Inspection on 20/06/06 for New North Road

This inspection was carried out on 20th June 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

CARE HOME ADULTS 18-65 New North Road St Martin of Tours Housing New North Road Islington London N1 3DN Lead Inspector Edi O’Farrell Unannounced Inspection 20th June 2006 10:20 New North Road DS0000067013.V288044.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 New North Road DS0000067013.V288044.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. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service New North Road Address St Martin of Tours Housing New North Road Islington London N1 3DN 020 7359 9990 020 7226 2714 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) St Martin of Tours Housing Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18) of places New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20/12/05 as part of St Martin of Tours House inspection. Brief Description of the Service: New North Rd is an 18 place care home for people with mental health problems who also have forensic histories. It is run by St Martin of Tours Housing, a registered charity that specialises in these types of services, including for homeless people. New North Road was registered as a care home in February 2006. Previously it was one of two units registered as St Martin of Tours House and the home continues to share a walled garden with the adjacent home, Wilton Villas. Staff at the home work very closely with the local multi-disciplinary forensic service, with a focus on service users achieving independence as soon as possible. Stays are generally up to two years, and are often dependent on conditions set at hospital discharge. The service is set over four floors, with the ground floor being mainly offices. The three upper floors each have the same lay out. This is a kitchen/dinning room, single bedrooms, toilets and bathrooms, and utility area. There is a small lounge on the ground floor, which has been enlarged by the addition of a conservatory. This leads into the garden. Eight beds are block purchased by Islington, six by Camden, and the remaining four are spot purchased.The cost is £970 per week, but there is no charge to service users. Service users self-cater. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection, took place on a weekday from mid morning to late afternoon. It included a visit to head office to look at staff files, as well as a visit to the home. Most service users were out or in bed, though two seen did raise issues of concern. Staff were asked about training and supervision and observed in a handover meeting. Records, including care plans, were examined. Aspects of the running of the home were discussed with the acting manager and deputy. A questionnaire was left with the manager so she could let the Commission know how the visit went. What the service does well: What has improved since the last inspection? The unit is now registered as a separate care home, whereas before it was a part of St Martin of Tours House. This means that the Commission judges each unit separately. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 6 A programme of refurbishment has resulted in bathrooms being upgraded, along with vacant bedrooms. Pictures and ornaments make the home less institutional. Night cover has been rearranged. There are now two waking members of staff, one being a night porter. This has increased security and safety. Care planning, risk assessment, and review, continue to improve. 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. New North Road DS0000067013.V288044.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 New North Road DS0000067013.V288044.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users have information about the home, though this could be improved by being produced in different formats. Service users only move in following a detailed and comprehensive assessment, including day and overnight stays. EVIDENCE: The Statement of Purpose could not be found during the visit so it was not possible to fully check if it reflects the service provided. This was discussed with the acting manager, in particular any exclusions, such as if a prospective service users was unable to handle their own finances. In addition records showed that there have been concerns over illegal drug use, and service users raised the issue of their food going missing. The evidence from discussion with the manager and deputy manager, and from examination of records, is that the home operates a ‘staged’ approach to inappropriate behaviour. The provider must check that the Statement of Purpose reflects this approach so that placing authorities are clear about the boundaries that the home works within. This is Requirement 1. A copy of the Statement of Purpose, following revision if necessary, must be forwarded to the Commission within the set timescale. There is a comprehensive Service User Guide, detailed house rules, and a license agreement. The service user who responded to the postal survey felt they had sufficient information to make an informed decision about moving New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 9 into the home. In most cases prospective service users have little choice about where they live as they are often subject to restrictions because of their history. This makes it especially important that information about the service is accessible to all prospective service users. Research shows that the population of institutional forensic mental health services includes a large number of people from Black and Ethnic Minority Communities. They also house a disproportionate number of people with low educational achievements, and an increasing number of people who have a limited English vocabulary. People who have limited skills and knowledge of written and verbal English would therefore be potentially discriminated against. It was reported that this situation had not yet arisen, and that arrangements could possibly be made for translation if needed. The Registered Person should consider providing the Service User Guide, and other information about the home, in a variety of formats, such as video, and languages other than English. The availability of alternative formats should then be made known to potential referrers. This is Recommendation 1. There is an excellent pre-admission assessment process, which includes both day and overnight stays. It is comprehensive, and in the two files seen included joint assessment by unit staff and a CPN. In one file the License agreement had not been completed; as the deputy agree to immediately deal with this no Requirement has been set. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Choice and independence continue to be key goals for the people who live at this home. EVIDENCE: Two service users, admitted since the last inspection, were case tracked. This included cross-reference of care plans with the accident and incident records and daily logs. Two other service users were spoken to, and some staff were asked about aspects of care. The activity and keywork records were also checked. The pre-admission assessments are used to set out detailed care plans. This includes risk assessment, particularly of potential triggers for relapse. Individual plans include personal goals, and weekly keywork sessions are used to support service users to attain these. The ethos of this service is based on service users regaining their independence as soon as possible. Any restrictions, which may impact on selfautonomy, are those imposed as conditions of hospital discharge. These are recorded in the care plans. Staff are very aware of the need for confidentiality. New North Road DS0000067013.V288044.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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The focus of the service is on personal development. The lack of a food hygience policy and procedure could put staff and service users at risk. EVIDENCE: As stated above the focus of this service is on personal development. The vast majority of service users have been living in institutions for some considerable time prior to admission. They are also often subject to lifestyle restrictions as a condition of hospital discharge. These restrictions are recorded in care plans, and all changes are risk assessed. Staff, as part of pre-admission assessment, identify personal development goals with each service user. If information about local opportunities, such as lifelong learning, is not already available in the home, they then seek it out, or direct service users to information sources. Weekly keywork sessions are used to review, and record, changing goals. The balance of rights and responsibilities is also central to the ethos of this home. There was evidence in keywork and daily records, and in the staff handover, that staff and service users understand the need for boundaries. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 12 Service users self-cater, with staff providing support as needed. This includes accompanying individual service users on shopping trips and showing them how to cook certain dishes. The activity records had examples of both individual and group cooking. The previous manager had filled in a preinspection questionnaire, which stated that a policy and procedure on food hygiene was not needed because of self-catering. This was discussed with the acting manager during this visit. Whilst the home does not provide or prepare the food it remains responsible for this aspect of care. A policy and procedure, including appropriate training for staff so that they are equipped to provide sound advice to service users about food hygiene, must be in place. This is Requirement 2. New North Road DS0000067013.V288044.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ health and care needs are met via comprehensive care planning and review. Medication errors would not always be picked up by the current audit system. EVIDENCE: The home does not provide personal care, apart from administering medication where service users cannot self-medicate. Physical and emotional health needs are identified in pre-admission assessments and set out in the individual care plans. A core element of this service is the promotion of positive mental health. Keywork sessions and group work are used to support service users to achieve this. Care plans and risk assessments are regularly reviewed. The North London Forensic Team is fully involved in the delivery of individual care plans. The home’s current medication audit system is carried out weekly. This is a count of the number of tablets, rather than a cross-reference with amount received and amount brought forward from the previous month. It means that verifying the number of tablets is extremely difficult. In the sample audit of two service users’ medicines checked during this visit it proved impossible, as numbers did not match. If surplus medication is not going to be returned to the pharmacist at the end of each prescription cycle then the amount remaining must be noted. In most homes this is done on the new MAR chart. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 14 This is Requirement 3, which includes the need for full and regular audit. In the case of one MAR chart it was reported that the service user regularly goes on leave. The charts clearly state that this must be recorded with an ‘L’, but this policy is not being followed. Staff sign when they give the service user the medication to take on leave. There is also no record of how much medication the service user takes on leave or gives back on return. This again means that audit is practically impossible. Staff must follow the company procedure for medication administration. There must be an accurate record of all medication that service users take on, and return from, leave. This is Requirement 4. There was a sudden death at the home in January of this year. Staff dealt with this distressing situation appropriately. They confirmed that they had received support from the organisation and from peers. This covered both supporting service users and dealing with the situation as a staff group. The policy and procedure includes guidance on dealing with the death of people who are nonChristian, which is excellent, given the multi-racial backgrounds of the client group. New North Road DS0000067013.V288044.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 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 adequate. This judgement has been made using available evidence, including a visit to this service. Complaints are taken seriously, though cannot always be resolved to the satisfaction of all service users. Service users are not fully protected by the homes recruitment procedure. EVIDENCE: Two service users raised concerns regarding food being stolen, with one also raising issues of drugs and alcohol being consumed in the home. The record of complains substantiated their concerns about food being stolen from the fridges and freezers. Service users each have a locked cupboard in their floor kitchen, and some have chosen to have fridges in their rooms. The kitchen doors are supposed to be locked whilst empty, but during the visit one was found to be unlocked. The level of security within the home is currently being reviewed. No Requirement has been set but the Commission will monitor this at the next inspection. Complaints are taken seriously and recorded using a format that identifies outcomes, follow-up action, and whether the complaint has been upheld. Concerns and complaints are also discussed in the community meeting and in the weekly keywork sessions. Staff reported that they have received adult protection training and training records substantiated this. Since the last inspection some new staff have commenced work before CRB checks have been received. In the files seen there was no evidence of a POVAfirst check having been carried out. This contravenes regulations and guidance. This was pointed out to both the manager of the home and the organisation’s Human Resource department the day following the visit. If staff start work at the home before a CRB check has New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 16 been completed then a POVAfirst check must be obtained. In addition the full Commission guidance must be complied with. This is Requirement 5, which also relates to Standards 34 and 37. New North Road DS0000067013.V288044.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, 27, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users needs are met by the environment, which continues to be improved. Maintaining a safe environment is a high priority, and a continuing challenge, for the service. EVIDENCE: The building was toured, including one vacant bedroom. There is an improvement programme, and many areas have been redecorated since the last visit. Some further, necessary, improvements were pointed out to the deputy manager during the tour. As these are included in the improvement plan no Requirement has been set. The Commission will monitor these intended improvements at the next visit. The washing machine on the first floor was reported to be out of order for over six months. It was repaired last week, but during the visit was once again out of use. Alternative arrangements are in place for service users on this floor to do their washing. The safety of the environment is under continual review. There are two main challenges: Visitors from the adjacent home; and visitors from the community. Staff and service users are aware of the need to safeguard the environment. There are risk assessments and strategies in place to deal with these challenges. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users are not fully protected by the homes recruitment procedure. Staff are trained and competent to support service users, but could benefit from training in transcultural interventions. EVIDENCE: Two case files were examined and two service users spoken to. One service user questionnaire was returned. Staff were observed in handover and some were separately asked questions about the care provided. Recruitment files were examined at the organisation’s head office on the day of the site visit. Staff demonstrated a sound knowledge of the needs of service users during the handover meeting. This was also reflected in the keywork session and activity records. Staff are clear that their role is to support service users to maximise their independence, within a risk management framework. Staff reported that they had received training appropriate to their work. Several are currently working towards NVQ3. They receive group, clinical, supervision on a regular basis. Individual supervision had slipped due to vacant management posts, but this is now monthly. The organisation has a thorough recruitment process, apart from obtaining a POVAfirst check prior to new staff taking up post. This check was introduced in New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 19 mid 2004, and allows for employers, in exceptional circumstances, to start new staff before a full CRB check is received. Refer to Requirement 5. The current group of service users are from a variety of racial and cultural backgrounds, as is the staff team. Traditional psychological interventions, such as counselling, have a white Eurocentric bias, which may not fully take account of race and culture. Staff reported that they work with service users as individuals, and this was reflected in the records seen. However, staff receiving training in transcultural interventions may improve the service, and make it more accessible to non-white service users. This is Recommendation 2. The lack of POVAfirst checks has adversely affected the judgement on this set of outcomes. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The temporary management arrangements benefit service users and the home is generally well run. The homes recruitment procedure does not totally safeguard service users. EVIDENCE: The Registered Manager has recently left and a locum manager is currently managing the home. In discussions during the visit she displayed knowledge of the needs of the service user group, and the strengths and weaknesses of the service. She also demonstrated an ability to transfer knowledge of other types of services to the management of this home. The post has been advertised, and once a permanent manager is appointed they must apply to the Commission for registration. As the Responsible Individual is well aware of this no Requirement has been set. The Commission will monitor the situation, as care homes are required to have a Registered Manager under the CSA 2000. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 21 There are good management systems in place, such as monthly room checks, staff meetings, supervision, keywork sessions, and clinical supervision. Health and Safety records were sampled, and those seen were up-to-date. Examination of the incident records showed that the home has not been reporting all incidents to the Commission as required under Regulation 37. This is Requirement 6. The Commission has recently issued new guidance on this Regulation, which is available on the website. The monthly visit reports required under Regulation 26 are of a good standard, informative, and identify actions to improve the service. An annual service user survey is carried out, as well as exit surveys when service users move out. The lack of POVAfirst checks has adversely affected the judgement on this set of outcomes. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 4 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 1 3 3 3 3 3 3 New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 23 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 YA1 Regulation 4 Requirement Timescale for action 30/09/06 2 YA17 16 (2) (j) 3 YA20 13 (2) 4 YA20 13 (2) The Statement of Purpose must fully reflect the service that the home can provide. This must include any exclusions and boundaries, particularly in relation to substance misuse. A copy of the up-to-date document must be forwarded to the Commission. The Registered Person must 30/09/06 ensure that staff and service users have access to a policy and procedure relating to safe handling of food. This must include arrangements for staff training so they are in a position to support and advise service users. The Registered Person must 30/09/06 ensure that the medication policy and procedure protects service users at all times. This must include regular audits of stock received, given, and held. The Registered Person must 30/09/06 ensure that all medication given to service users who are going on leave is correctly recorded. Medication administration charts must be accurate, and staff must DS0000067013.V288044.R01.S.doc Version 5.2 New North Road Page 24 5 YA23 YA34 YA37 13 (6) 18 (1) & 19 6 YA37 37 comply with company procedure. Medication taken away by service users going on leave, and returned, must be recorded. The Registered Person must not employ people to work at the home before all required checks have been completed. No person may work at the home until a satisfactory POVAfirst check has been carried out and the results received. Their duties following this, and until a full CRB disclosure is received, must be in accordance with the regulations. The Registered Person must ensure that the Commission are informed of all events that fall within the remit of Regulation 37. 21/06/06 21/06/06 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 YA1 YA35 Good Practice Recommendations The Registered Person should consider providing information about the home, such as the Service User Guide, in a range of formats. The Registered Person should consider providing staff with training in transcultural interventions and approaches. New North Road DS0000067013.V288044.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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. 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