ level 3 in care. The majority of care staff at Broad Horizons have completed or are completing NVQ level 2 in care. Mrs Revelle said that she hopes to meet the requirement of having 50 of care staff in each home achieving a care NVQ level 2 by the end of 2005. Within the staff group at Broad Horizons Limited there is a worker who is aged under 18. They are on a BTEC Business Management course and undertake domestic duties only. Mrs Revelle said that this worker works under the direct supervision of qualified staff and does not undertake personal care tasks. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 18 At this inspection clarification and confirmation of staffing levels, being determined with consideration given to the Department of Health Residential Forum Guidance, was requested. An immediate requirement was left with the registered manager and subsequently calculations and staffing levels have been sent to the Commission. Current staffing care hours at McKechnie House are calculated to be 110.98 hours, with the provision of 168 hours detailed in an action plan. The need to regularly review staffing levels, with regard to service users’ changing needs, is highlighted. The file of one care staff member was sampled and inspected. This contained evidence that all the required checks, including references and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, had been satisfactory carried out and copies of relevant identification documents had been obtained e.g. birth certificate, passport and photograph. A copy of Terms and Conditions were seen. The General Social Care Council (GSCC) code of conduct and practice were not considered at this inspection. Mckechnie House DS0000017880.V255929.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, 39, 40 & 42. Staff and service users are well supported by the home’s manager, who is hands-on and part of the care team in the home. An effective quality assurance and quality monitoring system is still required. The home needs to monitor, review and revise their policies and procedures to safeguard service users’ rights and best interests. The health, safety and welfare of service users is promoted and protected by the registered manager helping to ensure safe working practices through the implementation of safety certifications, basic training opportunities and knowledge of relevant legislation. EVIDENCE: Mrs Revelle, the registered manager has completed the National Vocational Qualification Assessor’s course and is looking to working with her staff on their NVQ training courses. Mrs Revelle said that she is currently working on her NVQ level 4 in care and management. One senior care staff member working at McKechnie House over the inspection period said that they found the manager to be readily available and supportive. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 20 Whilst a quality assurance survey had been completed in the past, Mrs Revelle acknowledged that there is a need to consider undertaking a new survey and to develop an annual development plan. Policies and procedures were sampled and reviewed. It became clear from viewing policies and procedures in each of the three homes that senior care staff were unclear as to the current and old policies and procedures on file. Mrs Revelle was made aware of this and copies of policies and procedures are to be reviewed, revised, amended and dated. Broad Horizons Limited has employed a business consultant to complete an internal audit of the care homes. Some recommendations were made and these were found to be completed. Basic training courses, videos and workbooks help ensure safe working practices. Examples of these courses and training are detailed earlier in this report. Mckechnie House DS0000017880.V255929.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 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mckechnie House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 2 X 3 X DS0000017880.V255929.R01.S.doc Version 5.0 Page 22 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. 1 Standard YA6 Regulation 14, 15 Requirement The registered person must ensure that individual care plans are reviewed at the request of the service user or at least every six months and updated to reflect changing needs and agreed changes are recorded and actioned. The registered person must ensure that there is an annual development plan for the home, based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. The registered person must ensure that all policies and procedures are signed by the registered manager and are dated, monitored, reviewed and amended. Timescale for action 25/11/05 2 YA39 24(1) 25/11/05 3 YA40 12,13, 16-19, 23,24 25/11/05 Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA9 Good Practice Recommendations The Service Users’ Guide should be summarised in a clear and accessible format and addressed directly to service users in terms that can be easily understood by them. Risk assessments for individual service users should be frequently reviewed and recorded to enable increased independence through effective risk management strategies. Mckechnie House DS0000017880.V255929.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Mckechnie House DS0000017880.V255929.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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