Inspection on 29/04/05 for Oak Lodge

This inspection was carried out on 29th April 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 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oak Lodge 21/06/07

Oak Lodge 12/06/06

Oak Lodge 30/09/05

Oak Lodge 06/01/05

Oak Lodge 25/08/04

Oak Lodge 25/02/04

Oak Lodge 14/01/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Oak Lodge 136 West Hill Putney London SW15 2UF Lead Inspector Jon Fry Unannounced 29 April 2005 11:55 am th 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 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 Stationary 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. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oak Lodge Address 136 West Hill Putney London SW15 2UF 020 8788 1648 020 8780 0286 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cranstoun Drug Services Mr David Hoy Care Home (CRH) 14 Category(ies) of D - Drug Dependence past/present (7) registration, with number A - Alcohol Depend past/present (7) of places Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th & 21st January 2005 Brief Description of the Service: Oak Lodge provides care for up to 14 residents on a short-term programme for the treatment and rehabilitation of drug and alcohol problems. The home is a large detached house situated on a busy main road in the West Hill area of Wandsworth. It is conveniently situated for local shops, transport and community facilities. The internet address for the registered provider is www.cranstoun.org. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The previous inspection of the home took place in January 2004. This unannounced inspection took place over one day in April 2005. The inspector spoke with eight residents and two members of staff during the course of the inspection visit. The term ‘residents’ is used throughout completed sections of this report instead of ‘service users’. What the service does well: What has improved since the last inspection? What they could do better: Further improvements must be made with regard to the recording of the administration of medication by staff members. All staff employed to work at the home must understand and fulfil their individual responsibilities with regard to accurate record keeping. Shortfalls were again found during this inspection visit and these ongoing issues undermine the positive work undertaken by the manager as reported on above. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 6 Risk assessments must be uniformly completed and fully evidence the process of assessment as applied by the home. The kitchen presented particularly poorly in terms of appearance and contrasts sharply with the comfortable and well-maintained lounge facilities. Carpeting within the communal hallways throughout the building requires replacement. 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. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 5. The information provided within the Statement of Purpose requires further review. The Residents Handbook in place provides good information to individuals. The needs of residents are assessed prior to moving into the home. Licence agreements are provided to all individual residents. EVIDENCE: The Statement of Purpose in place requires further review to ensure that this document specifies the qualifications and experience of the provider, manager and staff working at the home. The CSCI must additionally be referenced within this document. The Residents Handbook (Service Users Guide) in place provides good information for individuals regarding the house rules and rehabilitation programme in place. Assessments were in place for three residents whose care documentation was examined. Licence agreements were seen to be kept on file and had been signed by individual residents. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 9 Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 and9. Care plan documentation is well-maintained and subject to regular review. Residents are encouraged to take responsibility for all aspects of life in the home and are supported by staff as necessary. Risk assessments are not consistently completed for each resident accommodated. EVIDENCE: Care plan documentation examined for three residents was observed to address individual need in areas such as drug use, health, relationships and housing. An ongoing review process was evidenced with the documentation updated as required. Staff acting as key workers meet with individual residents on a weekly basis. Reports of these 1-1 meetings were seen to be kept on file. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 11 The weekly timetable for the home includes weekday community meetings, senior resident meetings and a weekly business meeting. Residents take responsibility for all household tasks and daily cleaning chores – rotas were displayed for these at the time of inspection. It is an important aim of the service to ensure that residents take responsibility for their actions and various aspects of the home life within a structured and supportive environment. House rules are clearly specified within the Residents Handbook. A common theme from residents on the day of inspection was the consistency applied by staff in the home in enforcing the rules/boundaries in place. One resident stated that ‘the rules are not applied rigidly enough’ and that inconsistency by staff in their application were justified as ‘being person centred’. Three other residents stated that they felt some residents ‘get more chances than others’ and there was ‘favouritism’ by staff. These issues were discussed with the staff on duty and the inspector was informed that these feelings had arisen due to a recent incident where a member of staff had made a misjudgement regarding a particular situation. One staff member stated that they felt it was ‘sometimes difficult’ to balance the reinforcement of boundaries whilst also taking into account each individual residents situation. It was clear to the inspector that residents had opportunities to air any grievances within the groups held on a regular basis or individually with their key worker. Risk assessment documentation was not consistently completed for the three residents whose care files were examined. An ‘initial’ risk assessment was seen to be completed for one resident at the point of their first referral assessment. This document was seen to stipulate that a full risk assessment should be completed ‘upon entry’ to the service. These were not in evidence at the time of inspection. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 15 and 17. Residents are supported to maintain links with friends / family subject to restrictions in place as part of the rehabilitation programme. Residents are actively supported to assume full responsibility for the meal provision at the home. The residents make menu choices as a group. The home must ensure that suitable arrangements are in place at all times for the safe storage of food items. EVIDENCE: The Residents Handbook contains clear guidelines regarding visits. Care plan documentation in place was seen to document individual contact with partners and children. One resident spoken to reported that they had been in regular contact with their children whilst living at the home. Residents were observed to be cooking their own lunch on the day of inspection. This consisted of burgers, chips and beans. Meal planners were displayed in the communal areas as completed by the resident group. Everybody is expected to be present at the dining table during mealtimes as Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 13 part of the therapeutic programme. Staff members were observed to take their meal with the residents at the time of inspection. Feedback regarding food was positive on the day of inspection. Comments included ‘good’ and ‘its fine’. One resident stated that ‘we are responsible for choosing and preparing it’. Two shortfalls were identified at the time of inspection with regard to the storage of food. Condiments such as tomato sauce were seen to be kept out on the dining table between meals. Some of these items require refrigeration once opened. Temperatures recorded for two out of the four fridges in use were observed to be consistently in excess of safe levels at times. This issue has been highlighted at previous inspections and must be properly addressed by the home. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 18 and 20 Personal care is not provided at the home. House rules are clearly stated within the Residents Handbook and are an integral part of the rehabilitation programme. The systems in place for the administration and recording of medication have improved. Procedures in place are still not consistently being followed by staff and further training is required. EVIDENCE: Residents do not require ‘hands on’ support with their personal care. Any issues regarding personal hygiene / self-care are addressed within individual key work sessions. Residents sign a consent form on admission to agree to drug / alcohol testing and room searches as required. Improvements have been made with regard to the administration and recording of medication. Lockable storage cabinets have been provided for each resident and individuals are encouraged to take responsibility for the safekeeping and administration of their medication. The inspector was informed that medication training had been provided for staff since the last inspection took place. A small number of staff were unable to attend and still require this provision. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 15 The filing cabinet used for the storage of medication held by the home has been secured to the wall. The inspector noted that this cabinet was used for other purposes such as administration records. It is recommended that a cabinet used solely for the storage of medication be provided in line with Royal Pharmaceutical Society guidelines. One medication item was seen to be administered by staff at the time of inspection. The record of administration was not accurately maintained with a number of entries observed to be left blank. The home must ensure that these records are fully and accurately maintained at all times – a daily audit must be introduced to ensure that all staff are following the procedures in place and maintaining records properly. The organisational medication procedure was seen to state that individual key workers of residents who are self-administering assume responsibility for monitoring compliance on a weekly basis. There were no records available at the time of inspection to confirm that this ongoing monitoring was taking place. Records for the administration of homely remedies such as paracetamol were in evidence. These were generally well maintained but more recent entries failed to specify the time of administration. Risk assessment documentation was in evidence for residents who selfadministered their medication. It is recommended that further information be added to this document to fully support the assessment process. The current pro-forma in use asks the assessor to indicate ‘yes’ or ‘no’ to four questions regarding potential risks / hazards. This does not effectively evidence how the decision was made and what individual factors were taken into consideration. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 22 A satisfactory complaints procedure is in place and this is supplied to all new residents on admission to the home. EVIDENCE: The complaints procedure for the home has an appendix added to state that complaints can be made at any time to the CSCI. This document includes the local address and telephone number of the Commission. The record of complaints was not available at the time of inspection. Staff on duty were unaware where this document could be located. One complaint regarding noise was seen to be received by the home by telephone on the day of inspection. This must be logged within the central record and actions taken appropriately recorded. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 27 and 30. Further maintenance and re-decoration of some communal areas is now required. This is with particular reference to the kitchen and carpeting in communal hallways. The shared bedroom accommodation was seen to be comfortable and satisfactorily maintained. The toilet and bathroom facilities are adequate for the number of residents accommodated. EVIDENCE: Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 18 The main lounge of the home presents very well and offers spacious & comfortable communal space for residents. Many residents were seen to be utilising the large well-maintained garden located to the rear of the home on the day of inspection. The kitchen area of the home presents poorly and now requires deep cleaning & re-decoration. This was commented on by one resident at the time of inspection. Carpeting in the communal hallways on both upper floors of the home requires replacement as these were observed to be in a poor state in many places. The meeting room located by the main office has been partially decorated and this work still requires completion. Toilets and bathrooms were seen to be generally well maintained. Flooring in two communal bathrooms presents as requiring renovation or replacement in the short-term. All the bedrooms are shared in accordance with the homes policy. This is that service users are in a short-term treatment programme for six months. The Client Information document states shared rooms underpins the peer support ethos of the programme. Individual residents reported that they were satisfied with their bedroom accommodation at the time of the inspection visit. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35. Adequate numbers of staff on duty are maintained at the home to meet resident need. Further training must be provided to staff with regard to First Aid, Medication, Food Hygiene and Health & Safety. EVIDENCE: Feedback from residents regarding staff was generally very positive. Issues were raised regarding the consistency of staff in applying house rules as reported previously within this report. General comments included ‘staff give 100 ’, ‘the staff are supportive’ and ‘good’. There were three staff on duty at the time of the inspection visit. Two staff were seen to facilitate a therapy group and an individual staff member later met with a resident for an individual key work session. Two staff on duty stated that they felt well supported by the manager in their role and that there were sufficient staff numbers allocated for each shift. One member of staff is always present at the home on an overnight (sleep-in) shift. The inspector audited available training records for three members of staff. Courses attended included a corporate induction, drug & alcohol awareness and Medication. The individual records examined did not satisfactorily Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 20 evidence that all staff had attended up to date training in areas such as First Aid and Food Hygiene. The Requirement made at the previous inspection has been re-stated. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. Systems are in place for the on-going consultation with residents living at the home. Residents are encouraged to take responsibility for all aspects of life in the home. Records pertaining to Fire Safety have been improved since the previous inspection. Further development is required with regard to the systems in place for areas such as food storage and risk assessment. EVIDENCE: The timetable in place for residents includes daily weekday community meetings and a weekly business meeting. A resident satisfaction questionnaire exercise had been completed in 2004 – the inspector was unable to ascertain whether this had been repeated yet in 2005 at the time of this inspection visit. Unannounced visits to the home by the registered provider are occurring. The reports of these monitoring visits are still not being supplied to the CSCI on a monthly basis as required by the applicable Regulations. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 22 Fire Safety records were observed to be fully maintained and up to date at the time of this inspection. As stated earlier in this report, shortfalls were identified with regard to the safe storage of food items. The risk assessment documentation in place requires development. These must be individual and fully evidence that an assessment process has been applied with regard to areas of risk such as medication self-administration, safe use of hazardous cleaning substances and unrestricted windows. Records as required to confirm that a five yearly electrical installation check has been carried out were not available to the inspector. The Requirement has been re-stated from the previous report. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 x x 2 Standard No 11 12 13 14 15 16 17 x x x x 3 x 2 Standard No 31 32 33 34 35 36 Score x x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oak Lodge Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 24 Yes 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(1) Requirement The Registered Persons must ensure that the Statement of Purpose is reviewed to reflect the contents as required by Schedule One of the Care Homes Regulations 2001. (Previous timescale of 01.03.05 not fully met). The Registered Persons must ensure that full individual risk assessment documentation is put in place with regard to any identified risks. Documentation in place must fully evidence the assessment process and be personalised to the individual. (Previous timescale of 01.03.05 not fully met). 3. YA17 13 (4) The Registered Persons must ensure that food items are appropriately stored at all times. (Previous timescale of 01.02.05 not fully met). The Registered Persons must 01.05.05 Timescale for action 01.07.05 2. YA9 13 (4) 01.07.05 4. YA20 13 (2) 01.05.05 Page 25 Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 ensure that the nonadministration of medication is recorded correctly on the administration records. (Previous timescale of 14.02.05 not fully met). The Registered Persons must ensure that the time of administration is recorded accurately for all homely remedies given. The Registered Persons must ensure that records are maintained to evidence that residents who self administer medication are monitored as to their compliance on a weekly basis. The Registered Persons must ensure that: The kitchen area is intensively cleaned and re-decorated. The carpeting in the communal hallways throughout the home is replaced. The small meeting room is fully re-decorated. The Registered Persons must ensure that all care staff receive training in First Aid, Medication, Food Hygiene, Fire Safety and Health & Safety. (Previous timescale of 01.04.05 not fully met). The Registered Persons must ensure that written reports of monthly unannounced visits by the registered provider be supplied to the CSCI. (Previous timescale of 01.03.05 not fully met). The Registered Persons must 5. YA20 13 (2) 01.05.05 6. YA20 13 (2) 01.06.05 7. YA24 23 (2) (b) (d) 01.08.05 8. YA35 18 (1) 01.08.05 9. YA39 26 01.06.05 10. YA42 13 (4) 01.07.05 Page 26 Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 ensure that a five yearly electrical installation check is carried out by a suitably qualified person. Written confirmation must be supplied to the CSCI that this check has been completed within the timescale specified. (Previous timescale of 01.03.05 not fully met). The Registered Persons must ensure that refrigerators are maintained at specified safe temperatures for food storage. Full witten records must be kept to evidence action taken by the home to ensure this. (Previous timescale of 01.02.05 not fully met). 11. YA42 13 (4) 01.05.05 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 YA20 YA24 Good Practice Recommendations It is recommended that an appropriate secure cupboard be provided for the sole purpose of storing items of medication. It is recommended that the flooring in two communal bathrooms is replaced. Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Oak Lodge G54-G04 S10215 Oak Lodge V222990 280405 Stage 4.doc Version 1.30 Page 28 - 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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