Inspection on 18/09/06 for Melrose House

This inspection was carried out on 18th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Melrose House 20/02/06

Melrose House 28/10/04

Melrose House 21/06/04

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

CARE HOME ADULTS 18-65 Melrose House 41a Muswell Avenue Muswell Hill London N10 2EH Lead Inspector Karen Malcolm Key Unannounced Inspection 18th September 2006 10:10 Melrose House DS0000010707.V304118.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 Melrose House DS0000010707.V304118.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. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melrose House Address 41a Muswell Avenue Muswell Hill London N10 2EH 020 8444 8483 020 8444 8483 rford81128@aol.com 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) Mr Richard John Ford Mr Richard John Ford Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Four specific service users. Four specific service users who are over 65 years of age, may continue to be accommodated in the home. The home must inform the registering authority if any of these service users leave the home. 20th February 2006 Date of last inspection Brief Description of the Service: Melrose House is a care home registered to provide personal care for six service users who have mental health problems. It has been operating for a number of years. This is a family run home, with the registered proprietor/manager and his family providing the main support system for service users. Care practice is focused on promoting levels of independence that service users are comfortable with and that enables them to have a quality of life that they enjoy. The home is a large first floor maisonette that has been converted to use as a care home. There are spacious communal areas consisting of a lounge/dining area, a kitchen that is large enough to accommodate a table and chairs for informal meals and a more private sitting area located on the upper floor/ office area and sleeping room. There is a large garden to the rear of the home. There are two double bedrooms and three single bedrooms, a bath/shower room with toilet, shower room and two separate toilets. There is also a laundry area, which stores a washing machine and dryer, space for ironing and a separate shower unit with toilet and washbasin. The home has been recently decorated to a high standard. The home is located in a residential street close to the shops, services and businesses in Muswell Hill and local transport links. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The cost of placements are £385.11 per week plus service users contribution of £111.00. There are no other additional costs Following “Inspecting for better lives” the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was completed over approximately three hours. The registered provider/manager and the deputy assisted the inspector throughout the inspection. In the home were two service users. The other service users were out at their allocated day centres or socializing. The inspection involved sampling care plans, policies and procedures, records, a tour of the building and observing the interaction between staff and a service user, the latter of which was found to be positive. Overall the inspector’s impression was that the home remains very well managed and progress has been made to meet all the areas of improvement from the last inspection. The inspector commends this. The manager\provider and the deputy manager were very open and helpful throughout the inspection. What the service does well: What has improved since the last inspection? At the previous inspection three areas of improvement were made and one recommendation. At this inspection all areas of improvement had been addressed and the inspector commended this. These were: • Reviews for all service users have now been undertaken by each social workers • The manager has now obtained an authentic reference for one member of staff relating to their last place of work • The registered person has now liaised with the two specific service users social workers with regards to obtaining verification of the service users next of kin Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. The service considers carefully the needs assessment for each prospective service user before agreeing admission to the home. Therefore prospective service users know that their care needs will be met by the home. EVIDENCE: Melrose House is a care home registered to provide personal care for six service users who have mental health problems four of whom are over sixtyfive. The home started as a board and lodging accommodation for people with mental health needs in the early 1980’s and some of the service users have lived in the home since then. The ethos and the standard of care in the home are excellent. Over the years, this has been maintained to a high standard with regards to individual care & support needs. There is clear evidence that the home is able to meet the needs of all service users accommodated, with clear and up to date service user plans available. There is a high level of satisfaction amongst service users in the home. The manager stated that a part of the agreement on admission was that this home was a home for life and the manager has supported this for all the service users. One care plan was examined and the contract on file was signed & dated. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. The ethos of the home is that service users are involved in all aspect of their care. Service users make decisions about their lives with assistance as needed and are supported to take risks as part of their independence. Therefore staff actively promote service user’s rights, independence and decision-making. EVIDENCE: One care plan was examined. This was found to be very comprehensive and detailed, taking into account the care, support & changing needs of the individual service users living in Melrose House. Evidence was available that review meetings are held at six-monthly intervals by the home and yearly with the placing authorities. For this specific service user, the manager stated that due to a recent change to their care needs another review is being arranged. The manager has updated the individual’s risk assessment relating to their mobility and personal care needs. At the previous inspection it was required that the manager ensures that all service users reviews are completed yearly as there was no evidence of this on file at the time. The manager informed the inspector that these were all completed on 15th August 2006. However, copies of each review were not on file, but a clear account was written in the Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 10 individual’s daily log that this had taken place. The manager stated that the social worker stated to him that they were impressed with the home, the dedication of the manager and how the service users were supported. The care plans for the service users who are over sixty-five are reviewed by the home monthly. In discussion with the manager and deputy it was evident that staff respect service users wishes and their rights to make decisions. Service users are kept informed of any changes through meeting or general discussions, about the home, their care or wellbeing. The service user spoken to also stated this. The home has a strong ethos of involving service users in all aspects of their life and this was evident through the care plans, speaking to the service user and, how reviews are conducted and recorded. The inspector commended this, as this was impressive. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. Service users have opportunities for personal development and being a part of the local community on a daily basis. Service users are able to maintain contact with family and friends. The meals in this home are good offering both choice and variety catering for special dietary needs. EVIDENCE: Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 12 One service user attends the day centre in Clarendon Road, one service user attends Et Cetera workshop in Haringey, two go to Woodside day centre and one service user stays at home and is not interested in going to a day centre, However, from the specific service user’s review notes dated December 2005. it clearly stated that the specific service user had changed their mind about going to the day centre and the social worker was looking into this. But since then, the specific service user’s health needs has changed and this is now being put on hold. During the visit the same service user was watching television in the lounge and another service user was in for a while, and then went out. The manager stated that all the service users make extensive use of free bus passes provided by the local authority. The service user said that they knew the local shops, supermarkets and cafes well. The manager, the deputy and service users have a good relationship with their neighbours. The manager and deputy informed the inspector that over the past seven months the service users have been on several planned trips out to Brighton, Southend on Sea and other places of interest. All the service users except one are able to go out independently. The manager stated that Christmas is a special time in the home, a big family occasion. Since the manager and the deputy live in the maisonette flat downstairs Christmas is a shared event and has always been like this since the home was set up. The service user spoken to stated this is a good time. The manager advised that there are no restrictions on visitors and relationships outside of the home are encouraged. However few service users have significant contacts outside the home. At present the manager is seeking further advice from the social worker about two specific service users who do not have a named next of kin, as this was a requirement from the previous inspection. Evidence of contact with the social worker on this matter was on file. One service user’s family member visits occasionally, evidence of this was in the visitors’ logbook. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 13 The service user interviewed indicated that the food available in the home was of good quality, and varied. A current menu was on display indicating that well balanced, varied and nutritious foods were served in the home. Service users cultural needs with regards to meals are also addressed as this was discussed with the manager and evidence of this was also displayed. Appropriate stocks of fresh fruit and vegetables were available within the kitchen. Foods in the fridge and freezer were found to be stored/labelled appropriately. One service user advised that they enjoyed cooking in the home with support from staff members, however this was not possible now due to their change in care needs. The kitchen area was found to be homely and welcoming, service users are able to sit in the kitchen or the dining/lounge area if they so wish. The manager informed the inspector that, as part of the home business plan for the coming year the kitchen would be redecorated. The manager advised that one service user is vegetarian, two service users are diabetic and are catered for accordingly, meal time options are varied. On Sunday evenings staff and service users prepare a menu for the week ahead. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to this service. Personal support in this home is offered in such a way as to promote and protect service users privacy, dignity, healthcare needs and independence. The medication at this home is well managed promoting good health. EVIDENCE: Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 15 The manager stated that all the service users are very independent and need minimum support with personal care, except two users, who need assistance with having a bath or a shower. The manager stated that the two services are one man and one woman and the manager ensures that their personal care needs are addressed by having a male and female carer on shift when their personal needs require it. Recently another service user’s mobility and continence needs have changed over a matter of weeks. This has impinged on the individual independence, therefore the service user needs one to one support to get around and up and down the stairs safety. Records indicated that the service user has been seen by the GP and referrals have been made for a specialist imput. The manager states that he is concerned about the individual’s health and has requested a re-assessment of their care & support needs by the social worker, to enable the home, to support the service user appropriately through this time. However, if it happens that the individual’s needs do not improve, the manager has also considered whether or not the placement would remain suitable. However, this would be the last result. The inspector was impressed by the care and dedication of the manager and deputy, as this was apparent throughout the inspection. The only advice given was that the manager must contact the local continence advisor clinic with regards to assessing the specific service users continence needs that has deteriorated. There was evidence within service user plans, that service users have access to local primary care services and specialist mental health services. The manager advised that the practice nurse from the GP practice also carries out an annual health check. Separate records of service users’ medical conditions were available, and there was evidence that ongoing medical problems were being recorded appropriately within the service user plans. Medication policies and procedures were found to be in good order. The manager has a good knowledge and awareness of current legislation regarding service users’ medication prescribed. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. Service users know that their views are listened to and acted on. Service users are protected and safeguarded by care staff that are aware of how to recognise the different forms of abuse. Therefore the service users are confident and feel safe in their needs being protected by the home. EVIDENCE: The complaints and abuse policies and procedures are in place. Both are robust, comprehensive and clear. The abuse policy reflects the local authority’s adult protection procedures very clearly. There are no records of complaints since the last inspection. However, compliments were discussed. The manager stated that the home does receive a number of compliments however, mainly verbally. It was recommended that the manager should find a way of recording these verbal comments as part of the home’s overall quality assessment. All staff have undertaken Adult Protection training, evidence of this was on file. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. Recent investment has significantly improved the appearance of this home creating a comfortable and safe environment for those service users living and visiting Melrose House. Therefore service users feel comfortable, safe and secure in their homely surroundings. EVIDENCE: Melrose is a three-storey town house in the middle of Muswell Hill. The home accommodates six service users with mental health problems four of which are over 65 years of age. Bedrooms consist of two double and three single bedrooms. All bedrooms examined are provided with furniture and fittings sufficient and suitable to meet individual needs and lifestyles in the home. The double rooms are adequately sized to accommodate the service users sharing, ensuring that their privacy and dignity is upheld. The home is comfortable, warm and inviting providing a homely place, one service user spoken to confirmed this. Since the previous inspection the manager has decorated three bedrooms, beautifully. The redecoration included, new wallpaper, carpet, curtains, furniture and fittings. Each room examined was homely and comfortable. The manager informed the inspector that he undertakes all maintenance of the home and this includes the redecoration. The manager was asked how service users were consulted with regards to the redecoration Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 18 programme and the disruption it caused. The response given was that service users were consulted, disruption was kept to a minimum, service users were not moved out of their rooms as the redecoration was completed whilst service users were at their allocated day centres and the paint used was environmental friendly. The service user in the home was asked about the redecoration programme and was pleased with their bedroom. The service user gave the inspector a big grin of approval. The home was beautifully presented. The laundry room on the top floor is now refurbished and an additional shower room has been added for the service users. This is also beautifully decorated. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 19 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, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. Staff morale is high, resulting in an enthusiastic workforce that works positively with the service users. Service users are supported and protected by the home’s recruitment policy and practices. Therefore service users benefit from a well supported, competent and trained staff team. EVIDENCE: Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 20 The number of staffing hours and skills of staff members working in the home meets the current requirements of service users accommodated. The manager takes the primary role in administrative work and is, responsible for medication recording and administration and care planning within the home. He advised that the deputy and support worker are particularly skilled at working directly with service users in groups and one to one interactions. However he advised that all support workers had the necessary skills to be involved in care planning, administrative tasks and medication administration in his absence. All staff files were inspected, and were found to contain the required information as specified in Schedule 2 of the Care Homes Regulations 2001. Staffing turnover in the home is very low. At present the manager employs three staff, one of which is the deputy and two who work part-time. Records of all training undertaken by each staff member were available. Evidence was available that the manager continues to arrange supervision approximately two-monthly, and records were maintained appropriately. There was evidence that annual appraisals were also carried out and recorded. A comprehensive set of policies and procedures were also available within the office to guide and support staff. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is excellent. This judgement has been made using evidence gathered both during and before the visit to this service. The manager has a good understanding of the home and service users needs. Therefore the ethos of the home is very good and this is evident as soon as you walk in. Record keeping is excellently kept, therefore access to information is available for all to view if they so wish. The health and safety and welfare of service users are promoted and protected by the regular review and upkeep of equipment on site. Equality and diversity issues are recognised and managed by the home. EVIDENCE: Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 22 Service users benefit from a well run home. The manager’s knowledge and experience of the service user is excellent. The management approach has created an open, positive and inclusive atmosphere, which the service user stated is very good. The home is homely, warm and inviting; this is because the manager and deputy treats each service user as family members. The inspector observed this on the day. The service user confirmed that the home provides services in an accountable and informed way. They also stated that they feel involved and part of the family, and that there is open and regular discussion about day-to-day matters of importance. The home’s record keeping is excellent and well maintained. All information held is easily accessible, with a clear index system as a guide. All service users files gives clear comprehensive guidance to understanding individuals needs within the home. The service users care plans are very well maintained and monitored by the manager. Throughout the service there is a highly evolved understanding of the equalities and diversity needs of individual service users. Staff are confident in delivering high quality oucomes for service users in the areas of race, ethincity, age, sexuality, gender, disability and beliefs. The service is highly proactive and never assumes that issues have been resolved, it will review and suggest further ideas and developments to furhter promote the diversity agenda within its service, or even externally with others. There was evidence that an initial audit had been undertaken, and questionnaires had been distributed and completed by all service users, some relatives and several staff members from day centres and sheltered workshops. There was also evidence that feedback from the audit was used to inform the business plan for the home. It was recommended, as part of the home’s quality assurance, that the registered person should complete a Regulation 26 report now again, to ensure that the Standard of care and other aspect of the home service are being met. The manager ensures that all health and safety checks are kept up to date and this was evident on the day. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 23 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 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 4 X 4 3 X 3 X Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 24 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 YA19 Regulation 13(1)(b) Requirement The registered person must seek further advice and guidance with the continence advisor regards to the specific service users change in continence needs. Timescale for action 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA22 YA39 Good Practice Recommendations It is recommended that verbal compliments should be logged. The registered person should consider undertaking Regulation 26 reports to ensure that the standard of care is consistently maintained and reviewed. Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Melrose House DS0000010707.V304118.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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