Inspection on 28/06/06 for Queens Lodge

This inspection was carried out on 28th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queens Lodge 25/06/07

Queens Lodge 27/02/06

Queens Lodge 13/09/05

Queens Lodge 20/12/04

Queens Lodge 15/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Queens Lodge 3b Queens Road Colchester Essex C03 3NP Lead Inspector Jane Greaves Key Unannounced Inspection 28th June 2006 09:30 Queens Lodge DS0000017914.V302619.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 Queens Lodge DS0000017914.V302619.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. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queens Lodge Address 3b Queens Road Colchester Essex C03 3NP 01206 575410 01206 575410 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) H4037@mencap.org.uk Royal Mencap Society Manager post vacant Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of a learning disability (not to exceed 6 persons) Persons of either sex, aged 45 years and over, who require care by reason of a learning disability (not to exceed 6 persons) The total number of service users accommodated in the home must not exceed 6 persons 27th February 2006 Date of last inspection Brief Description of the Service: Queens Lodge is owned by the Royal MENCAP Society. The home provides residential care for 6 individuals with learning disabilities, some of whom may be over 65. Accommodation is offered in a bungalow situated in a residential area on the outskirts of Colchester whereby service users can access local facilities. The premises have been extended to provide extra communal space. All rooms are single occupation. There is parking to the side of the property and a pleasant garden to the rear. A Copy of the most recent inspection report from the Commission for Social Care Inspection was accessible to service users and their representatives on a corkboard in the dining room. The range of fees charged for the care and accommodation provided at Queens Lodge range from £1060.42 to £1867.34. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 28th June 2006 over 6 hours. The level of assistance and co-operation the inspector received from the manager, support staff and service users was appreciated. 23 of the 43 National Minimum Standards relating to this care service were assessed with 15 being met. This inspection report includes some outstanding requirements made at the previous inspection visit. Some requirements remain outstanding however there had been progress made towards compliance and evidence was available to confirm ‘work in progress’ in these areas. Views of the quality of care provided were gathered from discussion with the service users and observation of practice on the day. Overall the standard of care and quality of life for the service users at Queens Lodge was good. What the service does well: What has improved since the last inspection? The communal hallways have been re-decorated since the last inspection visit giving the home a fresher and more welcoming appearance. The staff team have received training in safer people moving and handling and the Protection of Vulnerable Adults from abuse since the last inspection. The services users benefited from a Gazebo installed on the patio area affording them a pleasant shady area to sit. Bean bags, new storage facilities in the quiet lounge, a water feature and colourful planters on the patio were just a few of the items purchased for service users benefit since the previous inspection visit. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Queens Lodge DS0000017914.V302619.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 Queens Lodge DS0000017914.V302619.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users could be confident that their needs and aspirations would be understood and that the staff and management team at Queens Lodge would be able to deliver the services it offered to provide. EVIDENCE: Queens Lodge Statement of purpose and Service User Guide had been updated to reflect the current staffing structure at the home since the previous inspection visit. The care plan of a service user recently admitted to the home was sampled at this visit. A comprehensive assessment of the individual’s needs covering all aspects of daily life formed the basis of the care plan. Documentary evidence of relevant healthcare professional input was included at the point of assessment. The area manager had undertaken preliminary meetings with the service user and their representative. Prospective service users were invited for trial visits including day time visits and overnight stays. The manager reported that great care was taken to ensure that any person moving into the home did so with the agreement of the established service users. Queens Lodge DS0000017914.V302619.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users could be confident their ‘plan of care’ reflected their needs, aspirations and goals whilst providing appropriate information for staff to provide support and encouragement for the service users to make major life decisions as well as everyday choices. EVIDENCE: Two care plans sampled at this visit contained all relevant information for the support staff to provide appropriate individual support for service users in areas such as healthcare, personal feelings, social needs, spiritual preferences and individual choices. Care plans included evidence of regular reviews with the involvement of the service user and other representative if the service user wished. One file sampled contained a large print copy of the review produced for the service user’s benefit. Individuals were supported to make decisions and their rights and choices were only limited through the risk assessment process. Infringements of Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 10 rights were documented with evidence of the service user’s involvement in the process. The manager was able to demonstrate where individual choices had been made and instances were recorded appropriately when others had made decisions on the service user’s behalf. Risk assessments were in place for such activities as using the Parker bath, making hot drinks, accessing community activities from a wheelchair and smoking. Evidence was available to confirm that the risk assessment process is a continuous one within the home and that individuals’ assessments were subject to constant review. Queens Lodge DS0000017914.V302619.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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff and management team supported service users to live fulfilling lives both inside and outside the home. Service users could be confident that the ethos of the home was one of respecting individuals’ dignity, privacy and individuality whilst promoting their well being and independence. EVIDENCE: All those living at Queens Lodge were over the age of retirement, one service user had shown an interest in working outside the home and the manager reported that avenues for voluntary work were being explored with this service user. Three service users attended college regularly whilst all enjoyed activities within the community such as ten-pin bowling, wheelchair ice skating, visiting the cinema and the local county fair, window-shopping, and day trips out. The staff recorded some special events such as birthdays and day trips and put them onto DVD for the service users to enjoy from the comfort of their armchairs. The manager reported that the lack of a vehicle suitable for wheelchairs was impacting adversely on the social experiences of the service users however Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 12 there were plans to secure a dedicated vehicle for the service within the next financial year. All service users had their own bank accounts and were responsible for their own finances. Each service user had a locked tin held within a locked cupboard in the office for personal funds to be stored. Service users issued their cheques for their rent personally; the manager then forwarded these to head office. The manager reported awareness that the service users may need more support with their finances in the future and various options were discussed. Advocacy services had been secured for some service users within the home to good effect. The manager reported on the many ways the service users had been supported to maintain family relationships such as providing transport for individuals to visit family members at home where appropriate. Family and friends were welcomed at any time at Queens Lodge; a pleasant quiet lounge was available for service users to receive visitors in private. Daily life at Queens lodge was made flexible around the individuals’ needs and wishes. Where a service user chose to be alone or eat meals alone this was respected. It was reported that the kitchen at Queens Lodge was scheduled for refurbishment. The previous inspection report identified that all staff members had not received food hygiene training. The manager reported efforts made in vain to secure training in this area in a format other than by distance learning and that the intention was to enrol all staff members on distance learning courses in the absence of any other provision. The home had recently had a visit from the Environmental Health Officer with no requirements made. The home has a menu system with all meals being chosen by the service users on a monthly basis. Minutes of service users’ meetings provided evidence that discussions were underway to change the system. The manager reported that a more flexible individual approach was being considered with service users being asked on a day to day basis what they fancied for dinner as they would in their own homes. Queens Lodge DS0000017914.V302619.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users received personal, physical and emotional support in the way they preferred and required however their safety and well being were not always protected by the home’s procedures for dealing with medicines. EVIDENCE: The staff team at Queens Lodge provided sensitive and flexible personal support and care to maximise service users’ privacy and dignity. Induction training for all new staff included protecting service users’ dignity. Personal support and care were delivered in private. Service users confirmed they went to bed when they wished and rose when they wished, mealtimes were flexible around service users’ activities and preferences. Service users’ individual care plans provided evidence to confirm the support provided to access NHS facilities in the locality, details of appointments made and corresponding actions to be taken in response to healthcare professionals advice and guidance. Medication administration records contained some ‘gaps’ in recording meaning that it was not always possible to be sure which member of the support staff had administered each medicine. Not all staff members responsible for the Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 14 administration of medication had received refresher training in this area. The manager reported that 5 staff had completed a foundation module in the care of medicines and that the rest of the team were scheduled to undertake this training over the next three months. Queens Lodge DS0000017914.V302619.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employed clear procedures that enabled and empowered service users to make their views or concerns known and they could be assured that they would be listened to and that appropriate action would be taken. EVIDENCE: The home had received one complaint since the previous inspection visit, the manager had forwarded a copy to the Commission for Social Care Inspection. Actions to investigate this anonymous complaint had been taken within the 28 day timescale and been documented appropriately. An index system was in place to identify ‘at a glance’ if patterns or trends should emerge either in the nature or the subject of complaints. The manager reported that a more ‘active’ complaints and compliments folder would be a better reflection of the ethos encouraged within the home and valuable as a quality assessment tool. The home’s complaints policy and procedures were included within the Statement of Purpose and Service User Guide and contained contact details of the Commission for Social Care Inspection. All staff working at Queens Lodge had received up to date training in the Protection of Vulnerable Adults from abuse. Two staff files were sampled at this inspection and both contained evidence that a Criminal record Bureau disclosure had been obtained. Queens Lodge DS0000017914.V302619.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users lived in an environment that required some alterations in order for them to be able to move around the home independently and safely. The home appeared to be clean and hygienic on the day of this inspection. EVIDENCE: Since the last inspection visit the communal areas of the home had been redecorated and appeared much fresher and more welcoming. The manager reported that the kitchen was to be refurbished; no date had been agreed for this work to start however there was provision in the home’s budget. Plans were afoot to widen doorways enabling service users in wheelchairs to have access throughout the home without the danger of catching their knuckles on doorframes as highlighted at the previous inspection visit. Individuals’ bedrooms were decorated to their personal taste and the communal areas were ‘homely’ in appearance. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 17 The rear garden was neat and tidy with a raised planter to the side of the building for the service users to grow vegetables. The home had acquired some guinea pigs as pets and they had their accommodation in the garden. Service users were observed enjoying some time with the guinea pigs. An attractive gazebo was in situ on the patio area affording the service users a pleasant shaded area to sit and enjoy some fresh air. The patio had a small water feature, colourful planters and some outdoor lighting making it a relaxing place to sit on a summer’s evening. The home was generally clean and tidy on the day of this visit. The manager reported that the PCT had been approached to provide infection control training for all support staff and that this had not yet been delivered. The home operated under MENCAP infection control policies and procedures. The community nursing team had provided specific infection control advice and guidance to the support staff, including hand-washing techniques to meet the specialist needs of one service user. Queens Lodge DS0000017914.V302619.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, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ health, safety and well being would benefit from the staff team receiving appropriate training and refresher courses that are scheduled, planned and budgeted for. The home’s recruitment practices supported and protected the service users. EVIDENCE: Two recruitment files were sampled at this inspection visit and both contained all documentary evidence required to confirm a thorough recruitment procedure had been followed. Staff members provided professional and competent care to the service users at Queens Lodge. All the service users spoken with during this inspection process praised the commitment and dedication of the staff team however support staff had not been provided with the mandatory training and refresher training required to update their skills and continue to protect the health, safety and welfare of the service users. The home had a staff development and training plan that identified which staff members were required to attend particular courses. Evidence was available and discussion with staff confirmed that in the past 12 months all staff had received training in safer people moving and handling and the Protection of Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 19 Vulnerable Adults from abuse. Basic Food Hygiene training was to be provided via distance learning and Infection Control training was to be provided by the PCT but no date had been arranged at the point of this visit. It was reported at the previous inspection visit that Mencap had chosen to secure a new training provider for the NVQ training, as they had not received consistency from their previous providers. The manager reported that 1 member of staff was part way through the NVQ level 3 training and that 2 support staff had been put forward for a 17-week intensive NVQ level 3 course and were waiting for a start date. If this course should prove to be effective the rest of team would be trained to NVQ level 3 in this manner. At the previous inspection visit it was reported that the manager and deputy were to enrol for their NVQ level 4 training; this had not been progressed at this visit. The manager was able to demonstrate that formal supervisions were now scheduled, planned and undertaken for the day staff and reported that supervision sessions for the night staff were to be arranged imminently. The manager’s personal supervision records were produced for scrutiny, it was reported that some staff members may not be comfortable having their personal supervision records accessed by inspectors and discussion took place with the manager regarding ways of providing evidence that effective supervision took place. Queens Lodge DS0000017914.V302619.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, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their families and representatives could be confident that the leadership and management approach of the home ensured that their views underpinned all self monitoring, review and development of the unit, however the health and safety of service users was not always promoted and protected. EVIDENCE: At the time of this inspection the manager had not applied to be registered with the Commission for Social Care Inspection. The manager had significant management experience in care settings and was due to embark on the level NVQ 4 qualification. Support staff spoken with reported that the manager’s approach was open, inclusive and supportive. General improvements towards compliance with the National Minimum Standards and Regulation had taken place since the previous inspection visit. The manager demonstrated an imaginative and visionary approach towards the service, valuing the diversity of service users and providing encouragement for them to live their lives to the maximum supported by the risk assessment framework. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 21 The home had undertaken a service user survey in September 2005 and it was reported that this was an annual survey. The inspector had been provided with a summary of the responses and an improvement plan addressing the identified shortfalls in the service. Evidence was present to confirm that electrical system/fire alarm/water temperature/portable electrical appliance/hoist/gas/wheelchair testing had taken place. Staff demonstrated a ‘hazy’ knowledge of COSHH policies and procedures. Mandatory training in areas of health and safety including infection control, food hygiene and safer administration of medication had not been provided/updated for all staff. All accidents, injuries, incidents of illness or communicable disease, or death of a service user were recorded and reported appropriately. Queens Lodge DS0000017914.V302619.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 X 2 3 3 X 4 X 5 X 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 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 x Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 23 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 YA17 Regulation 16(2)(j) Requirement The registered person shall, having regard to the number and needs of service users, after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of food hygiene within the home. This specifically relates to training staff in Basic food hygiene. This is a repeat requirement with an agreed timescale for action as 30/06/06 The registered person shall, having regard to the size of the care home, the Statement of Purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform This specifically relates to training in the safer handling and administration of medicines. The registered person shall, having regard to the number and needs of service users, ensure the physical design and layout of the premises to be Timescale for action 30/09/06 2 YA20 18(1)(c) 30/09/06 3 YA24 23(2)(a) 30/09/06 Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 24 4 YA42 13(3) YA30 5 YA32 18(1)(a)(c) YA35 used as the care home meet the needs of the service users. This is a repeat requirement with an agreed timescale for action as 30/06/06 The registered person shall make suitable arrangements by training staff or other measures to prevent infection, toxic conditions and the spread of infection at the care home. This is a repeat requirement with an agreed timescale for action as 30/06/06 The registered person shall having regard to the size of the care home, the Statement of Purpose and the number and needs of the service users (a) ensure that at all times suitably qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. (c) Ensure that persons working at the care home receive training appropriate to the work they are to perform. This is a repeat requirement with an agreed timescale for action as 30/06/06 30/09/06 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA37 Good Practice Recommendations It is a recommendation of good practice that the registered person shall ensure the appointed manager for this service applies for registration with the Commission for Social Care Inspection. Queens Lodge DS0000017914.V302619.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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