Inspection on 14/02/06 for Raola House

This inspection was carried out on 14th February 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 no outstanding requirements from the previous inspection report, but made 23 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Raola House 22/05/07

Raola House 15/05/06

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 Raola House 205 Woodcote Road Wallington Surrey SM6 0QQ Lead Inspector Mohammad Peerbux Unannounced Inspection 14th February 2006 9:00am Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Raola House Address 205 Woodcote Road Wallington Surrey SM6 0QQ 020 8835 2258 020 8669 3533 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) Tordarrach Mrs Ayodele Obaro Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Not Applicable Brief Description of the Service: Raola House is registered with the Commission for Social Care Inspection (CSCI) to provide residential care for up to six adults with learning disabilities and or sensory impairment. The property is situated on a busy residential road close to the centre of Wallington and is well placed for local shops and public transport links. There is ample space in the front garden for parking and the back garden, which has a patio area and large lawn, is extremely well maintained. The philosophy of care and principle objectives of Raola House are based upon the development of community-based initiatives, recognising that people with learning disabilities have the right to a normal pattern of life. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2005/06. It was an unannounced inspection and took place over five hours. Some times were spent looking at the policies and procedures, records, talking to staff and to the registered manager. They are all thanked for their time and assistance. A tour of the building was also carried out. Presently there are only two service users at the home. It was difficult to gain their views about the care that they are receiving due to their cognitive abilities. An immediate requirement was issued to the registered provider as none of the staff working in the home had a POVA or CRB check that have been done through the present employer. What the service does well: What has improved since the last inspection? This is the home’s first inspection since it was registered in November 2005. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 and 2 The Statement of Purpose, and Service User Guide provide prospective service users with details of the services the home offers. This enables them to make an informed decision about admission to the home. EVIDENCE: The home has a comprehensive Statement of Purpose, and Service User’s Guide. Both are extremely well presented and cover all the information required by the Care Homes Regulations (2001), including the aims and objectives of the home and the facilities and services provided. It is recommended that the service users’ guide be made available in formats suitable for the service users for whom the home is intended (e.g. appropriate languages, pictures, video, audio or explanation). Service users are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective service user/recognised representative. It was noted that the home also carries out its own assessment. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 Service users individual and changing needs are not being appropriately met, as the care plans do not reflect information on their needs and personal goals. Service users are not always safeguarded from financial abuse, as the records are not appropriately maintained. EVIDENCE: The service user’s care plans were sampled, it was noted they do not clearly set out how current and anticipated needs would be met. The registered manager must develop and agree with each service user or their representative an individual plan, which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The plan must establish individualised procedures for service users likely to be aggressive or cause harm or self-harm, focusing on positive behaviour, ability and willingness. It was also noted that none of the care plans were drawn up with the involvement of the service user together with their family, friends and/or advocate as appropriate, and relevant other agencies/specialists. The registered manager must ensure that service users care plans are drawn up after consultation with the service user, family, friends Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 10 and an advocate where appropriate. The care plan must also be made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. The manager stated that she is in the process of introducing Person Centred Planning. Staff provide service users with the information, assistance and communication support they need to make decisions about their own lives. However there has not been any service users’ meeting since the home opened in November 2005. The registered person must ensure that service users’ meeting take place on a regular basis so as to ascertain and take into account their wishes and feelings. This can be achieved by involving the service users’ advocates or any person who can speak on their behalf. The registered manager stated that none of the service users manage their own finances. Service users’ financial records were in the main clear, accurate and appropriately maintained. However at the times of inspection the amount of money recorded for one of the service users did not match what was in the envelope. The manager was unable to comment on the matter but stated that she would investigate this. The registered manager is required to keep an up to date records and receipts of all the expenses made by the service users or on their behalf by staff. Risk assessments for service users were examined and it was noted that they were not comprehensive nor clear about what actions need to be taken by staff to minimize identified risks and hazards. The registered manager must ensure that service users’ risk assessments identify potential risks covering all aspects of their daily living both inside and outside the home. The risk assessments must give details to what action is required to minimise identified risks and hazards. The registered manager must also ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk assessment and risk management strategies. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 and 17 Service users are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. EVIDENCE: The registered manager stated both service users still attend the day centre that they were attending before they entered the home. None of the service users attend colleges or adult educations. Service users are able to access a wide range of community activities. None of the service users are registered to vote due to their level of learning disability. Service users are actively encouraged to maintain links with their families and friends. The manager stated that the home has an ‘open’ visitors policy and simply recommends that visitor’s telephone to say they are coming to ensure there loved ones will be available. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 12 The home does not have a planned menu. The manager stated that this is in the process of being completed. The registered manager must ensure that there is a planned menu is in place, which meet the service user’s dietary and cultural needs, and which respect their individual preferences. It was positively noted that the home keeps a record of what the service users have eaten on a daily basis. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 Overall the arrangements for health care needs of the service users is good and they receive personal support in the way they prefer. However the system for administration of medications is poor and potentially place service users at risk. EVIDENCE: Staff provide sensitive and flexible personal support to maximise service users’ privacy, dignity, independence and control over their lives. The manager stated that where needed, guidance and support regarding personal hygiene (e.g. to wash, shave) is provided. Times for getting up/going to bed, baths, meals and other activities are flexible. Service users at the home are registered with a General Practitioner. They are supported by the staff team when attending outpatient or other medical appointments as required. They also have access to other health professionals such as opticians and dentists. The medication administration records were audited. There was one instance where prescribed medication has been omitted or administered but not signed for. While it transpired that there was an acceptable explanation for this, the explanation has not been recorded. In all cases where medication is not given as prescribed, staff must ensure that they record the reason for this. The Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 14 registered person must ensure that medication administration records are accurately completed at all times. During the inspection a tube of ointment was found in the cupboard under the washbasin in one of the service users’ bedroom. This potentially places the service users at risk. The registered manager must ensure that Medicines in the custody of the home are handled according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs Act 1971. Currently there are no service users who self medicate. The registered manager must also ensure that care staff that administer medications have accredited training. The home has a medication policy however it needs to be amended to include how receipt and disposal of medications would be recorded. It was also noted that the medication cupboard was on the worktop in the kitchen and was not secure to the wall. The registered manager must ensure that the medication cupboard is secured to the wall or is kept in a locked cupboard in the home and that its location is suitable in respect of temperature and humidity. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 home has appropriate complaints procedure in place. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure the service users are so far as reasonable practicable, protected from abuse, neglect or harm. EVIDENCE: The current complaints procedure is good and gives clear step-by-step guide of how to make a complaint. The procedure is also available in symbol format. There has not been any complaints since the home opened in November 2005. The home has a copy of London Borough of Sutton adult protection procedures. The manager stated that all staff have had abuse awareness training as part of their induction. The home has an appropriate whistle blowing procedure. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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, 26 and 30 The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the service users’ health and emotional wellbeing. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet service users’ individual and collective needs in a comfortable and homely way. Service users’ bedroom are personalised to reflect their individual needs, and personalities. There is plan to put a conservatory at the back of the home. Overall the home was decorated to a good standard throughout and appeared to be very comfortable, bright and warm. However the home is not complying with fire regulations and there are also some health and safety issues (see standard 42). The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. However the COSHH cupboard was left unlocked (see standard 42). Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 17 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): 34,35 and 36 One concern was identified in regard to recruitment checks not being completed satisfactorily, which impinge on the safety and protection of service users being ensured. EVIDENCE: As part of the inspection process staff records were sampled for references, criminal record checks, application forms and copies of identification. It was noticed that some of the staff did not have all relevant documentations. The registered provider must ensure that staff files contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001. It was also identified that none of the staff had a CRB or POVA check that have been carried out by the home. The manager stated that she thought that if the CRB’s were recently done, they could be portable. The registered provider must ensure that no staff are working unsupervised without having carried out a POVA check first on them and they have applied for a CRB check. The manager stated that staff have regular training however it was very difficult to ascertain which training they have undertaken, as no records were available at the time of inspection. The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 18 and meet the changing needs of service users. The registered manager must also ensure that a training needs assessment is carried out for the staff team as a whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. The registered manager advised that the care staff are receiving regular supervision sessions however only one staff supervision records were available. The registered manager is required to ensure that care staff receive at least six supervisions a year covering good care practices and career development. It is recommended that the manager keep a yearly record of staff supervision signed by both the supervisor and supervisee for easy monitoring. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 19 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): 42 and 43 The home is generally managed well however the health, safety and welfare of service users and staff are not being promoted/protected and this potentially places them at risk. EVIDENCE: A number of health and safety issues arose during this inspection and are follows: The lounge, kitchen, dining room and service user’s bedrooms doors were wedged open by pieces of wood. The registered manager must ensure that doors are not wedged open unless held open by a magnetic door holder that responds to the fire warning system. One of the dining room doors is also a fire exit. At the time of inspection it was locked and the staff were unable to locate the key to unlock the door. This places service users at risk in case of fire. The registered manager is required to ensure that all emergency fire exit doors are openable without the use of a key whenever the premises are occupied. The home was advised regarding this Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 20 issue in September 2005 when the London Fire and Emergency Planning Authority visited the home. It was also noted that the fire exit on the side of the property was not clear. There were pieces of carpet, bins and some roof tiles left within the area. The staff on duty removed all the objects that were obstructing the exit on the same day of the inspection. The registered manager is required to ensure that all fire exits are kept clear at all times to ensure service users, visitors and staff safety. There were cleaning materials left in the laundry room, ground floor toilet and in one of the service users’ bedroom. The registered manager must ensure that all cleaning materials and chemicals are kept locked in accordance to Control of Substances Hazardous to Health Regulations (COSHH) 1999. All service users bedrooms doors have locks on them however it was noted that these locks couldn’t be opened from outside in an emergency if the service user has locked himself/herself in. The registered provider must ensure that the locks are replaced by one that can be open from outside. The home has current employers liability insurance and the certificate is displayed in the hallway. The manager stated that the business and financial plan have already been forwarded to the Commission. Raola House DS0000065735.V282652.R01.S.doc Version 5.1 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 Standard No Score 1 3 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 2 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X X X X X X 1 3 Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 22 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 YA6 Regulation 15(1) Requirement The registered manager must develop and agree with each service user or their representative an individual plan, which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The registered manager must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. The registered manager must ensure that care plans are made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. The registered person must ensure that service users’ DS0000065735.V282652.R01.S.doc Timescale for action 31/03/06 2 YA6 15(1) 31/03/06 3 YA6 15(2) 31/03/06 4 YA7 12(2) 31/03/06 Raola House Version 5.1 Page 23 meeting take place on a regular basis so as to ascertain and take into account their wishes and feelings. 5 YA7 17(2) The registered manager is required to keep an up to date records and receipts of all the expenses made by the service users or on their behalf by staff. The registered manager must ensure that service users’ risk assessments identify potential risks covering all aspects of their daily living both inside and outside the home. The registered manager must ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service user’s individual plan and of the home’s risk assessment and risk management strategies. The registered manager must ensure that there is a planned menu is in place, which meet the service user’s dietary and cultural needs, and which respect their individual preferences. The registered person must ensure that medication administration records are accurately completed at all times. The registered manager must ensure that Medicines in the custody of the home are handled according to the requirements of the Medicines Act 1968, DS0000065735.V282652.R01.S.doc 14/02/06 6 YA9 13(4) 15/03/06 7 YA9 13(4) 15/03/06 8 YA17 16(2) (I) (h) 31/03/06 9 YA20 13(2) 14/02/06 10 YA20 13(2) 14/02/06 Raola House Version 5.1 Page 24 guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs Act 1971. 11 YA20 18(1)(c) The registered manager must ensure that care staff that administer medications have accredited training. The medication policy needs to be amended to include how receipt and disposal of medications would be recorded. 31/03/06 12 YA20 13(2) 31/03/06 13 YA20 13(2) The registered manager must 15/03/06 ensure that the medication cupboard is secured to the wall or is kept in a locked cupboard in the home and that its location is suitable in respect of temperature and humidity. The registered provider must ensure that staff files contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001. 31/03/06 14 YA34 19 15 YA34 19 The registered provider must 14/02/06 ensure that no staff are working unsupervised without having carried out a POVA check first on them and they have applied for a CRB check. The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered manager must ensure that a training needs DS0000065735.V282652.R01.S.doc 16 YA35 18(1)(C) 31/03/06 17 YA35 18(1)(C) 31/03/06 Raola House Version 5.1 Page 25 assessment is carried out for the staff team as a whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. 18 YA36 18(2) The registered manager is required to ensure that care staff receive at least six supervisions a year covering good care practices and career development. The registered manager must ensure that doors are not wedged open unless held open by a magnetic door holder that responds to the fire warning system. The registered manager is required to ensure that all emergency fire exit doors are openable without the use of a key whenever the premises are occupied. The registered manager is required to ensure that all fire exits are kept clear at all times to ensure service users, visitors and staff safety. 31/03/06 19 YA42 13(4) 14/02/06 20 YA42 13(4) 14/02/06 21 YA42 13(4) 14/02/06 22 YA42 13(4) The registered manager must 14/02/06 ensure that all cleaning materials and chemicals are kept locked in accordance to Control of Substances Hazardous to Health Regulations (COSHH) 1999. The registered provider must ensure that the locks on the service users’ bedroom doors are replaced by one that can be open from outside so staff can DS0000065735.V282652.R01.S.doc 23 YA42 13(4) 15/03/06 Raola House Version 5.1 Page 26 gain access in an emergency. 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 YA1 Good Practice Recommendations It is recommended that the service users’ guide be made available in formats suitable for the service users for whom the home is intended (e.g. appropriate languages, pictures, video, audio or explanation). It is recommended that the manager keep a yearly record of staff supervision signed by both the supervisor and supervisee for easy monitoring. 2. YA36 Raola House DS0000065735.V282652.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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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