Inspection on 11/01/08 for Milbury 3 Barn Rise

This inspection was carried out on 11th January 2008.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milbury 3 Barn Rise 30/08/06

Milbury 3 Barn Rise 03/01/06

Milbury 3 Barn Rise 25/07/05

Milbury 3 Barn Rise 10/02/05

Milbury 3 Barn Rise 16/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Milbury 3 Barn Rise Milbury Care Services Limited 3 Barn Rise Wembley Middlesex HA9 9NA Lead Inspector Andreas Schwarz Key Unannounced Inspection 11th January 2008 09:00 Milbury 3 Barn Rise DS0000017428.V342941.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 Milbury 3 Barn Rise DS0000017428.V342941.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. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milbury 3 Barn Rise Address Milbury Care Services Limited 3 Barn Rise Wembley Middlesex HA9 9NA 020 8904 4596 020 8904 4596 info.ms@milburycare.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) Milbury Community Services Ltd Mr Carl Eastman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2006 Brief Description of the Service: 3 Barn Rise is a residential home providing personal care and accommodation for 6 men with profound learning disabilities and challenging behaviours. The provider is Milbury Care Services, a nationwide organisation. The home aims to provide a normative life for the service users and enable them to enjoy all the facilities and amenities available within the community. The home is situated in a quiet residential area of Wembley and is close to public transport and shops. The ground floor accommodation consists of a lounge, dining room, kitchen, utility room, one bedroom with en suite and two toilets. The dining room has a patio, which opens on to a large enclosed garden. The first floor accommodation consists of 5 single bedrooms, one of which is en suite, bathrooms and toilets. Some of the residents are supported to attend local day services and the home also provides day care in house. The home has its own transport that enables the residents to access the wider community. The weekly fees vary from £1,305 to £1,386 per week. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This unannounced key inspection took place in January 2008 and lasted one day. The registered manager Mr Eastman was available throughout this key inspection. I interviewed two members of staff and observed staff interacting and supporting people using the service. People using the service are non or pre verbal and communicate through gestures or with the help of staff. The home forwarded a completed Annual Quality Assurance Assessment within the given timescale. I viewed care plans, staffing records, rotas, menus and other records to make a quality judgement about the home. I left six user-friendly surveys in the home for people using the service to comment on the service, which have not been returned to me. I would like to take this opportunity thanking everybody involved with this unannounced key inspection. What the service does well: The core staff team has been working in the home for a number of years and is very experienced and familiar with people using the service needs. The registered manager has been working in Barn Rise since opening the home and demonstrates very good knowledge of caring for people with learning disabilities as well as changes within the care sector. The home is spacious, comfortable and nicely decorated to meet the need of the people using the service. Care plans are of good standard and person centred. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 6 People using the service I have observed are comfortable with staff and good interaction was noted during this Key inspection. Health records and guidelines are of excellent standard and provide staff and people using the service with the necessary information to provide and receive person centred support. 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. The summary of this inspection report can be made available in other formats on request. Milbury 3 Barn Rise DS0000017428.V342941.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 Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. Prospective people using the service are given the opportunity to spend time in the home. EVIDENCE: The home had one admission since the last key inspection, the person transferred from another home owned by Milbury Care Services (Voyage). The person was known to the organisation and home. Prior to the admission the person visited the home for lunch, dinner and one overnight stay. Staff working in the previous placement supported the person in their new home and helped care staff to understand the person’s needs. The person brought his person centred plan from his previous placement and the key worker at Barn Rise is currently in the process of designing a new care plan. The registered manager informed me that the time scale for completion is the 21/01/08. Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service needs are identified and they are enabled to make choices. They are encouraged to develop independence. Care plans are person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individual’s life. EVIDENCE: I viewed two care plans during this key inspections, both plans are person centred, use pictures and symbols. Care plans have been reviewed regularly. Key worker and Co-key worker are responsible for the review and up keep of care plans and care files. The registered manager showed me an example of the new care plan format, which is currently introduced by the organisation. This care plan appears more person centred and addresses a wider spectrum of peoples needs. Support needs are well documented in care plans viewed during this key inspection. People using the service, their relatives or advocates are invited and involved in the care planning process. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 10 As mentioned earlier the use of pictures and symbols enables people to take part in their care plans. I observed staff offering choices to people using the service during this key inspection. For example one person was asked if he wants to listen to music or play a tabletop activity. People’s benefits are paid to Milbury Care Services, who forward the money to the person’s bank account. The registered manager is an appointee on bank accounts for people unable to sign and is responsible for the management of people’s finances. Financial records checked during this key inspection were of good standard and records are correct. Restrictions on choice have been imposed to ensure the health and safety of people using the service in view of their profound learning disabilities and challenging behaviour. There were examples of restrictions on choice, which were documented. These included entering the kitchen unaccompanied, taps being turned off in bedrooms. The sample of risk assessments viewed confirmed that they had been reviewed recently. They covered a variety of potential risks to people using the service in engaging in activities such as: eating and drinking, bathing or taking a shower, pushing whilst using stairs. The risk assessments ensured that adequate precautions are taken to minimise risks to people using the service. Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service are enabled to undertake activities in the home and in the local community. People who use the service have the opportunity to develop and maintain important personal and family relationships. The staff team help with communication skills, both within the service and in the community, to enable people using the service to fully participate in daily living activities. They take responsibility with staff support for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. EVIDENCE: I spent the whole day at the home and had the opportunity to observe the interaction between staff and people using the service. It was difficult for me to consult with the people using the service about their activities and interests. I gained information by observation, by interviewing staff and from Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 12 documentation. During the inspection staff were observed interacting with people using the service in a respectful and positive manner. People using the service are not able to seek employment but take part in activities in the local community. They go for a drive, bus rides, walks, park, shopping or for a meal. People using the service attend day centres as was observed on the day of inspection. People using the service went on holiday to Blackpool. One of the people living in the home chose not to go to this holiday and staff provided daily outings in the local community. Staff’s interviews and records confirmed that each person using the service had an individual programme of activities to suit his preferences. This has been reviewed and updated. Activities offered range from relaxation, drives, music, go to café’s. I observed staff doing tabletop activities and taking out play equipment to stimulate people using the service. The home has a sensory room and has arranged planned sessions to access this room with support. The registered manager informed me that not all people using the service choose to take part in these sessions. . There was evidence that family contacts were encouraged and that the family was invited to Care Plan reviews. Staff has also accompanied a person using the service to visit his family. Most of the people using the service have good family contacts and one person has an advocate. The home is providing three meals a day, menus showed a varied, healthy and nutritious diet. One of people using the service comes from an Asian background and the home is providing meals reflecting this. The home has individual guidelines in place to help staff to serve meals the way people using the service choose. For example, to reduce challenging behaviour for one person, he is only asked to join the dinning table when the meal is served as he is not able to wait for his food. Staff stated that as far as possible, people using the service are consulted about the meals and preferences are incorporated into meals to ensure people using the service enjoy mealtimes. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service receive effective personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Staff ensures that care is person led, personal support is flexible, consistent, and is able to meet the changing needs of the people using the service. The home has a good record of compliance with the receipt, administration, safekeeping, and disposal of controlled drugs. Staff have completed and passed an appropriate medication course. EVIDENCE: I have viewed Health Action Plans in care plan files; the plans are of excellent standard and provide information for staff in how to support people using the service around personal care and health care issues. Health care appointments are well documented. I observed staff supporting a people using the service sensitively in personal care. Staff ensured that doors were closed and the person was not exposed. The team is multicultural and staff interviews confirmed that they have a good understanding of people using the service Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 14 cultural backgrounds. People using the service were dressed appropriately for the time of the year. Staff informed me that they assist people using the service in choosing what they want to wear. The home has access to Brent Learning Disabilities Partnership for clinical support such as psychologist, psychiatrist, etc. People using the service are registered with their own local General Practitioner, and can make appointments as and when required. I found very detailed epilepsy guidelines in one of the files. Seizures are clearly recorded and procedures are available for staff to follow. The home is using the Monitored Dosage System, staff has received medication training and training in how to administer rectal diazepam. The Medication Administration Sheets had no gaps and medication received or returned is clearly recorded. A detailed medication policy is in place, which has been reviewed in March 2007. None of the people using the service self medicate. The home ensures that only trained staff has responsibility for the administration of medication Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows people using the service to express their views and concerns in a safe and understanding environment. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. The home understands the procedures for safeguarding adults and will attend meetings or provide information to external agencies when requested. EVIDENCE: The home has a complaints procedure in place; this procedure is available in pictorial form. The complaints procedure is available to people using the service in the service users guide. Staff interviewed told me that they would complain to the manager or inform the manager of any complaints they receive. The registered manager showed me complaints records, which took a while to find. I suggest making the complaints book easily available for people using the service, staff and visitors. The home has received two complaints since the last key inspection, which have all been dealt with. Protection of Vulnerable Adults guidelines from the funding and hosting borough is available in the home. The home has adult protection guidelines in place. Since the last key inspection the home received 3 adult protection referrals, which have all been dealt with and resolved. Staff has received Protection of Vulnerable Adults training as part of their induction. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 16 Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. The home is well lit, clean and tidy and smells fresh. EVIDENCE: I toured the building. All of requirements of the last inspection pertaining to the physical environment had been met. The following requirements have been made on the date of this inspection: • • • The sink in the small downstairs toilet must be boxed in to prevent people using the service scalding themselves on hot water pipes. The broken fire alarm panel must be repaired to stop ringing during different times of the day. The leak in the downstairs bathroom must be investigated and repaired. DS0000017428.V342941.R01.S.doc Version 5.2 Page 18 Milbury 3 Barn Rise The loose kitchen door must be repaired to stop it from falling off. The dead flies in the ceiling light in the kitchen must be removed as it presents a Health and Safety hazard. Due to the challenging behaviour of people using the service the home is frequently required to repair/ replace fixtures and fittings. People using the service bedrooms viewed were spacious and individualised. Personal items were stored in their bedrooms and reflected their personal and cultural needs. Equipment was provided to maximise their independence. A semi-professional washing machine and clothes dryer is available for people using the service. Staff told me that they have received Food Hygiene training. A Health and Safety policy is in place and monthly Health and Safety checks are undertaken. Cleaning responsibilities are allocated to care staff and the home was observed to be clean and tidy. • • Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the staff that cares for them. The staffing structure is based around delivering outcomes for people using the service and is not led by staff requirements. All staff receives relevant training that is focussed on delivering improved outcomes for people using the service. Staff recruited confirm that the home was clear about what was involved at all stages and was robust in following its procedure. Supervision sessions are regular and staff find them helpful with a focus on improving outcomes for people using the service. EVIDENCE: The home has a recruitment policy, which is based on equal opportunities and checks ensure the protection of people using the service. The home’s recruitment policy states that applicants must pass a Criminal Records Bureau check and Protection of Vulnerable Adults and Protection of Child Abuse check before being employed. They must also have two satisfactory current references and show that they are eligible to work in the UK. Staff files inspected were of an appropriate standard. The manager Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 20 informed me that the home is continuing to recruit staff and is in the process of filling the vacant posts. On the day of this inspection there were four members of staff on duty when all people using the service were present. This staffing ratio was judged adequate to meet the needs of all six people using the service when present at the home. Staff undertakes duties such as cleaning, cooking, driving in addition to caring duties. Staff interviewed informed me of having received a wide range of training, i.e. Fire Training, Person Centred Planning, Medication, Protection of Vulnerable Adults, Manual Handling, Health and Safety, etc. Files examined confirmed this. Staff have received a minimum of six planned supervisions per calendar year. The Annual Quality Assurance Assessment stated that the home is currently employing ten staff including agency, four of these staff do have or work towards National Vocational Qualification in Care. This does not fully meet the required minimum standards of 50 . Milbury 3 Barn Rise DS0000017428.V342941.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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area This judgement has been made using available evidence including a visit to this service. The registered manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. The Annual Quality Assurance Assessment contains clear, relevant information that is supported by a wide range of evidence. The home works to a clear health and safety policy. All staff are fully aware of the policy and are trained to put theory into practice. Regular random checks take place to ensure they are working to it. EVIDENCE: The home is well managed by a Manager who is enthusiastic in caring for the people using the service. The manager is a registered mental health nurse and is in the process of completing the registered manager’s award. The registered Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 22 manager has undertaken periodic training in a number of areas including interviewing techniques, management and supervision. The registered manager informed me that he has applied for management development training. Staff interviewed told me that the manager is very supportive and listens to staff needs and problems. The home is unable to hold meetings with the people using the service due to their challenging and difficult behaviours and limited verbal communication skills. The home is obtaining feedback from families and visitors. An annual quality assurance plan for 2007/08 is in place. Staff members meet monthly and minutes have been viewed during this key inspection. The Annual Quality Assurance Assessment informed me that the Portable Appliances Test Certificate expires in March 2008, Landlords Gas Safety Certificate expires August 2008, Fire equipment has been serviced in October 2007. Records viewed confirmed this. The last fire drill was undertaken in November 2007 and the general fire risk assessment is up to date. Current Legionella and Control of Substances Hazardous to Health risk assessment are in place. Milbury 3 Barn Rise DS0000017428.V342941.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 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 3 X Milbury 3 Barn Rise DS0000017428.V342941.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 YA24 Regulation 23(2)(b) Requirement The registered person must ensure that the following work is carried out: • The sink in the small downstairs toilet must be boxed in to prevent people using the service scalding themselves on hot water pipes. The broken fire alarm panel must be repaired to stop ringing during different times. The leak in the downstairs bathroom must be investigated and repaired. The loose kitchen door must be repaired to stop it from falling off. The dead flies in the ceiling light in the kitchen must be removed as this presents a Health and Safety hazard. 01/04/08 Timescale for action 01/03/08 • • • • 2. YA35 18(1)(a) The registered person must ensure that a minimum of 50 of care staff hold or work towards their National Vocational DS0000017428.V342941.R01.S.doc Milbury 3 Barn Rise Version 5.2 Page 25 Qualification in Care. 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. Refer to Standard YA22 Good Practice Recommendations The complaints book should be made available for everybody wanting to make a complaint. Milbury 3 Barn Rise DS0000017428.V342941.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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