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Inspection on 20/12/05 for Northmead House

Also see our care home review for Northmead House for more information

This inspection was carried out on 20th December 2005.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Northmead House is a pleasing environment in which residents stay for shortterm respite care. The home is clean and in good condition well. Staff appeared to interact with residents in a caring and supportive manner. Residents are supported to continue accessing community educational or activity appointments as they were usually doing before the respite stay at the home.

What has improved since the last inspection?

At the last unannounced inspection in August 2005 eight requirements and four recommendations were made. Requirements relating to medication, the kitchen fridge, care and supports plans, lockable storage facilities in resident`s rooms and infection control have been met. The requirement that a suitable call bell system be installed at the home continues to be discussed and the manager is arranging for household waste storage facilities to be enclosed, this will then meet the requirement made in the previous report regarding infection control. The four recommendations made in the previous report have all been acted upon satisfactorily. Since the last inspection a new manager has been appointed to the service and some personnel issues at the home have been addressed and concluded by Social Services. This is resulting in staff working at the home feeling more optimistic resulting in a better cohesive working team at the home.

What the care home could do better:

As a result of this inspection two requirements and one recommendation are made. The manager Mr. Binding is required to apply to the CSCI for consideration as Registered Manager. The other requirement is that two baths in the home require LOLER inspections. It is recommended that the home seriously review the routine use of bed rails in the home in terms of safety guidelines from the MDA/Health and Safety Executive.

CARE HOME ADULTS 18-65 Northmead House 3 Northmead Puriton Bridgwater Somerset TA7 8DD Lead Inspector Judith Roper Announced Inspection 20th December 2005 1:30 Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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 Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Northmead House Address 3 Northmead Puriton Bridgwater Somerset TA7 8DD 01823 423126 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) Somerset County Council (LD Services) Ms Clare Lois Marks Care Home 10 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for up to 10 persons in category LD who may have a concurrent physical disability. Registered for respite care placements only. Date of last inspection 18th August 2005 Brief Description of the Service: Northmead House is a large detached house situated in the village of Puriton. The home provides respite care for adults who have a learning or physical disability. Appropriate adaptations have been provided within the home to meet service users needs. There is an enclosed garden at the rear of the property. Northmead House is run by Social Services. There has recently been a change of manager at the service and the new manager Mr. Paul Binding is currently applying to be the registered manager with the CSCI. The Responsible Individual for the service is Mr David Dick. Northmead House is registered with the Commission for Social Care Inspection to provide short stay accommodation for up to ten people who have a learning or physical disability. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by one inspector and took place over one day between the hours of 1.30 pm – 18.30 pm. Six residents were at the home on the day of the inspection. There are currently four vacancies at the home. The inspector was able to interact with four residents during the inspection. There were no relative visitors at the home during the inspection visit. Prior to the inspection eighteen comment cards from a mixture of residents, parents and carers were received at the CSCI. General comment findings were shared with the management at Northmead House. In general feedback was positive but some comments were critical of the management of laundry at the service and frequent users of the service wanted better in-house activities/games to be available for use. Staff on duty were able to give time to speak with the inspector. The service manager Mr. Binding and deputy manager Ms. Saunders were on duty and available for comment during the inspection. The inspector would like to thank the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and informal. Staff carried out their duties in a friendly and professional manner. The home was festively decorated and was welcoming. The focus of this inspection was to revisit requirements and recommendations made at the unannounced visit in August 2005. There was also a follow-up inspection visit held in October 2005 at the home to further discuss medication management at the home. In this December announced inspection the inspector has assessed Standards not met and Standards not inspected in August. Some key Standards have also been inspected at the announced visit. Records examined during the inspection were the pre-inspection questionnaire submitted by the home to the CSCI, two resident care and support plans, staffing rosters, resident risk assessments, medication records, kitchen cleaning records and cold storage of food temperature records and a sample of staff recruitment files; other records will be examined at subsequent inspection visits. What the service does well: Northmead House is a pleasing environment in which residents stay for shortterm respite care. The home is clean and in good condition well. Staff appeared to interact with residents in a caring and supportive manner. Residents are supported to continue accessing community educational or activity appointments as they were usually doing before the respite stay at the home. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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 Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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. Northmead House is a respite facility and there is a high turnover of resident numbers. The home has a Statement of Purpose and guide for service users. This information is available in Somerset Total Communication symbol form. The documents will require revising when a registered manager is approved by the CSCI for the service to include the name and experience of the registered manager. EVIDENCE: The home has a Statement of Purpose and a copy of this is held at the local CSCI office. There is a guide for residents, which is also produced in Somerset Total Communication. The manager plans to review the admission process in the New Year to ensure that admission procedures are more robust to ensure harmony of residents and flexible staffing levels that meet resident need. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9, 10. Care and support plans for individual residents were detailed and holistic. Evidence of regular review is clear. Risk assessments for individual residents were completed for a variety of identified hazards. Risk assessments for the use of bedrails has been completed but would benefit from being more detailed. Routines at the home are flexible and tailored to resident’s daily commitments. Resident confidentiality is maintained at the home. EVIDENCE: Care and support plans were maintained for all current residents. Two plans were inspected. Information held within plans was tailored to individual need. All care and support plans for the current six residents had been recently thoroughly reviewed. Risk assessments had been completed for a variety of individuals’ needs. Two current residents have bedrails fitted to their beds for health and safety reasons. The use of bedrails had been risk assessed but it is strongly recommended that the risk assessment be made in more detail and the routine use of bed rails in the home be reviewed taking into consideration whether the resident routinely uses bed rails at home and if the respite admission poses more risk of falling out of bed than at home. The home is auditing the safe fitting of bedrails monthly, which is good practice although both sets of bed rails inspected were somewhat lose on one side each. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 10 Resident personal possessions brought into the home were recorded. Routines at the home are flexible and tailored to residents continuing to access community leisure or educational placements committed to prior to the respite stay at the home. The home has a Confidentiality policy. Records relating to staff and residents are stored securely in accordance with Data Protection principles. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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): 13, 14, 16, 17. The home is enabling respite residents to continue accessing the day care, activities and educational commitments made prior to admission to the home. Those residents that have stayed beyond three months have an activity programme devised for them in addition to community commitments. Some feedback cards were critical of the perceived limited range of entertainment equipment of games available at the service house. Meals are flexible and residents likes and dislikes are known. The kitchen is clean and maintained well. EVIDENCE: The home aims to provide residents with the opportunity to continue accessing the services that they would normally access from home. This is being achieved. Residents are continuing to also access day services whilst staying at Northmead House. This helps to provide consistency of care and routine for the people accessing respite at the home. The two people who have stayed at the home for more than the registered three months also have an activity plan tailored to individual need. This includes evening activities detailed in Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 12 individual care and support plans. The home management is aware that new admissions must not exceed a three month placement. Northmead House has a vehicle to provide transport for residents into the local community. In the village of Puriton there is a village shop within walking distance of the home. Three CSCI feedback cards from residents said that there seemed to be a lack of entertainment at the home for the evenings such as electronic games, multi-media equipment or indoor sports. The inspector raised this with the manager, who was aware of some of the comments and who said that he would like to take on board some of the comments raised. Due to the nature of the service provided, there is considerable contact with families and carers. The home has an open visiting policy. Contact with relatives or carers are documented in care and support plans. In only one feedback card to the CSCI from relatives was a negative comment regarding staff communicating effectively with families/carers over the health needs of residents. Of the positive comments relatives/carers wrote of kind staff and flexibility at the service to accommodate respite stays to family need. Routines at the home are flexible to individual’s daily needs. Residents can hold a key to their room if they wish. There is a four week running menu. A choice of main meal is offered. Shopping for food is locally sourced. Fresh fruit and vegetables are available in the home. The dining facilities at the home are congenial and provide sufficient space for residents and staff to assist at meal times. Records are kept of residents’ meal likes and dislikes. Staff record fridge and freezer temperatures daily. The faulty fridge in the kitchen identified at the previous inspection has been replaced. Some staff are still waiting to complete a food hygiene update, but these staff have been booked onto refresher courses. There is a written cleaning schedule for the kitchen and on the day of the inspection the kitchen was clean. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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. Staff are providing individualised and sensitive support to residents. The inspector still believes that a call bell system in key areas of the home would provide more independence and dignity for residents. Community health care is accessed and documented with outcomes. Residents are continuing to receive health support, as they would normally expect whilst receiving respite care at Northmead House. Medication management has improved greatly since the last inspection so that the systems in operation now are robust and less liable to error. There has not been a death at the service. Wishes of residents in the event of serious illness are recorded in individual care and support plans in order to guide staff and support residents and their families/carers. EVIDENCE: During the inspection staff were observed interacting with residents in a sensitive and friendly manner. Staff were communicating with residents in a language that they understood. Staff are trained in Somerset Total Communication. All residents spoken with indicated that the home was friendly and that staff were nice. The call bell system in the home is not operational and this is a pity as call bells in key areas in the home could help Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 14 to maximise resident’s independence and dignity. This was highlighted in the previous inspection report. Nursing care is not provided at the home. Community nurse support is accessed if need is assessed and identified. This is recorded in the individual’s care and support plan. Resident’s retain their own GP whilst using the respite service at Northmead House. A record is maintained in care and support plans of health care appointments accessed from the home and of outcomes. Medication systems were inspected and this has greatly improved since the previous inspection findings. The home management and Social Services have worked hard into put into place procedures for the management of medication that are robust and supported by sensible policy guidelines. As a respite facility it would be unusual for the home to experience the death of a resident. The home does try to ascertain the wishes of residents in respect to them becoming seriously ill in order to provide appropriate care. Staff also have access to counselling services in the unlikely occurrence of a death at the home. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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 has appropriate policy and procedural guidelines for handling complaints and Adult protection. EVIDENCE: The home displays its’ complaints procedure, also available in Somerset Total Communication, in the home. There have been four complaints raised to the home about the service in the last year. All were upheld. Two were to do with laundry management; one regarding a resident’s shoes being washed and shrunk at the service and one was regarding a care management issue. Complaints tend to be investigated by the network manager for the service. Staff receive training in Adult Protection as part of induction and on-going core role training. The home has appropriate local procedural guidelines for the reporting and investigating of abuse allegations. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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, 25, 26, 27, 28, 29, 30. The environment is attractive and offers a range of communal space. There are good facilities for physically disabled residents. The home was clean to a high domestic standard on the day of the inspection. EVIDENCE: Pleasing accommodation at the home is provided over two floors. There is a passenger lift at the home. All bedrooms are for single occupancy and are of a good size. Two ground floor bedrooms have overhead hoists available. All but one bedroom has en-suite facilities. All rooms now have lockable facilities provided for valuables. The standard of decoration and furnishing is good. Outdoor space is attractive and offers privacy from the road. As recommended at the previous inspection the management sought advice from the local fire service regarding a hinged bar at the top of the first floor stair. There are two assisted bathrooms and one shower room. Servicing for two baths is overdue. Toilets are accessible for wheelchair users. Facilities for physically disabled residents are good in the home. Communal areas comprise of a lounge, dining room and a quiet room. The main lounge would be a little cramped if all residents and staff used it at one Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 17 but this is unlikely. There is sufficient compensatory communal space provided. There is provision at the home for staff on sleeping-in duties. The sleeping-in room also includes an en-suite for staff. The laundry facilities and laundry infection control equipment is sufficient. COSHH is handled appropriately. Hazardous chemicals used in the home were appropriately stored. Residents assisting with domestic cleaning in the home do so under staff supervision. The domestic standard of cleanliness in the home was high on the day of the inspection. There are now provided sufficient facilities in the home for staff to wash their hands after attending to personal care with residents. This was made a requirement at the previous inspection. There is now provided liquid soap, paper hand towels and flip to bins in resident communal bathrooms and toilets. The same arrangements are also now provided in bedrooms of any residents who receive assistance with personal care from staff in order to manage the risk of cross infection and infection control in the home. The manager is arranging for the outside storage area for household waste to be enclosed. This will then provide protection to public health from bin bags of waste from the home waiting refuse collection. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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. Staffing levels in the home are sufficient to provide personalised individual care for residents. Staff roles are clearly defined and an annual staff training plan based on individual staff need is in place to provide residents with staff who can demonstrate professionalism via regular training updates. Recruitment practices for newly appointed staff are robust in order to protect vulnerable adults. EVIDENCE: Staffing rotas were seen by the inspector. Staffing levels in the home vary to the number of current residents. Staffing levels allow for 1:1 support of residents. The new manager is currently undertaking a review assessment of staffing need at the home to provide more flexible, efficient and suitable staffing levels linked to admissions. The manager reported that staff have job descriptions. Staff spoken to during the inspection were optimistic about the change of management at the service and were appreciating the direction that the new manager was giving the staff team. The home has an annual staff training plan that is based around core training competencies and individual staff training needs. Samples of three staff recruitment files were inspected. It is usual for Social Services to process staff recruitment centrally, but the manager of the service Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 19 was able to obtain and demonstrate evidence to the inspector of robust staff recruitment practices during the inspection. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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, 41, 42, 43. Mr. Paul Binding is the newly appointed manager for the service. He has hitherto experience of managing similar services and had been assisting in managing Northmead House on a part-time basis for a few months. He is required to apply to the CSCI to go through the ‘fit person’ process in order to be the registered manager of the service. Records examined were maintained in good order demonstrating good management of records at the service. Health and safety issues inspected were generally well managed but two baths require servicing. The service is run by Somerset County Council, which was awarded three stars in its recent inspection. EVIDENCE: There is a new manager in post, supported by a deputy manager. Both are experienced in care home management. Staff spoken with during the inspection were supportive of the home management team. Records examined were maintained well and this has improved since the last inspection. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 21 Processes for managing monies of residents sent in during the admission were inspected and these were satisfactory. Equipment servicing records were inspected via the pre-inspection questionnaire and cross-checked by servicing stickers on equipment in the home. The home has three baths, two that are height adjustable. These two baths have their six monthly LOLER inspections and service overdue. This is required to be followed up. It was reported that staff who require a first aid update have been booked on a course in February 2006. The manager reported that this would then provide at least one staff member with a current first aid certificate per shift. Somerset County Council, a three star authority, runs the service. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Northmead House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 X X X 3 2 3 DS0000042169.V261716.R01.S.doc Version 5.0 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 YA37 Regulation 8 (1) (a) Requirement Timescale for action 31/01/06 2 YA42 It is required that Mr. Paul Binding applies to the CSCI to be the Registered Manager for the service. 23 (2) (c.) It is required that the two height adjustable baths in the home are serviced 6 monthly as part of LOLER servicing inspections. 31/01/06 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 YA9 Good Practice Recommendations It is strongly advised that the home reviews the routine use of bed rails. The home’s risk assessment would be more robust if it followed the points in the MDA safety guidance notice or advice available from the Health and Safety Executive in risk assessing the use of bed rails. Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Northmead House DS0000042169.V261716.R01.S.doc Version 5.0 Page 25 - 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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