Inspection on 10/08/05 for PIA 4 Milverton Terrace

This inspection was carried out on 10th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

PIA 4 Milverton Terrace 07/01/08

PIA 4 Milverton Terrace 03/01/07

PIA 4 Milverton Terrace 01/02/06

PIA 4 Milverton Terrace 10/02/05

PIA 4 Milverton Terrace 12/08/04

PIA 4 Milverton Terrace 11/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Milverton Terrace 4 Milverton Leamington Spa Warwickshire CV32 5BA Lead Inspector Sheila Briddick Unannounced 10 August 2005 10:00 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. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pia - Milverton Terrace Address 4 Milverton Terrace Leamington Spa Warwickshire CV32 5BA 01926 882831 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) People in Action Ms D C Kelly PC 8 Category(ies) of LD - Learning Disability(8) registration, with number of places Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 February 2005 Brief Description of the Service: Milverton Terrace is a registered care home providing short-term care with the aim of supporting people with learning disability wishing to live, with support, in their own home and wider community. The parent company, People in Action provide 24-hour care and support for service users living in the home.The home is a large converted house, close to the town centre of Leamington Spa. Shared accommodation consists of a lounge, dining room and kitchen. There is also a bathroom, toilet, laundry and office on the ground floor. There are two service user bedrooms on the ground floor which are suitable for wheelchair users. Other service user bedrooms and the staff sleep in room, and a shower/toilet facility are located on the first floor. There is a large garden to the rear of the property. There is limited access to the front of the property for car parking. Entrance to the home at the front is via a series of steps up to the front door. There is wheelchair access to the property however at the side of the building. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th of August 2005 between the hours of 9:30 a.m. and 1:30 p.m. During this time the inspectors had the opportunity to meet with the service users and their views are included in this report. The interactions between service users, staff and their environment were observed and a tour the home took place. Documents relating to service users and the management of the home were examined. What the service does well: What has improved since the last inspection? People in Action have recently recruited a designated person for the training and development of staff. The impact of this has had a positive effect in the developing of staff’s skills through NVQ in Care, Adult Protection and Communication. The registered manager has now achieved the Registered Managers Award. Recent investment in the maintenance budget for the home has resulted in some improvement to the environment; this has included purchasing of new furniture, redecoration to shared areas and replacement of carpets on stairways and hallways. People in Action are consulting with Social Services regarding the Service Level Agreement they have for the service to Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 6 ensure that staffing levels in the home will be sufficient to meet individual and collective needs of service users at all times. 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. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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) 2 and 3 The admissions procedure could be more robust to ensure that a proper assessment takes place prior to people moving into the service. Without this there is not assurance that individual care needs of existing service users and the prospective service user will be met. EVIDENCE: Three service user’s care plans were examined at this visit. Care management assessments had been obtained as part of the admissions procedure for two service users. The home was completing its own assessment of needs for one service user who had recently been admitted through the emergency admissions procedure. This assessment was partially completed and with the involvement of the service user. Staff spoken with were aware of the individual needs of this service user. Care plans were being developed following assessment of needs and the advice and guidance of specialist services and this included Psychologists and Community learning Disability Nurses. People living in this home are doing so as part of the assessment process in enabling them to develop skills necessary, with support, to move into a supported living environment. Service user spoken with were being fully involved in this process. Staff spoken with felt they had the skills and experience to deliver the service being offered. However the number of Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 9 service users and mix of their individual needs at any one time can have a direct impact on the service always being able to meet individual needs and aspirations. The service was currently experiencing this situation at the time of the inspection visit. A service user spoken with expressed concerns regarding their health and well being and feeling safe at this time. The service user spoken with however said that staff cared for them well and they generally liked living in the home. Staff spoken with were aware of the concerns service users had and of not always being able to meet all service user needs satisfactorily and appropriately. The manager had identified an action plan to address the shortfall in the service provision and was in the process of reviewing the homes Service Level Agreement with Social Services. This will include an assessment of staffing levels for each individual admission to ensure that the health and well being of all people living in the home can be maintained safely. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 and 9 The care plan system focuses on positive outcomes for service users ensuring that their individual needs and goals towards moving on to a supported living environment can be achieved. Service users are not being consulted with when risk management strategies have the potential to restrict their daily activities in the home and this is limiting individual choice and freedom in the home. EVIDENCE: Care plan programmes are being generated from care management assessments and focus on developing skills to enable people to move on into a supported living environment. The guidance and support of specialist services is being accessed as part of developing care plan programmes; this includes community learning disability nurses, psychologists and occupational therapists. Staff spoken with were aware of procedures to follow with service users likely to cause harm or self-harm. Written guidelines however were not always in place on the care plans examined. Service users spoken with were familiar with their care plan and that this was what staff look at and it tells them what I want . Service users also knew where their care plan could be found. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 11 Risks to individuals are assessed during the admission process and strategies are agreed and recorded on the care plan. Psychology services are involved in risk management assessment. The strategies and written guidelines for staff to follow were found on two of the care plans examined. Risks had been identified on the third care plan however; written guidelines for staff to follow were not in place. Policies were examined that had been developed by the home for a locked kitchen door policy and restriction of clients liberty in May 2005. There was no evidence of service user consultation in agreeing these policies. Staff spoken with were concerned that these restrictions were having some impact on individuals liberty and also in developing skills towards independent living. At the time of the visit there were sufficient staff on duty to meet individual needs of service users and risk management strategies were not impinging on community activities for individuals. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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) 12 and 16 The people living in this home are supported to develop the skills necessary to live ordinary and meaningful lives and enabling them to be part of the community in which they wish to live. Daily routines do not always promote independence; individual choice or freedom of movement and this is impinging on service user’s rights and choices. EVIDENCE: Service users spoken with were developing individual living skills and looking forward to moving into their own environment. Service users said they were involved in shopping activities, looking after their own money, accessing local services and leisure activities. This included swimming, going to the hairdressers and attending local health services. A weekly timetable of activities has been identified for each individual and the manager monitors this happens. Throughout the inspection visit staff were seen to respect service user’s privacy and dignity through knocking on doors before entering bedrooms and bathrooms and supporting individuals sensitively to meet needs. Service users spoken with said they felt well cared for by the staff team and that staff looked after their things nicely. Service users said that staff listened to them although it could sometimes be noisy in the home, which they did not like. Services users said they could go to their room if they wished and Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 13 could have a key to their room if they wished. A service user spoken with was not aware that this choice was available to them. The focus, and success, of the home is in supporting people to move on into supported living accommodation, therefore there is a consistent movement of new people coming to live in the home. The management of risk therefore, and the effect this has on individuals, is dependent on the number and needs of people living in the home at any one time. At the time of this visit risk management necessary to maintain the safety and well being of some individuals was having a direct impact on the lifestyle of others living in the home. Service users spoken with expressed their concerns regarding this and the effect it was having on them personally. This included not being able to access all areas of the home freely, concern about their well being in shared areas and not being able to freely access drinks and snacks. Service users said they would like more opportunity to talk about their concerns with staff in the home. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 19 Personal care and support is provided sensitively and flexibly to promote dignity and independence. Individual care plans do not always detail how aspects of individual health care are to be supported. Without this staff do not have sufficient and clear information necessary for maintaining health and well being. EVIDENCE: Throughout the inspection service users were supported to meet personal care needs in a sensitive manner that promoted dignity and respect. Service users spoken with said that they were looked after well and that staff know what I need. Staff spoken with said that service users can choose when to get up, go to bed and have baths. Care plans identify service users preferences for meeting daily routines. At the time of the inspection service users had a choice of staff working with them, which included a mixed gender care team. Occupational therapy advice is being sought as part of the provision of technical aids and equipment service users may need for maximum independence. This has included provision of a bed with suitable bed rails for ensuring and maintaining safety and well being. A key working system is in place and service users confirmed that family and friends are involved in the care provision if they wish them to be. When examining care plans it was found that the management of diabetes for one service user had not been recorded on their care plan. Staff spoken with Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 15 demonstrated a knowledge of the diabetic needs for the individual, who was quite independent and self managing of the condition. A record of an assessment on the individuals capacity to manage their diabetes and a process for reviewing ongoing competency however was not seen on the care plane. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 and 23 There are policies and procedures in place for the protection of service users from harm however these do not include a process for listening to service users concerns about the effects some procedures have on daily routines in the home. EVIDENCE: Service users spoken with highlighted the importance of being listened to and identified that they would like more opportunity to discuss concerns they had regarding the compatibility of the people living in the home. Service users are familiar with the complaints procedure and this is provided for them in written and symbol format to meet their individual needs. A record is maintained of complaints made regarding the service provision. Staff spoken with demonstrated a good understanding of vulnerable adult policy and procedure and had recently accessed training in Crisis Intervention and Protection of Vulnerable Adults, (POVA). Service users spoken with said that staff looked after their money and were able to have their money when they requested it for shopping and leisure activities. Records are maintained of service users finances and the manager for the home monitors these. Poor practice when recording service users finances is responded to immediately by the manager. Two service users personal monies were checked against records held and found to be compatible. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 and 30 The standard of the physical environment has deteriorated since the last inspection visit and is not providing service users with an attractive, homely and safe place to live EVIDENCE: A tour of the premises took place and this highlighted issues regarding the safety and well being of people living in the home. Carpets in two service user bedrooms were in poor condition and needed replacing. The manager said that new carpeting was an order and would be fitted shortly. A new bed had been purchased for the vacant bedroom however the pillows and quilt in the room were in poor condition. The provision of bathing and shower facilities are adequate to meet service user needs however there were no curtains in the main bathroom window, the shower tray was in disrepair and required cleaning, paint was flaking off the wall in the upstairs shower room. The home has an infection control policy and all staff access infection control training as part of their induction. At the time of the inspection however there were areas of the home which required attention as part of good care practice in the control of infection in the home and this included; • The handle/seal on the fridge was broken and inside raw foods/salad/cooked foods being stored on the same shelf. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 18 • • • • • The freezer had not been defrosted for some time. Chipped worktop surfaces in the kitchen. Protective clothing for meeting personal care needs was stored in a kitchen drawer. Clinical waste was not stored securely in a locked bin. Fly screen protectors at the kitchen window were unclean. The staff sleep-in facility was in poor decorative order, although in the process of being decorated. The room was being used for storage of records some of which were financial records. The washbasin was not clean and there were insufficient storage facilities for staff to keep their belongings. There is a lift facility in the home and at the time of the inspection an engineer visit was expected to repair the lift, which could not be operated from the firstfloor. Facilities in shared area were generally adequate to meet needs and the manager said that new net curtains and dining room furniture were on order and would be fitted shortly. Recent maintenance in the home had included provision of sufficient wall sockets in service user bedrooms for the safe use of all their electrical equipment, completion of the redecoration of the short stay bedroom and repair to the kitchen ceiling so that effective cleaning could take place. Several items in the garden area had the potential to cause trips or falls, this included, trailing hosepipes, unused bedding, furniture and carpeting. A large paddling pool was full of water that had become foul posing a health hazard. There is a cleaning schedule for the home however and staff sign when completing a task; there were many omissions in July and the beginning of August. The cleaning schedule for the kitchen was not available. The rear garden is enclosed and can be easily accessed by service users. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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) These standards were not assessed on this occasion. EVIDENCE: Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 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 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) 37 The manager has a good understanding of the areas in which the home needs to improve and considerable planning was in place indicating how this improvement was going to be resourced and managed EVIDENCE: The registered manager demonstrated the competency and skills necessary to foster an atmosphere of openness and respect in which service users, family and staff feel valued. Their overall responsibilities are set out clearly in their job description to ensure that the aims and objectives of the home can be achieved. The registered manager is qualified in NVQ at Level 4 in both Management and Care and is supported by People in Action to undertake training and development necessary to maintain their knowledge, skills and competency while managing the home. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x x x 2 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Milverton Terrace Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 12 Requirement The compatibility of the new service user with others already living in the home must be assessed as part of the admissions process. A copy of the Reviewed Service Level agreement must be forwarded to the Commission. The views of service users must be sought, and considered, as part of any risk assessment strategy that has the potential to restrict lifestyle in the home. Restrction on Lifestyle policies must have an action plan for removal of the restriction including regular review timescales. Written guidelines for staff to follow as part of any risk management strategy must be in place on the care plan. Management of specific healthcare needs must be recorded on the individuals care plan. This must include Diabetes Care and a process for monitoring the individuals ability to manage their condition independently. The registered manager must E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Timescale for action 30 August 2005 2. 3. 2 9 12 12 1 October 2005 30 September 2005 30 September 2005 30 August 2005 30 September 2005 4. 16 12 5. 16 13 6. 19 13 7. 22 12 15 October Page 23 Milverton Terrace Version 1.40 8. 24 23 9. 24 16 10. 11. 12. 24 24 24 16 23 23 13. 14. 30 30 16 16 15. 16. 30 30 16 23 ensure that service users can collectively, and/or individually have opportunity to discuss all areas of the service provision and take action to address any concerns or views expressed. A record of all meetings must be maintained. Carpets in service user bedrooms that are soiled as a result of continance issues must be replaced. The registered manager must ensure that all bed linen to be provided for new and existing service users is in good condition. All bathrooms and toilet windows must have curtains fitted to ensure privacy. Flaking paintwork in the shower room must be repaired and the shower tray replaced with new. All external areas must be cleared of condemed furniture and carpeting and equipment used in external areas must be stored away when not in use. This includes the hosepipe and paddling pool. The small kitchen must be kept clean at all times. The damaged fidge must be removed. Effective cleaning schedules must be identified for all areas of the home and records of cleaning activity must be maintained up to date. This must include timescales for defrosting the freezer. Raw foods must not be stored in the fridge on the same shelf as cooked foods. Chipped worktop areas in the kitchen must be repaired so that effective cleaning can take place. 2005 30 October 2005 30 September 2005 30 September 2005 30 October 2005 30 September 2005 30 September 2005 30 September 2005 10 August 2005 30 October 2005 Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 24 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. 3. 4. Refer to Standard 3 16 17 30 Good Practice Recommendations It is recommended that the Residential Forums Staffing Guidelines are used when assessing staffing levels to meet changed service needs. It is recommended that service users wishes regarding whether to have a key to their room is recorded on their care plan. It is recommended that a record is maintained of the temperature of cooked meats when served to service users. It is strongly recommended that personal care protective clothing is not stored in food preparation areas. Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa Warwickshire. CV32 4YB 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 Milverton Terrace E53 s4224 Pia - Milverton Terrace V244480 100805 stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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