Inspection on 24/10/06 for Piper House

This inspection was carried out on 24th October 2006.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Piper House 17/09/07

Piper House 11/01/06

Piper House 27/06/05

Piper House 31/01/05

Piper House 30/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Piper House 2B St Mark`s Road London W11 1RQ Lead Inspector Sheila Lycholit Unannounced Inspection 24th October 2006 10:30 Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Piper House Address 2B St Mark`s Road London W11 1RQ 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) 020 7229 7623 MICHAEL.DOWNEY@RBLC.GOV.UK Royal Borough of Kensington & Chelsea Michael Anthony Downey Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Piper House is a residential home for 12 people with learning disabilities, situated in a residential area of North Kensington with good access to transport and other services. The service is run by the Royal Borough of Kensington and Chelsea. Six service users are accommodated in flat B on the ground floor, which is adapted for people with restricted mobility. Six people, who are more independent, live in flat C on the first floor. Each flat comprises of 6 individual bedrooms, a sitting room, kitchen/dining area and bathrooms and lavatories. The main office and a large communal room are on the ground floor. The residents of flat B have access to a garden and patio area. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place from 10.30AM until 5.15 PM on Tuesday 24th October 2006. Five of the service users were at home in Flat C and three in Flat B, while the remaining service users were attending day services. The Manager, who had completed a pre-inspection questionnaire made himself available throughout the day. The Team Leader, who was doing that evening’s sleep-in, came on duty at 2PM and introduced the Inspector to Flat B. What the service does well: What has improved since the last inspection? What they could do better: The planned replacement of the kitchen in Flat B, referred to in the last inspection report, has not taken place and the Manager is still awaiting a date for the work to start. Although re-decoration and some renewal of flooring have taken place, the standard of work is variable and the new carpet is already fraying in places. Some of the furniture in service users’ bedrooms and in the ground floor sitting room is reaching the end of its life and needs to be replaced. Storage space for wheel-chairs, suitcases and other large items should be provided. One bedroom on the first floor is quite dark because of overhanging trees and the Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 6 lights have to be switched on in the day time. Steps to remove or cut back the trees, which are in another garden, need to be taken. 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. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 The quality of outcomes for these standards is assessed as good. Information for service users is available in a variety of formats, including a video. Assessments are comprehensive and are regularly updated. An experienced staff team, together with the multi-professional learning disability team, ensure that the service meets residents’ changing needs. Licence/tenancy agreements should be regularly updated, show the current fees and charges and be in an accessible format. EVIDENCE: Information for service users is displayed in the flats, including their rights as tenants. A video about the service, originally produced for a TV programme, is also available for prospective residents, although no new admissions have been made in the last year. Service users files show that comprehensive, multi-professional assessments are undertaken, which are regularly updated. Service users changing needs are met, in one case by additional staff being employed. The advice and involvement of members of the Learning Disability Team, including Speech and Language Therapists, Physiotherapist and Psychologist are regularly sought. Although copies of licence agreements were seen on file, these were out of date and did not show the current fees and charges. An accessible licence agreement/contract should be available, which is updated in line with any changes to charges for the service. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 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, 7, 8 and 9 The quality of outcomes for these standards is assessed as good. Person centred plans, which are up to date and in a pictorial format, reflect service users’ lifestyles and aspirations. Service users are regularly consulted about life at Piper House and are made aware of other accommodation options. EVIDENCE: The individual files of four service users were looked at – two from each flat. Pictorial person-centred plans have been developed, in addition to a care plan in a pictorial format, which is used during the review process. Detailed notes of review meetings are also available on file. The Manager and Team Leaders monitor the implementation of decisions made at reviews in supervision and through day to day recording. Risk assessments were seen on individual files and in a separate folder in Flat C. These are comprehensive and regularly updated. No unnecessary restrictions are placed on service users. The residents of Flat C are scheduled to have a weekly meeting, though records show that meetings take place less frequently. It is recommended that the notes of the meeting are made available in an accessible format and are displayed in the Flat and/or copies given to service users. The Deputy Manager explained that residents’ meetings in Flat B were found to be unproductive Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 10 because of the communication needs of service users. Staff therefore try to elicit their views and inform them about events and news on a one to one basis. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 The quality of outcomes for these standards is assessed as good. Steps have been taken to improve communication with service users through the use of Makaton, multi-media profiling and the use of objects of reference and PECS. Service users take part in a wide range of activities and make use of the services and facilities in the area. Relationships are sensitively supported by staff. A programme of healthy eating has been introduced over the past year. EVIDENCE: Staff recognise that improving service users’ ability to communicate their needs and wishes is essential for their personal development and fulfilment. Records and discussion with the Manager show that the Speech and Language Team have assessed the communication needs of service users and have provided advice for staff. Staff have attended training in the use of signs and symbols and five staff are booked to attend a 2 day Makaton course. The use of multi-media has been identified as a training need in the training plan. Staff may good use of digital photography to support service users communication, although access to PCs and software is limited. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 12 It is clear from PCPs and daily logs that service users take part in a wide range of activities both in specialist services and in the wider community. Personal relationships are supported by staff showing sensitivity. Staff go to considerable lengths, including e-mailing news and updates to relatives abroad, to maintain relationships with family members, a number of whom regularly visit Piper House. The need to encourage healthy eating among service users, a number of whom suffer from weight related health problems, has been recognised. A supply of fresh fruit and vegetables was seen in both kitchens and menus show that meals are varied. One service user has been assessed as being at risk of choking, though she does not need food to be liquidised. Staff have received training in supporting her to eat safely. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The quality of outcomes for these standards is assessed as good. Staff know the service users well and are very familiar with how they wished to be assisted with personal care. Service users’ health care is given a high priority. There are sound policies and procedures regarding the administration of medication. EVIDENCE: Guidelines are available for staff regarding assistance with personal care. The guidelines for service users in Flat B are particularly well written, showing that staff are very knowledgeable about the way in which individual service users wish to be assisted. Guidance for staff in Flat C is more succinct and may need to be expanded for those service users with higher needs. Guidance should be kept in individual files, rather than displayed on the notice board in the sleepin room/office. Records show that service users’ health care needs are regularly assessed. Staff provide excellent support to service users to access health services, including referral to the multi professional learning disability team, GPs and the Community Matron. Staff accompany service users to appointments making a record of the visit and its outcome. A number of service users have complex health care needs, which are well managed and are regularly monitored. None of the current service users is assessed as being able to self-administer medication. There is well written guidance for staff who receive training in the Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 14 administration of medication during their induction. Medication which is supplied by a local Pharmacy, is dispensed from Dosset boxes that are made up by senior staff. Medication is kept locked away in each flat. Guidance on medication is available for each service user, which enables staff to understand why the medication is prescribed, how to give it, or apply the cream or lotion and any contra-indications or side effects. MAR sheets seen were in good order. There were a very small number of gaps, where staff had not entered the correct code for non-administration. At the moment training is provided by senior staff at the home. The Manager will look into obtaining external training for staff in the administration of medication to ensure that the home’s practice is up to date. The purchase of thermometers for the medication cupboards/room would ensure that a safe temperature is maintained. The purchase of a separate medication fridge could also be considered for Flat B where a number of service users regularly have eyedrops and other preparations that need to be kept refrigerated. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality of outcomes for these standards is assessed as good. Training, policies and procedures are in place to promote service users rights and to protect them from abuse. EVIDENCE: Piper House has a charter of rights for residents, which is displayed on notice boards and is covered in the video of the service. Records show that service users views regarding the service are sought at reviews and case conferences. Service users attend a number of external groups, including ‘It’s my Life’ and Equal People, where they are encouraged to express their views and to raise concerns. No complaints have been received in the last year. There is an adult protection policy and procedure for the home and all staff receive training in adult protection as part of their induction, as well as attending external training. There has been one adult protection strategy meeting in the last 12 months, which the Manager called to support staff in handling an issue between service users. The financial records for two service users who are unable to manage their own money were seen. These were very well kept, with receipts available for all purchases. A running balance is kept, which staff regularly check. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 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 and 30 The quality of outcomes for these standards is assessed as adequate. Much of the building has been redecorated in the past 12 months and staff who do all the cleaning without domestic help keep the building clean and tidy. However some aspects of the physical environment require attention to ensure that service users are provided with attractive and well maintained accommodation. EVIDENCE: The building is well located close to local services and public transport. The 2 flats are in a quiet cul de sac, with an attractive garden and outdoor furniture. Each flat has a good sized kitchen/dining room. Most of the kitchen units in Flat C have been replaced, though some of the old units remain. The kitchen in Flat B is in urgent need of replacement. A budget is available for the work but the Team Leader is still awaiting a start date. A number of carpets have been recently replaced but are already showing signs of wear, particularly over inspection hatches. Four of the service users in Flat C and two in Flat C showed the Inspector their rooms. Bedrooms are personalised, showing service users interests, for example in music, entertainment and pets. The quality of the bedroom Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 17 furniture varies and some is coming to the end of its life. The wardrobe door was propped against the wall in one room and the doors to the top cupboard in another were missing. No storage space for suitcases, wheel chairs and other large items is available. Consideration should be given to providing additional storage space in the ground floor communal areas, including staff lockers. Although it was the early afternoon on a bright autumn day, the occupant of one room on the first floor had to put the lights on to show the Inspector his room. Overhanging trees from a nearby house block out some of the natural light to his room and need to be removed or cut back. A resident who uses a wheel chair showed the Inspector her room in Flat B. Her room was spacious and had been adapted to meet her needs, with low level cupboards and a suitable washbasin and taps. The sitting room in flat B is of an irregular shape, with glass panels around it creating, as staff remarked, a fish bowl effect. The sofas are covered in drapes as they are in need of replacement. A range of bathrooms and showers are available. Flooring has been replaced in the bathrooms recently. Signs of damp and water penetration need to be rectified. The staff sleep-in room is in Flat C and although a small room, also acts as an office for this flat. No PC is available on this floor for staff or service users. There is a larger office in Flat B with office equipment. Office furniture in this room is in need of replacement. Staff and service users clean the flats, which were found to be clean and tidy at this unannounced visit. Laundries are provided in both flats, with washing machines that wash at a high temperature. Infection control guidelines are available and staff are provided with any necessary protective clothing. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 The quality of outcomes for these standards is assessed as good. An experienced staff team has been established that has access to a comprehensive training programme, including accredited training. Staff retention is good and staff are well supported by senior staff. EVIDENCE: Staff are supported to undertake NVQ training, with 5 staff completing NVQ3. Two staff have submitted their portfolios and are awaiting confirmation of the award and 1 member of staff has recently started NVQ3. The Team Leader is completing NVQ4. The Team Leader for flat C, who has been appointed but has not yet started at Piper House, is a NVQ Assessor. In addition to NVQ training, records show that staff attend regular workshops and training to update their practice. The exception is the waking night staff who, although experienced, have not made use of training opportunities. In discussion the Manager confirmed that while he has no concerns about the performance of waking night staff, he will raise with them again the need to ensure that their practice is up to date, particularly their communication skills with service users who communicate non-verbally. An assessment of the team’s training needs and a training plan for 2006/7 is available. A structured induction programme is available for new staff, which is recorded. All staff have an annual performance assessment. Recruitment checks are Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 19 carried out by the Department’s HR Team. The Manager keeps a record of all CRB checks, including those for agency staff. Rotas show that a member of senior staff is on duty on all day shifts. Team Leaders regularly work at weekends and the Manager works occasional weekend shifts. Staff receive regular supervision at least 10 times a year. Supervision records for 2 staff in Flat B were seen, which showed that detailed notes are kept with action clearly defined. Staff receive a copy of their supervision notes. The Manager monitors the frequency of supervision. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 The quality of outcomes for these standards is assessed as good. The team is led by an experienced and qualified Manager, who seeks to develop and maintain a person-centred approach in the delivery of the service. Senior managers in the Department and elected Members regularly visit the home and complete reports. Health and safety issues are given a high priority. EVIDENCE: The Manager is very experienced in providing services for people with a learning disability. He is a Registered Social Worker and has completed NVQ4. The home’s good retention record indicates that staff enjoy working at Piper House. Policies and procedures are available on the intranet, as well as in hard copies. The Manager has established a number of procedures to ensure that he receives information about the operation of the two units. As well as staffing and operational issues, all service users are discussed in the Manager’s supervision with Team Leaders. A business plan is available for Piper House, which the Manager was reviewing with his line manager the following day. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 21 A number of initiatives have been developed in the Borough to seek the views of people with a learning disability, including people who communicate nonverbally. Records are in good order. Service users’ records in Flat B are particularly well maintained. Health and safety, including fire safety is given a high priority. All staff undertake health and safety training as part of their induction. First aid and other health and safety training is regularly updated. Accidents and incidents are carefully recorded and action taken to reduce the likelihood of a reoccurrence. For example one service user who has fallen on a number of occasions has been referred to the falls clinic. The fire alarm is tested monthly and regular fire drills take place. These are scheduled to take place every month, though records show drills take place more frequently. A fire risk assessment is available and has recently been reviewed by the Borough’s Health and Safety Officer. The Manager has not yet received a report on his findings. Records show that the fire detection system and fire fighting equipment are regularly serviced and maintained. The Manager is supported by his line manager who has visited several times since taking up her post. Her photo is available in the home so that residents know who she is and can approach her with any concerns. Copies of reports of visits made on behalf of the provider are available in the home and show that visits usually take place at least monthly. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X X 3 3 3 3 3 X Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 23 N/A 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 YA5 Regulation 5 Requirement Service users must be provided with an up to date contract in an accessible format that sets out the current fees and charges. A higher standard of decoration and maintenance is needed, for example the kitchens need to be replaced straightaway and damp patches repaired and repainted. Sofas in the ground floor sitting room are in need of replacement. Some bedroom furniture should be replaced and service users provided with adequate storage, which may need to be elsewhere in the building. Steps must be taken to ensure that branches blocking the light to one bedroom are removed. Timescale for action 30/11/06 2 YA24 23 30/11/06 3 4 YA28 YA26 23 23 30/11/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Piper House Refer to Good Practice Recommendations DS0000035201.V315199.R01.S.doc Version 5.2 Page 24 1 2 3 Standard YA8 YA32 YA41 Notes of residents’ meetings should be produced in an accessible format, using signs, symbols and photos and given to service users or displayed in the flats. The training of waking night staff should be updated, particularly regarding the development of specialist communication skills. Consideration should be given to keeping contemporary records for each service user in Flat C in one file and to providing more detailed support guidelines in line with recording in Flat B. Piper House DS0000035201.V315199.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Piper House DS0000035201.V315199.R01.S.doc Version 5.2 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. 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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