Inspection on 11/07/06 for North View (21)

This inspection was carried out on 11th July 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

North View (21) 13/07/09

North View (21) 14/07/08

North View (21) 28/06/07

North View (21) 24/02/06

North View (21) 16/09/05

North View (21) 02/09/04

North View (21) 21/05/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 North View (21) Jarrow Tyne And Wear NE32 5JQ Lead Inspector Lesley Scriven and Katie Tucker Key Unannounced Inspection 11 July, 21 August and 14th September 8:30 th st North View (21) DS0000000259.V302897.R02.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 North View (21) DS0000000259.V302897.R02.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. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service North View (21) Address Jarrow Tyne And Wear NE32 5JQ Telephone number Fax number Email address M , 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) 0191 420 0125 0191 483 8857 None United Response Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th February 2006 Brief Description of the Service: 21 North View is a registered care home owned by United Response. It provides accommodation with personal care and support for up to six men and women aged between eighteen and sixty-five who have learning difficulties. Some service users may also be physically disabled or have a sensory impairment. Nursing care cannot be provided. The property is a detached purpose built two-storey house, which stands in its own grounds. It has an accessible garden and patio, and blends in well with neighbouring houses. It has six single bedrooms, all located on the ground floor, a shared living room and a separate dining room and newly refitted kitchen. Staff accommodation is on the first floor. Within walking distance of Jarrow town centre, the home is close to local shops, Churches, pubs and a range of leisure facilities. It enjoys very good public transport links. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 3 days. Two inspectors visited over these days and spent time speaking to people using the service and staff. Several residents were identified. The care they received was tracked through discussions with all concerned and by looking at the service user plans and other records. Also information supplied by the home and comment cards were used to make decisions about the quality of service. 21 Northview provides care for people with a learning disability. Some of the people could share their opinions on the quality of the service. Staff practices, attitudes and approaches were also watched and judgements made on how well staff worked with people. What the service does well: What has improved since the last inspection? The manager and staff are looking at how to improve the recording systems in the home. They are aware of weaknesses in the systems and are trying to rectify them. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. North View (21) DS0000000259.V302897.R02.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 North View (21) DS0000000259.V302897.R02.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 and 3 Staff are not ensuring full assessment information is obtained need to be extended to cover all aspects of people’s lives. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home’s statement of purpose and service user guide do not include all of the information required by regulation and have needed to be improved since May 2004. This type of information is important as it explains what people can expect from the service and should help those looking for a place to live make an informed choice. The service user guide in its present format may be difficult to understand for people who cannot easily read the written word, so pictorial or audio versions should be supplied to everyone living at the home. Before a person can move into the home, they must have their needs assessed by a social care or health professional. The assessment looks at what each person can do to take care of them and what support they will need with the tasks of daily living and personal, emotional and health care. If the manager is sure those support needs can be met, a place will be offered. Once the person has moved in, the manager and staff use the assessment information to write an individual support plan. Wherever possible this is agreed with the service user or a family member and clearly explains how the person prefers to be cared for and supported in a way that helps them to stay North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 9 as independent as possible for as long as possible. It is kept up to date and altered as needs change. All of the staff involved in supporting the person are made familiar with the plan so they know exactly how best to offer assistance. Risk assessments are also carried out. Because the home encourages continuing independence, this can involve a degree of risk. Most people take part in community activities and with staff assistance use facilities such as the local leisure centre or shops and pubs or public transport. The manager carefully assesses the level of risk involved, and together with the person and/or his or her relative or supporter (e.g. an advocate) weighs up the benefits and pitfalls. Clear guidelines are then put in place for staff to give the service user the correct level of support to reduce to an acceptable level the likelihood of anything going wrong. North View (21) DS0000000259.V302897.R02.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 and 9 There were some shortfalls in the recording systems. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Everyone who lives at the home has an individual support-plan, which is created by the manager or a senior staff member. The home no longer operates a ‘key worker’ system; so all workers share the responsibility of getting to know service users well and familiarising themselves with the plans. This means that service users can be confident that their needs will be met by any of the staff on duty at any given time. The plans look at all aspects of service user’s lives, both inside and outside the home. They set out step-by-step instructions for staff about the type and level of emotional and physical support each person requires to achieve their personal goals whilst remaining as safe as possible. They also include nice details about personal preferences, such as favourite food and drinks, leisure pursuits, clothes and cosmetics. However, the plans are not written in an easy to understand language with pictures or symbols and so are not accessible to all service users. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 11 Whilst there is written evidence to show how the plans are evaluated and why decisions are made to change them, this information is being recorded in a variety of different ways in different books and on different forms. This means that staff spend a lot of time duplicating information, which isn’t always quickly, translated into updated support plans when people’s needs have changed. Despite this, staff were very knowledgeable about service user’s individual personal and health care needs and how these should be met. A visiting district nurse confirmed this to be the case in her discussions with the inspector about one person’s skin pressure care needs. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 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, 13, 15, 16 and 17 Although staff are person-centred the difficulty people have engaging in social activities outside the home creates shortfalls. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Although the staff want to promote independence and provide a range of stimulating activities for the residents for large parts of the week two staff are on duty. Staffing levels and shift patterns prevent people from going out. So other than the use of a day centre residents tend to spend the majority of the time at the home. Some of residents love to go out but trips out on their own with a staff member are extremely limited. For the vast amount of times these people only go out to complete domestic tasks such as going shopping. This is very limiting for the people using the service and does not reflect the person centred approaches staff are promoting. Some of the residents go to day centres and college on a daily basis. Residents’ have very complex needs and difficulty expressing their needs verbally. Staff have learnt to interpret what people mean by their gestures. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 13 Staff had a very in-depth knowledge of people’s likes and dislikes. Staff do try to meet peoples wishes in terms of going to pubs, cinemas, leisure centres. They were aware of which activities would be enjoyable for each resident but recognised the difficulties the current staffing levels posed in terms of meeting residents’ goals. They certainly wanted to offer a recognised ‘everyday lifestyle’ but were unable. Residents were very accommodating and accepted these limitations imposed by the type of service on offer. However these and other limitations are not recorded. A number of the residents need staff to make decisions on their behalf. Also staff limit everyday risk-taking activities for all of the people inclusive of going out of the home by themselves. At present staff do not record the justifications for the decisions they make or the limitations they impose on residents. Them manager was made aware of the requirements of the Mental Capacity Act and Bournewood judgement in terms of least restrictive practices. On the whole staff have formed good relationships with residents relatives and actively support people to maintain links. Relatives commented about the service saying ‘it was good’ and the ‘staff were very caring’. Staff are aware of residents meal preferences and make sure people receive a balanced diet. They also promote people’s independence and encourage residents to participate, as much as they can, in the preparation of the meals. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Although some good health and social care practices were evident flaws in the administration of medication persist. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There appears to be a genuinely warm rapport between staff and service users and workers have a good understanding of the needs and lifestyle preferences of the people who live at the home. This enables them to offer the right kind of assistance in a very personalised way. Service users are supported with personal care tasks by workers of the same gender to protect their dignity, and are able to choose their own clothes, hairstyles and make-up so that their appearance reflects their personality. The home works closely with health care professionals to make sure each person’s physical and emotional well-being is monitored and specialist attention is promptly sought wherever needed. A visiting district nurse told the inspector that she is confident in the team’s ability to identify user’s health care needs and promptly report any concerns to the local health centre. She added too that the team are “great” at following GP and nursing instructions where these are given. Although information about service user’s healthcare North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 15 needs is regularly kept by staff, the way this is recorded could be improved (see outcomes for standard 6). Previous inspections have highlighted some unsafe medication practices and although immediate steps were taken to put things right, and staff have received training in the safe handling of medicines, some mistakes are still being made and poor practices continue. In the last month for example, one service user was given medication prescribed for another person living at the home, and on a different occasion staff failed to administer a morning dose of medications to another person. Although two staff now work together administer medicines, the administration record is still being signed to indicate that medicines have been taken before they have even been given to the user. Any errors or omissions in administration that do occur may therefore not even be found. This exposes service users to further risk. Additionally, tools introduced by the previous manager to audit medication administration records are not being properly used and do not help staff to identify problems with stock balances. Case tracking also showed that the system for recording incoming medication is flawed. An auditable trail could not be established because of the lack of information about the amounts of medication received into the building. The medication recording system needs to include a mechanism for showing when and how much medication was received into the building. The manager stated that the mars sheet was usually filled in correctly but action is being taken to make sure the overall systems work more effectively than they have in recent months. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The manager and staff can deal with complaints and concerns but changes accessible information needs to be provided for residents. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The complaints procedure should be made available to residents and relatives through the service user guide. This guide should be written in an accessible style. A number of the residents have great difficulty expressing their views. Recently advocates have been visiting the service to ascertain the views of residents about proposals for the development of the home. It was hoped that now this support had been established it would continue. Thus providing additional help to staff around making sure the service was meeting people’s expectations. North View has a protection of vulnerable adults policy and follow Gateshead Social Services Department guidance. This guidance requires the owner to put in a section about what they would do if an allegation of abuse were made. Staff are being given access to the local authority protection of vulnerable adults training. Recently an allegation was made around staff practices and the manner in which the assisted residents to transfer from chair to chair. This matter was fully investigated and no evidence was found to support the allegation that staff were intentionally being abusive. However some issues were identified around the level of moving and handling training staff had received. North View (21) DS0000000259.V302897.R02.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 and 30 The home was well maintained. The quality rating is good. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: 21 North View is nicely decorated with good quality furniture and fittings in keeping with the age and lifestyle choices of the people who live there. Bedrooms reflect user’s individual interests and personality. Staff keep the property clean and tidy and free from infection to the benefit of everyone’s health. A number of improvements have been made to the home since the last inspection, including the laying of new wooden flooring in the communal living room. One of the washing machines requires repair, but this is in hand. The grounds are well maintained and provide pleasant additional space in the summer months. The manager has plans to further develop this area by putting up higher fencing to provide better privacy screening for users and their visitors, since the home is built next door to a busy health centre. He also intends to consult with users about planning a sensory garden for the home, with planting and features that have textures, fragrances and sounds North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 18 that stimulate all of the senses, and can be enjoyed in many different ways by people who have physical, sensory or emotional health needs. Where appropriate, environmental adaptations have been fitted and equipment is used to maximise people’s independence. These are regularly checked to ensure they remain fit for purpose. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The staffing levels and shift patterns need to be revisited to ensure they are adequate to meet the needs of the current residents living at North View. Staff training is provided around all aspects of residents’ needs. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Staff currently work set shifts and this often leads to one member of staff being in the house during the early part of the afternoon. At the time of the visit three residents were at home during this period. All three had very complex needs. Although one person wanted to use the toilet had to wait for the other staff to start work before they be assisted to use the toilet. Another person can present health and safety risks and staff found it difficult to monitor their safety as well as help the other people. These and other issues noted where discussed with the manager who stated that extra staff would be rostered over this time period. Also the shift pattern prevents residents from going out for the day or spontaneously. Currently residents at home during the day only have about 2 hours where they can go out during the morning as staff have to get back for a changeover of staff team. Staff acknowledged that this unduly limited people and wanted to improve people’s access into the community. Finally on the North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 20 weekend additional staff are not provided so again people may have to stay in. The manager recognised all of these difficulties and is looking at how to improve staffing levels and the opportunities staff can provide for people to go out. Staff have access to a wide range of training and the manager is always making sure staff get up dated information. Staff have completed a range of NVQ’s and continue to further their education. 96 of the staff have NVQ awards. The staff recruitment procedures were in line with those required but small amendments were needed to the application form so it complied with the Disability Discrimination Act 1993. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The manager is new to post and is revisiting the overall management system to ensure it is fit for purpose. The quality rating is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The new manager is in the process of submitting an application for registration. Also the owners are reviewing the type of service that they offer at the home. The owners need to revisit the quality assurance systems and mechanisms for monitoring medication as some errors have been made recently. Also the vast majority of requirements made by CSCI have not been addressed. These requirements directly relate to the overall operation of the service and are an indicator that the quality assurance system is not meeting its objectives. Personal allowances were being maintained appropriately. There were no health and safety issues noted at the time of the inspection. North View (21) DS0000000259.V302897.R02.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 1 2 1 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 2 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 3 X North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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&5Schedule 1 Requirement The statement of purpose and service user guide must be developed to include all of the information required by regulation. They must be made available to each person in a suitably accessible format TIMESCALE OF MAY 2004 NOT MET Timescale for action 30/11/06 2. YA1 17(2)Schedule Service user 4 contracts/statement of terms and conditions of placement must be revised to clearly show a breakdown of the home’s charges and what users can expect in return for their fees. United Response staff may not represent service users for the purpose of entering into contracts with the company. TIMESCALE OF MAY 2004 NOT MET 30/11/06 3. YA2 14 The home must ensure full assessment information is DS0000000259.V302897.R02.S.doc 18/01/07 North View (21) Version 5.2 Page 24 gathered prior to admission. The home must write to the prospective resident and inform that the service can meet their assessed needs. Staff must the complete assessment around residents needs and this must be up dated on a regular basis. Written evidence must be kept to show how each service users support-plan is evaluated and updated to reflect changing needs and circumstances. Risk management documents must be evaluated in the same way. TIMESCALE OF MAY 2004 NOT MET. Staffing levels and patterns must allow service users to participate in social and leisure activities outside the home. The medication system and practices must be reviewed to ensure accurate records are maintained and safe administration practices are adopted. Information must be recorded around restrictions that are imposed upon service users. The home’s ‘whistle-blowing’ policy must be amended in line with GSCC code of conduct requirements. TIMESCALE OF FEBRUARY 2005 NOT MET. Staffing levels must be increased during the early afternoon. 4. YA6 14(2)15 (2(b,c) 18/01/07 5. YA14 16 (2) (m & n) 23/12/06 6. YA20 13 (2) 25/11/06 7. YA16 12 (2) Schedule 3 (3) (q) 13 (6) 18/01/07 8. YA23 30/11/06 9. YA32 18 (1) (c) 23/12/06 North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 25 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 YA6 Good Practice Recommendations Following care plan reviews where ‘no change’ in a user’s needs has been found and plans have remained the same, information should be recorded to evidence staff judgments. North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 North View (21) DS0000000259.V302897.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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