Inspection on 03/01/06 for Milbury 3 Barn Rise

This inspection was carried out on 3rd January 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milbury 3 Barn Rise 11/01/08

Milbury 3 Barn Rise 30/08/06

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 3 Barn Rise Milbury Care Services Limited 3 Barn Rise Wembley Wembley Middlesex HA9 9NA Lead Inspector Monica Saunders Unannounced Inspection 3rd January 2006 09:00 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 3 Barn Rise Address 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 Care Services Limited 3 Barn Rise Wembley Wembley Middlesex HA9 9NA 020 8904 4596 020 8904 4596 info.ms@milburycare.com Milbury Community Services Mr Carl Eastman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: 3 Barn Rise is a residential home providing personal care and accommodation for 6 males 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 ensuite 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 ensuite, 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. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during the morning and early afternoon. The manager was not present at the beginning of the inspection, but later joined the Inspectors after taking the residents to the day centre. The inspection included discussions with staff, direct observations, resident’s case files, staff records and records relating to how the home is being run and a tour of the premises. It was not possible to communicate with the service users directly due to the severity of their learning disabilities and limited verbal communication skills. Therefore, this report cannot incorporate their views. The Pharmacy Inspector carried out an inspection on the medication systems in the home on the same day. A summary of her requirements have been incorporated into this report and will be reviewed at the next inspection. The Inspector would like to thank the manager, staff and service users who took part in the inspection. What the service does well: What has improved since the last inspection? The manager has complied with requirements from the last inspection and has relocated the old files from the office, and temporarily stored them in the garage for removal. The manager has created a care plan folder to include:care plans, medication records, IPP reviews, Risk assessments, health care 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 6 records, management guidelines and other charts the home uses, and are accessible to staff. Staff are writing monthly report summaries regarding activities, behaviour, health care, medication, progress in relation to care plans of the service users. What they could do better: The Manager must ensure: That checks relating to health and safety measures take place annually. That all service users have free and easy access to and from their bedrooms in the unlikely event of an emergency. That windows to a resident’s bedrooms, where the resident repeatedly removes the curtains, must be covered offering privacy to the resident from outsiders. The Inspector recommends that a protective film is applied to the windows, enabling light in the room and at the same time, allowing the resident’s to look out without being seen. Minor repairs must be carried out to:The upstairs bathroom: tiles missing, lino damaged, skirting board sections missing. The downstairs shower room/toilet light switch is not working and skirting board sections are missing. The kitchen area: the ceiling and area above the cooker hood has paint stripping. Cobwebs should be removed. There were no festive decorations up during the festive period. The Inspector recommended that a Christmas tree is purchased every festive season and place on the decking outside to minimise the risk of injuring to service users, whilst maintaining the festive spirit for service users. The Pharmacy Inspector issued a number of requirements and recommendations in relation to the administration, storage, recording, guidelines for the management of service users medication, medication reviews by the GP and training. A report with her findings and requirements has been sent to the home for action by the manager and staff. Staff must be vigilant in signing and countersigning for medication administered. Please contact the provider for advice of actions taken in response to this inspection. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Policies and procedures are in place to assess any prospective service user to ensure the home can meet their individual needs. Prospective service users and their relatives are able to visit the home prior to moving in to ensure they have spent time with both staff and other service users and can make an informed choice about the home. EVIDENCE: No new service users have been admitted to the home since the last inspection. The registered manager confirmed they would obtain as much information from the referrer regarding a prospective service user and would then carry out their own assessment to gather a detailed picture of the service user. Any prospective service user and their representatives would be encouraged to visit the home and spend time there, with a possible overnight stay, prior to moving in. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 Each service user has an individual care plan in place which reflects their health and social care needs. Risk assessments were in place and outlined current potential hazards and how to minimise those identified risks in order to safeguard the service users. EVIDENCE: Individual Personal Plans (IPP’s) were available and samples were viewed. The IPP’s were comprehensive and detailed the residents’ personal health and social care needs and how these would be met. IPP’s are completed at the commencement of the placement and reviewed six monthly. Staff endeavour to assist service users to make choices, to consult with them about the service provided and promote independence. The IPP’s are signed by several parties including the resident (if appropriate) as a form of agreement. Care plans were up to date with monthly summaries viewed. Any changes in needs would be documented on the care plans. Daily records viewed detailed the care provided and any relevant information was documented to inform other members of staff. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 11 Care Managers, befrienders, relatives and the staff from the day centre and any other agency who may be involvement with the resident all contribute towards the service users review of their individual care plans, assisting in the process to ensure that a holistic view is taken to encompass as far as possible, the wishes and feelings of the resident. It had been recommended at the last inspection that the manager and key workers compile a working care plan folder for day to day use and to archive old files and information. This has now been achieved. A sample of risk assessments viewed were seen to be up to date having been reviewed recently. They covered a variety of potential risks to service users, such as moving and handling, eating and drinking. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16, 17 Social activities are in place to occupy and encourage service users to have a varied lifestyle. Service users rights are respected and staff interact within a positive way. Meals are varied, and aim to provide a well balanced diet that also meets the preferences of service users. EVIDENCE: Service users have individual daily activities to suit their preferences and abilities. They are not able to seek employment but take part in activities both in the local community where they go out to do some personal shopping or for a meal. Some attend day centres. Due to the challenging and non-verbal ability of the service users to communicate, it was difficult to consult with the service users about their activities and interests. During the inspection staff were observed interacting with service users in a respectful and positive manner. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 13 Staff were fully aware of the individual needs of the service users and responded to sounds or gestures the service users made if they were unhappy or wanted something. Staff were observed taking out play equipment to stimulate the service users. Care plans indicated the daily routines of each resident. The inspection was carried out the week after the Christmas celebrations The inspector observed that there were no festive decorations up during the festive period. The Inspector was informed that the residents behaviour patterns tend towards removing any items that are not fixed to the walls, floors etc., making it difficult for staff to decorate the home during the Christmas period. The Inspector recommended that a Christmas tree is purchased every festive season, and placed on the decking outside to minimise the risk of injury to service users, whilst maintaining the festive spirit for service users. Menus were viewed and reflected a variety of foods offered to service users. Staff said, where possible, service users are consulted about the meals and preferences are incorporated into meals to ensure service users enjoy mealtimes. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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, 20 Personal support is offered in a respectful way and personal care is carried out in private. Medication practices need to improved to ensure service users are safe. EVIDENCE: The Health Action plans outline the personal support regime required for each of the service users. The service users had all been dressed and had their breakfast by the time the inspection had begun. All of the service users were appropriately clothed and groomed. Observations were made of one service user receiving personal care support. The Pharmacy Inspector carried out a detailed audit of the medication practices and procedures used within the home. The Pharmacy Inspector issued a number of requirements and recommendations in relation to the administration, storage, recording, guidelines for the management of service users medication, medication reviews by the GP and training (see requirements section for full details). Following this inspection the CSCI received an action plan for the pharmacy requirements. Medication had been administered for one service user, which had not been signed off. Staff must be vigilant in signing and countersigning for medication administered. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home had a complaints procedure, although for some of the service users, due to their individual needs, making a complaint could be difficult. Systems are in place for the protection of vulnerable adults. EVIDENCE: The home has a complaints procedure and the registered manager stated the home actively encourages service users and members of staff to complain if they are unhappy or wish to report something. The registered manager keeps details of complaints and responses locked for confidentiality reasons. The home has not had any complaints since the last inspection. CSCI have not received any complaints about the home. Some of the service users could find it difficult to understand to make a complaint. Many do not have relatives therefore, for these service users, it is vital that key workers, and other members of staff are aware of any changes in service users behaviour or reaction to situations or people as this could be a sign that they are unhappy with something. The home has clear procedure for the protection of vulnerable adults, (POVA). Some staff have received POVA training. The manager said that the home utilises Brent’s training programme, and will use this to draw up a training programme for the staff. The home has risk assessments on all service users and policies and procedures are in place to reflect the protection of vulnerable adults within the home. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 The home’s environment provides a homely, comfortable, safe and pleasant home for service users. The inspection found that the bedroom on the ground floor limited the independence of the resident. EVIDENCE: A full inspection was carried out of the building,. The home was observed to be kept clean and tidy throughout. The homes kitchen was seen to be tidy. Fridge/freezer were clean and fridge/freezer temperatures were within an appropriate range. There were cobwebs on the ceiling above the cooker hood. The home must ensure that the corners and ceilings are cleaned regularly so that the home remains hygienic throughout. There are areas to the upstairs bathroom in need of repair i.e. The lino is torn, and the tiles between the bath and wall are in need of repair, also the skirting boards have sections missing. The ground floor shower room pull light-switch is not working and some skirting boards sections are missing. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 17 The ground floor bedroom is either reached by an inter-communal door through a keypad system, or from the lounge area, which is kept locked. The resident was not present therefore, the inspector was unable to ascertain whether the resident had sufficient ability to enter or, leave his bedroom unescorted. The manager said the reason why the keypad system is used, is to protect service-users belongings from another resident who likes going into other peoples rooms and causes damage. The manager informed the inspector that the service user on the ground floor is not restricted, and could go to and from his room whenever, he wanted. The home must carry out a risk assessment on the service user who occupies the ground floor bedroom. The two doors possibly limits access in a crisis. The Inspector is recommending that the keypad, and door leading to the corridor are removed and the resident is provided with a key to his bedroom, to secure his belongings from other service users. Due to the challenging nature of the service-users the home is frequently having to repair/replace the curtains to bedrooms, it is recommended that the manager look at removing curtains from service users bedrooms who frequently dismantle the curtains. It is recommended that the manager cover the bedroom windows with a protective film to ensure that sufficient light enters the room, and at the same time, service users are able to uphold their dignity whilst in the privacy of their bedrooms. Service users bedrooms viewed were spacious and individualised. Personal items were in their bedrooms and reflected their personal, cultural and physical needs maximising their independence. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Service users are supported by a competent staff team who receive training. These training opportunities ensure staff gain the necessary knowledge and information to meet the individual needs of service users. The home has adequate policies and procedures in place on recruitment of staff to safeguard service users. EVIDENCE: Sample staff files were viewed and appropriate checks had been carried out by the home: POVA checks, CRB’s, ID’s, 3 references together with copies of qualifications/training certificates are all on file. In addition there is a completed induction checklist. Staff supervision notes only record up to August 2005. The manager must carry out regular supervision, which must be maintained and recorded on file. Staff spoken to confirmed they received supervision, found their supervisor approachable, they also said they were happy with the type and level of training offered to them The manager must ensure that the bottom section of CRB’s, which relates to the outcomes of the CRB should be destroyed and only the name, address, CRB number should remain on file. This is in line with recent CRB guidance published in November 2005. Sample inspection of staff files indicated that some certificated training were now out of date, and the manager was advised that refresher training was needed particularly first aid, and epilepsy training. The manager informed the Inspector that a new training schedule was being devised for the coming year and would include epilepsy and first aid training. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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, 42 The stability of a permanent manager and staff team enhances the process of the home being run in a consistent manner. Feedback from service users about their care is limited due to their limited verbal skills. EVIDENCE: The home is well managed and the Registered Manager is enthusiastic in his approaches to caring for the service users in a supportive way. The home is unable to hold meetings with the service users due to their challenging and difficult behaviours and limited verbal communication skills. Overall the servicing records were seen to be up to date. The following certificates were inspected: The Employers Public Liability Certificate was displayed on the notice board and expires 31/03/06. An agency called Paragon carry out the homes annual health and safety checks of electrical appliances and fire extinguishers, the last check was recorded to be on 19/10/04. The manager must ensure that these checks are carried out within the stated timescales. The manager carries out weekly fire checks and the records seen indicated this. These checks are audited by the home’s Operations Manager, 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 20 who visits monthly either announced or unannounced to carry out Regulation 26 visits. The CSCI has not received copies of these reports for some time. These are required for information and monitoring purposes by CSCI. The premises risk assessments, are carried out monthly by the manager, and documented. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 3 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 2 27 X 28 X 29 X 30 x STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 1 x 3 X 2 X X 2 X 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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. 2. Standard YA20 YA20 Regulation 13(2) 13(2) Requirement Staff must be vigilant in signing and countersigning for medication adminstered. Carers must be aware of the location of the current medicines policy. Old copies must be archived. The home/GP must update PRN guidelines and prompt reviews of medication to ensure protocols are current. All medicines must be recorded when adminstered and received into the home. Sticky labels must not be used on the MAR sheets. All staff must be trained in the safe handling of medication including rectal diazepam. That the pharmacist is requested to update the MAR so that it lists only current medication. The staff must ensure that the corners and ceiling in the kitchen are cleaned on a regular basis. The upstairs bathroom must have the following repairs carried out. DS0000017428.V279365.R01.S.doc Timescale for action 31/03/06 01/02/06 3. YA20 13(2) 01/02/06 4. YA20 13(2) 05/01/06 5. 6. YA20 YA20 13(6) 13(2) 01/04/06 01/02/06 7. YA24 16(j) 31/03/06 8. YA24 23(2)(b) 30/04/06 3 Barn Rise Version 5.1 Page 23 The lino must be repaired/replaced. The tiles between the bath and wall must be replaced/repaired. The skirting boards must be repaired. The ground floor shower room must have the following repairs carried out. The pull light switch to be fixed. Skirting boards sections must be replaced. 19 The manager must ensure that the bottom section of CRB’s which relates to the outcomes of the CRB should be destroyed and only the name, address, CRB number should remain on file. This is in line with recent CRB guidance published in November 2005. 18(2) The manager must carry out regular supervision which must be maintained and recorded on file. 26 The Service Manager must ensure that copies of the Regulation 26 reports are sent to CSCI. 23(2)(c)(4) The manager must ensure that the annual health and safety, fire safety and electrical checks carried out by Paragon are done within the stated timescale. 9. YA34 31/03/06 10. YA36 31/03/06 11. YA39 31/03/06 12. YA42 31/03/06 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. Refer to Standard YA12 Good Practice Recommendations The Inspector recommended that a Christmas tree is purchased every festive season, and placed on the decking DS0000017428.V279365.R01.S.doc Version 5.1 Page 24 3 Barn Rise 2. YA26 3. YA26 outside to minimise the risk of injury to service users, whilst maintaining the festive spirit for service users. It is recommended that the keypad and door leading to the corridor from the ground floor bedroom are removed, and the resident is provided with a key to his bedroom, to secure his belongings from other service users. It is recommended that the manager look at removing curtains from service users bedrooms who frequently dismantle the curtains. It is recommended that the manager cover the bedroom windows with protective film to ensure that sufficient light enters the room, and at the same time, service users are able to uphold their dignity whilst in the privacy of their bedrooms. 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 3 Barn Rise DS0000017428.V279365.R01.S.doc Version 5.1 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. 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